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ARRA authorizes CMS to provide a reimbursement incentive for physician and hospital providers who showcase “meaningful use” of an electronic health record. The incentives begin in 2011. Medicare will begin financial penalties for those who have not achieved meaningful use in 2015.
"Meaningful use" as required by the legislation is currently being defined by the U.S. Department of Health and Human Services (HHS). What we currently know is that the definition will include requirements for:
- personal health records
- health information exchange
- clinical decision support
- outcomes reporting
CMS is working with ONC and other parts of HHS to develop the meaningful use rules.
Key dates:
The recommendations begin with the capturing and sharing of data in 2011. The objectives and measurements get increasingly comprehensive by 2013 and 2015, creating ambitious goals compared to speed with which the industry currently moves.
- The proposed goals for 2011 are to electronically capture and share codified health data, potentially requiring:
- Use of computerized physician order entry, with 10 percent of all orders directly entered by authorizing provider
- Implement one clinical decision rule relevant to high clinical priority
- Incorporation of laboratory tests into EHRs and results shared electronically with public health agencies
- Generation of patient lists by specific conditions to use for quality improvement and outreach
- Provide patients and family with timely access to key clinical information
The proposed goals for 2013 are to guide and support care processes and coordination, potentially requiring:
- Generation and transmission of prescriptions electronically
- Management of chronic conditions using patient lists and decision support tools
- Bar coding for medication administration
- Access to all patients to a personal health record (PHR) populated in real-time with patient health data
The proposed goals for 2015 are to guide and support care processes and coordination, potentially requiring:
- Minimal levels of performance on quality, safety and efficiency measures
- Comprehensive patient data from all available sources.
- Automated real-time surveillance of occurrences such as adverse events, disease outbreaks and bio-terrorism
- Incorporation of clinical dashboards into the EHR
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