January kicked off a new era for health information technology (HIT). A new year brings new opportunities, with the Centers for Medicare and Medicaid Services (CMS) electronic health record (EHR) incentive program topping the list. But what is meaningful EHR use, and what does it mean for you? What are the steps to get started?
1) Review the ACR resources available.
If you want to take advantage of meaningful use incentives and avoid the 2015 penalties, the ACR has developing the following resources for you:
- Meaningful Use Guide for Rheumatologists: Download this point-by-point guide on what meaningful use regulation means for rheumatology practices at www.rheumatology.org/HIT.
- Webinar series and open call: The ACR health informatics staff host a monthly webinar series addressing the nuts and bolts of the meaningful use program, which includes two open question-and-answer calls. These calls give you the opportunity to learn more about the CMS EHR incentive program and ask questions. Visit www.rheumatology.org/HIT for a calendar of calls and events.
- Meaningful Use Road Show: The ACR will be on the road, visiting state specialty societies to review the meaningful use program and answer your questions. If you would like to know what programs are available in your area, or to have an ACR health informatics staff member speak to your state society, please contact Itara Barnes at [email protected].
- AmericanEHR Partners: ACR members and their practice teams have complimentary access to AmericanEHR Partners, a Web-based resource for EHR system selection and implementation developed by the ACR, other partnering medical associations, and Cientis Technologies. AmericanEHR Partners allows you to compare certified EHR systems to find the system that best suits your needs. The ACR is currently working with AmericanEHR Partners to add rheumatology-specific assessment to the EHR vendor survey.
What is Meaningful Use?
The American Recovery and Reinvestment Act of 2009 specifies three main components of Meaningful Use:
- The use of a certified EHR in a meaningful manner, such as e-prescribing.
- The use of certified EHR technology for electronic exchange of health information to improve quality of health care.
- The use of certified EHR technology to submit clinical quality and other measures.
Simply put, “meaningful use” means providers need to show they’re using certified EHR technology in ways that can be measured significantly in quality and in quantity.
2) Review requirements, measures, and timelines.
- Are you eligible for the incentive program?
- Where do you stand with regards to current technology and EHR utilization?
- How might the meaningful use requirements impact your workflow?
- Are you ready to pursue meaningful use incentives?
- How does EHR meaningful use fit into the long-term HIT goals for your practice? Meaningful use will be achieved most successfully if coordinated with your broader HIT plan, supporting the clinical, administrative, and business functions of your practice.
3) Identify your current readiness state.
Do you already have an EHR system? If your answer is yes, start a conversation with your vendor regarding their plans for meaningful use by asking the following questions:
- Does your vendor plan to pursue Office of the National Coordinator–Authorized Testing and Certification Body (ONC-ATCB) certification for meaningful use? If not, will you be able to upgrade your software, or will you have to adopt and implement a new EHR system? The system does not have to be certified as of January 1, 2011, but it does need to be certified by the end of the 90-day period you are using to attest to your EHR meaningful use in Year 1.
- How does your EHR system compare to meaningful use requirements? Keep in mind that systems will obtain certification based on their ability to support all of the meaningful use objectives, which might mean that you will need to upgrade your system or add additional modules, such as a patient portal.
- What do system upgrades or additional modules needed for meaningful use mean for your vendor contracting and business agreements? Many vendors offer discounts, guarantees, and delayed payment based on the incentive timeline. What is your vendor offering?
If your answer is no, begin the EHR selection and implementation process. Work with your vendor(s) to ensure that all systems are installed and customized for your practice and that all interfaces are working.
Remember that the incentive program begins in 2011, but you have until October of 2012 to begin reporting to receive the full incentive amount.
4) Get your team on board and develop a plan.
Meet with your clinical and administrative team to assess and identify internal barriers to EHR utilization and meaningful use. Review your practice’s workflow and utilization of the EHR system. Is everyone consistently and fully using the EHR system? What data is collected and where? Develop an approach and prioritized roadmap, along with estimated costs, to achieve the meaningful use requirements.
Read the ACR’s Meaningful Use Guide for Rheumatologists at www.rheumatology.org/HIT for information on developing a plan.
5) Use meaningfully.
Begin to utilize the EHR, tracking all meaningful use objectives. Your practice team is your greatest asset in successfully meeting the meaningful use criteria and metrics; ongoing attention to their role in the EHR utilization and the meaningful use program is worthwhile. Coordinate check-ins and regular assessments as well as development and training when necessary, and maintain a high level of continuity throughout the practice.
Quality Measures White Paper
Defining quality of care in rheumatology: The American College of Rheumatology white paper on quality measurement, published in Arthritis Care & Rheumatism (2011;63:2-9), synthesizes the information most relevant to the ACR membership regarding quality measurement and provides a consensus-based set of criteria for the review of quality measures submitted to the ACR for approval. The criteria guide measure developers and discourage adoption of subpar measures.
For more information about the White Paper and the ACR’s quality measurement initiatives, visit www.rheumatology.org/practice.
6) Register, report, and improve.
Register for the incentive program at www.cms.gov/EHRIncentivePrograms. Keep in mind that the five-year payment timeframe begins as soon as you register for the Medicare program, so wait until you are ready to report and submit attestation for meaningful use before registering.
Make sure you meet all the EHR meaningful use objectives applicable to your practice, and, for objectives with numerical thresholds, that you are attaining the levels specified. If your EHR system is certified EHR technology, it should be capable of support all Stage 1 Meaningful Use Objectives. Monitor the CMS website on EHR Incentive Programs to determine the format of the attestation for 2011. Keep in mind that accuracy is paramount—attesting to EHR meaningful use is making a claim to a federal program.
7) Influence rulemaking and guidance.
As you implement meaningful use, keep the ACR posted. We want to hear about any issues that you have, as well as best practices that you can pass on to others. We will be tracking your experience and concerns and will use them as we work with the ONC and CMS on Stage 2 and 3 final rules and guidance.
For more information on the CMS EHR Incentive Program—Meaningful Use, visit www.rheumatology.org/HIT, or contact Itara Barnes at [email protected].