Behind the Digital Door

At the onset, the definition of “meaningful” mostly addresses electronic collection and reporting of patient data. Providers must comply with a list of 20 objectives, including the creation of electronic patient summaries and drug allergy lists. The objectives and measures increase in three stages and apply to the eligible provider’s entire patient population, not just Medicare or Medicaid recipients.

“Meaningful” Confusion

Exactly what qualifies as “meaningful use” hasn’t been easy to understand for rheumatologists and their administrative staff, who jokingly rename the term “meaningless.” Craig W. Carson, MD, an Oklahoma-based rheumatologist, says even though his practice is already a paperless operation, he hesitates to implement meaningful use until the kinks are worked out of the government program.

“I can tell you that despite being totally and 100% electronic for several years, we are not, according to government definitions, meaningful users, which is quite distressing,” says Dr. Carson. “The problem is our government thinks we need to record not just age and gender but we need to record preferred language, race, and ethnicity. So we’re not compliant.”

Carson’s office recently started collecting expanded patient demographic information for meaningful use. However, the three-physician practice may wait until 2012 to seek incentive payments in order to collect federal funds for e-prescribing in 2011, since both are not allowed in the same year, says Karen Hansen, Dr. Carson’s practice manager.

The complexity for interpreting and implementing the rules goes hand in hand with adapting the best computer system to do the heavy lifting of data collection and measurements. Both are key building blocks to success. Some rheumatologists have just begun their search for a suitable records system while others already have EHR systems and are researching upgrades or added services that will be needed to qualify for incentives.

It is essential to verify that not only the system but also the particular software version is certified, says Itara Barnes, Senior Specialist of Registries and Healthcare Informatics at the ACR. The Office of the National Coordinator for Health Information Technology (ONC) provides a listed of certified EHR vendors on its website http://onc-chpl.force.com/ehrcert.