Looking for the Meaning of Meaningful Use

What is Meaningful Use?

Confused about the “meaningful use” component of the American Recovery and Reinvestment Act’s stimulus program? Well, no wonder. The definition is still in development, even though incentive payments are supposed to begin as early as October 2010 for hospitals. Payments to other “eligible professionals who are meaningful EHR users” are scheduled to begin in January, 2011.

To back it up a bit, for those who haven’t had time to scour the scads of government documents, in February of 2009, President Obama signed the American Recovery and Reinvestment Act of 2009, a measure to stimulate the economy.  Part of the stimulus package was incentives for providers (eligible hospitals, critical access hospitals or eligible professionals) who demonstrate meaningful use of certified electronic health record (EHR) technology. Payments range from $44,000 to $64,000 per physician, and up to $11 million per hospital.

The problem is, there’s no consensus on the term “meaningful use.” In December of 2009, The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), each issued a set of regulations on implementation of the Recovery Act, including a definition of meaningful use. The proposed CMS definition states that a hospital or provider will be considered to be a “meaningful EHR user” if they meet the following three requirements:

(1) “Demonstrates use of certified EHR technology in a meaningful manner;
(2) demonstrates to the satisfaction of the Secretary that certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of  health care such as promoting care  coordination, in accordance with all laws and standards applicable to the exchange of information; and
(3) using its certified EHR technology, submits to the Secretary, in a form and manner specified by the Secretary, information on clinical quality measures and other  measures specified by the Secretary.”

Well, that certainly clears things up.

Both the CMS and ONC regulations were opened up to a 60-day comment period that concluded on March 15, 2010. Committees and specialty associations submitted hundreds of comments, which are now under review. A final rule is supposed to be announced “in 2010.”

This leaves providers who haven’t yet purchased and EHR system in something of a quandary, as the provider, rather than the certified vendor, is responsible for ensuring that his or her system demonstrates meaningful use.

Read the CMS proposed rule and the ONC interim final rule.