Meaningful Use – RISC Management and Consulting

Challenges of Meaningful Use

Meaningful Use (MU) is the adoption of a certified Electronic Health Record (EHR) technology with a focus on improving quality, safety, efficiency, and reducing health disparities in the clinical/hospital setting. The idea is to increase patient engagement to improve care coordination while maintaining the privacy and security of the patient’s Protected Health Information (PHI).

According to Milan (July 27, 2015) “After a day spent hearing from health IT experts about information blocking practices, Republican Sen. Lamar Alexander, chair of the Senate Health, Education, Labor & Pensions Committee, said Thursday afternoon that he’s asked HHS to consider a delay of Stage 3 meaningful use”. The Department of Health and Human Services (HHS) is the U.S. government’s main agency for enhancing and protecting the health and well-being of all Americans.

Here are some quotes from Senator Lamar Alexander:

“Let’s not impose on physicians and hospitals a system that doesn’t work…”

“We want something physicians buy into, rather than something they dread…”

It is important to update and improve our current way of keeping health records as well as a more appropriate way to share health information with other providers. The quality of the EHR tool becomes the most desirable trait it seems. Remembering HIPAA where the importance of assessing all of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of all Protected Health Information (PHI) is required. However, each medical provider is unique in their operational environment with their own set of variables and must be factored in to the equation.

Another important piece of information according to McCarthy (July 22, 2015):

“Stage 3 of meaningful use for EHR implementation requires providers to send electronic summaries for 50 percent of patients they refer to others, receive summaries for 40 percent of patients that are referred to them and reconcile past patient data with current reports for 80 percent of such patients. If other providers do not send electronic summaries, however, the provider who was supposed to receive them will fail to meet the second and third requirements.”

Probst (2014) mentioned from an interview that Intermountain Healthcare is Stage 2 Certified in 2014 but will not be attesting at this time.

The Agency for Healthcare Research and Quality (AHRQ, March 26, 2015) provided some research data on barriers to meeting the stage 3 criteria for Meaningful Use:

Lack of provider and practice staff time – 69%
Complexity of required workflow changes – 68%
Difficulty with electronic exchange of information – 65%
Direct Financial Costs – 54%
EHR design and functions do not easily support care coordination – 51%

Readiness to meet criteria results:

Only 11% of those who participated in the research are able to meet all of the criteria

AHRQ’s mission is to “bring about evidence to improve health care quality and safety, increase accessibility, equitability and affordability within the HHS and other partners. Their objective is to ensure that the evidence is understood and employed.

For more information on Stages of Meaningful Use Click the link above

These are only some views on the subject of Meaningful Use, but there are many standards, policies, ideas that are available from other organizations that might be helpful.

Our work here at RISC Management has enabled us to view firsthand the privacy and security challenges of Meaningful Use, and of course HIPAA and HITECH. These are significant challenges that the Providers must meet, but they are reasonable and attainable.

For more information on Risk Analysis Click the link above

References

Agency for Healthcare Research and Quality. (March 26, 2015). Informing stage 3 meaningful use requirements through evidence: Webinar. Retrieved from https://www.youtube.com/watch?v=nQrMKcq0VAM

McCarthy, Jack. (July 22, 2015). Stage 3 meaningful use ignores market realities. Retrieved from http://www.healthcareitnews.com/news/brookings-meaningful-use-stage-3-ignores-market-realities

Meaningful Use. (2015) Definition. Retrieved from http://www.healthit.gov/providers-professionals/meaningful-use-definition-objectives

Miliard, Mike. (July 23, 2015). Senate suggests stage 3 MU delay. Retrieved from http://www.healthcareitnews.com/news/senate-call-stage-3-mu-delay?mkt_tok=3RkMMJWWfF9wsRohuKTPZKXonjHpfsX57e8uUKOylMI%2F0ER3fOvrPUfGjI4GRMVkI%2BSLDwEYGJlv6SgFQ7LHMbpszbgPUhM%3D

Probst (2014). CIO on MU stage 2: Certified but not attesting. Retrieved from http://bcove.me/kt82385m

New rules expected to arrive sometime this spring should reduce the 2015 Meaningful Use reporting period to just 90 days from the previously required full year. Many hospitals and health IT organizations were clamoring for a change to reduce the reporting burden for eligible providers and hospitals.

This change and the other proposals listed below will potentially help many providers who have already made steps towards implementing EHR systems but were not capable of reporting for the full year.

Realigning hospital reporting periods to the calendar year to allow eligible hospitals more time to incorporate 2014 Edition software into their workflows and to better align with other quality program.
Modifying other aspects of the programs to match long-term goals, reduce complexity and lessen providers’ reporting burden

The new rules are a welcome reaction to a letter written to CMS this past September co-signed by healthcare industry heavyweights CHIME, HIMSS, MGMA, AHA, and the AMA, urging the agency to address 2015 reporting period requirements. While adoption of EHRs has risen steadily since the first year of the EHR Incentive Program, many providers are struggling to provide all the necessary information in the time frame required. The letter proposed that HHS should “provide for a shortened, 90-day EHR reporting period in 2015, which would give time for providers to continue their transition without having to drop out of the program.”

The new rule “would be intended to be responsive to provider concerns about software implementation, information exchange readiness, and other related concerns in 2015,” wrote Patrick Conway, MD, chief medical officer at CMS, in a Jan. 29 blog post announcing the agency’s decision. “It would also be intended to propose changes reflective of developments in the industry and progress toward program goals achieved since the program began in 2011.”

Source: http://blog.cms.gov/2015/01/29/cms-intends-to-modify-requirements-for-meaningful-use/