Health IT policy committee presents framework for defining 'meaningful use'

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Health IT policy committee presents framework for defining 'meaningful use'

By Eva Marie Stahl Jun 23 2009, 06:20 AM

Cheered on by Health IT Czar David Blumenthal, the Health IT policy committee met last Tuesday to begin discussing how to define "meaningful use." These are the magic words that the medical community is striving to achieve with electronic health records in order to qualify for federal cash. Potentially lots of it.

Blumenthal told the committee, “We rarely stop to look at what we could achieve. It requires us to look into the unknown.” Well, yes, the EHR movement appears to be a venture into the unknown—yet it's eerily reminiscent of many large scale IT projects that linger…and linger…. and linger. Am I thinking of the DoD/VA EHR convergence? Yeah, not that easy.

The committee presented a three-tiered framework that set benchmarks for meaningful use. This is a monumental discussion, as providers and software vendors watch in anticipation of whether or not their products will qualify for federal reimbursement up to $44,000 per physician, according to the stimulus bill.

As part of the phased approach, physicians must demonstrate an ability to electronically prescribe drugs, track patient allergies, monitor vital signs and review lab results by 2011; this is the data capturing phase. By 2013, providers must engage in more sophisticated protocols that include the use of clinical decision support tools, demonstrate better management of chronic illness and an increase use of mobile devices to care for and communicate with patients; this is the establishment of patient care processes phase.

The really cool stuff, of course, comes last (2015) such as utilizing the latest and greatest technologies in imaging and sharing of these images through mobile devices and advanced multimedia systems; this is the measurement of outcomes phase. (These phases are neatly laid out by Federal Computer Week.)

While the generalist framework and incremental approach appear reasonable, the complexity has yet to completely surface. The underlying details will be difficult to regulate and mandate. These issues include patient privacy and security and data sharing through software interoperability. These two thorns in the side of the EHR darling are real risks that give patients pause in their support of the big government EHR investment.

The 20-member panel’s report is open to public comment through June 26. The Department of Health and Human Services will develop and publish rules regarding meaningful use based on the supplied policy framework by the end of 2009. In sum, the recommendations transition physicians slowly into EHR use (as individual users) to a more systemic reliance on and interoperable use of EHRs (as group users). We all hope, despite the mocking of the EHR as the end-all health care conundrum solution, that EHR adoption will translate into increased efficiency and reduced duplicative care and medical errors. This incremental approach to capture data, improve patient care processes, and finally, share data and measure outcomes looks really pretty on paper. So enjoy it now because it will most likely be like all other IT projects: rocky and over-budget.