Healthcare providers are antsy to start working toward becoming "meaningful users" of electronic health record technology so that they can claim some of the American Recovery and Reinvestment Act's financial incentives when they become available in fiscal year 2011 and 2012. While providers wait for the government's definition of "meaningful use" of EHR technology, which ultimately is the only definition that matters, they did receive some guidance this past week as just about every association and industry group released their own definition of what meaningful use should include. Here's a breakdown of those recommendations.
CHIME: The College of Healthcare Information Management Executives says that meaningful use should focus on the use of quality metrics and outcomes regardless of the technology in place, a phased approach should be used to encourage adoption, the industry should explore alternative ways to connectivity in the short term that can lead to participation in a health information exchange, and the industry should consider alternative ways to exchange health data other than the continuity of care document—at least initially—because some organizations may not have the capability to immediately deploy the CCD.
AHIMA: The American Health Information Management Association says the most crucial element of meaningful use is the widespread adoption of certified EHRs and that the expectations are applied uniformly across all industry segments and not vary by payer, patient, or provider. AHIMA recommends the focus should be on the end goals to improve quality, cost and health system performance not the technology itself; the initial criteria should be based on what is achievable with the current technology with the measures becoming more strict in the next several years; the certifying body should be the Certification Commission for Healthcare Information Technology; it should be measured and reported in a way that minimizes manipulation; and it should be relevant to consumers.
AMIA: The American Medical Informatics Association recommends that meaningful use should focus on process and care improvements over time, include EHR functionality and capability, and establish approaches to measure meaningful use. The AMIA notes that EHRs have the potential to support and enhance clinical care and decision-making, but simply implementing an EHR does not mean that the organization will effectively use the system or achieve the desirable patient outcomes and changes to clinical processes.
ANI: The Alliance for Nursing Informatics says meaningful use should include patient-centered documentation—initially focusing on patient summary data—that can enhance cross continuum communication and improve safety, quality, and processes of care delivery; collect standardized clinical performance measures as a byproduct of care delivery and clinician documentation; use processes and infrastructure defined by HITSP—initially focusing on a subset of existing NQF-endorsed measures—to submit quality measures; use existing initiatives such as HITSP and IHE to guide standards use within all systems that record, transmit, collect, and share information for care delivery; and expand the definition of "meaningful user" to include registered nurses and advanced practice registered nurses.
HIMSS: The Health Information Management Systems Society recommends that CCHIT be the certifying body of EHRs; using an incremental approach to adopt metrics that can be reasonably captured and reported beginning in fiscal years 2011 and 2012, and then made increasingly stringent using intervals of not less than two years; bridging the existing gaps in interoperability of health information by creating new standards and implementation guides in coordination with HITSP and IHE; and reconciling the gap between "certified EHR technologies," "best of breed," and "open source" technologies.