Summary
Not since the definition of a DRG (diagnosis related group) has another term been so important to articulate in a certain way to those in the healthcare industry than that of what it means to "meaningfully use" a certified electronic medical record. According to the American Recovery and Reinvestment Act of 2009 (otherwise known as ARRA or the Economic Stimulus Law) in order for hospitals and physicians to tap into the total of $34 billion in government incentive payments for adopting electronic records between 2011 and 2015, they must be able to show federal officials that they are "meaningfully using" them. The race is on among health IT vendors to ensure that their customers will be able to clear this threshold of "meaningful use", lest they could well see their fortunes dwindle dramatically after next year.
Analysis
On June 16, the Health IT Policy Committee of the Department of Health and Human Services (HHS) issued its initial recommendations for a definition of "meaningful use" of electronic health records. Although not constituting a formal definition, the Committee did issue its recommenation of the functionalities that will be required by 2011 when the $34 billion in federal incentives start to flow to hospitals. Just some of the most important of these 22 required functionalities include:
--Computerized physician order entry (CPOE) for all order types including medications;
--Drug-drug, drug-allergy and drug formulary checks;
--Electronic Prescribing;
--Exchanging of key clinical information among providers;
--Perform medication reconciliation at relevant encounters; and
--Collecting and reporting quality-related information on a wide variety of measures (e.g. CMS "Core Measures, Physician Quality Reporting Initiative or PQRI indicators, etc.), otherwise known as "electronic quality monitoring".
For hospitals and physicians not qualifying for meaningful use under the 2011 definition, the requirements will be ramped up in 2013, most notably to require the "meaningful use" of clinical decision support capabilities at the point of care by then. If not qualifying for federal incentive payments until the final year of them in 2015, then, in addition to having these functionalities, plus clinical decision support at the point of care, hospitals and physicians will need to demonstrate that their "meaningful use" of these has actually improved patient outcomes.
This stairstep series of ramped up "meaningful use" requirements is consistent with the overall goal of the Health IT section of ARRA, viz. to use electronic medical records to improve the quality, safety and efficiency of healthcare.
Companies best poised to benefit by these evolving definitions of "meaningful use" of their products include:
1. General Electric;
2. Siemens;
3. McKesson;
4. Cerner;
5. Eclipsys;
6. Allscripts;
7. eClinical Works;
8. Epic Healthcare;
9. Quality Systems, Inc.; and
10. IBM.
