By Paul Babiarz
In 2009, Congress passed the American Recovery and Reinvestment Act which includes incentives for healthcare providers and hospitals to implement and embrace Electronic Health Record (EHR) technology and become “meaningful users” of certified EHR technology. The Center for Medicare & Medicaid (CMS) is encouraging efforts to adopt, implement, and/or upgrade EHR technology and reward participation in the program by those who demonstrate meaningful use over the next five years. In doing so, the government hopes to move towards greater EHR acceptance nationwide, as one of its strategies to reform health care in the United States.
Health care reform encompasses not only health care coverage, but also addresses the way health care services are provided in this country. As far back as 1999, the call to improve health care delivery quality through information technology and health care exchanges was envisioned by industry leaders. Since then however, widespread adoption and usage of EHR technology has been slow to come about. Reasons include expense, lack of standards, resistance to change by providers and poor understanding by EHR consumers of the business and clinical processes affecting selection of the appropriate product.
Thus, Meaningful Use (MU) was born. MU’s intent is to create national goals for health care and measures for goal achievement. There are at least 23 different criteria defining whether an EHR system meets the guidelines ranging from computerize physician order entry (CPOE), to real time drug to drug interaction checks, to reporting quality measures, to clinical decision support.
By 2015, CMS hopes to have realized:
• Improved overall health care quality, safety and efficiency
• Reduced health disparities
• Increased access by patients to their own health care information
• Improved coordination of patient care
• Increased number of evidence based best practices
• Improved overall national health for the population
• Adequate assurance of privacy and security for personal health information
Having a patient’s health information centralized will make it accessible to all health care providers involved in that patient’s care and the patient themselves. Insurance and demographic information will be stored and updated in one place. Storing this data digitally will create an enormous data repository to help identify trends, assess efficacy of treatment regimens, improve clinical decision making and help determine best practices in medical care.
Part of the problem however, is that most EHR vendors fall short in meeting all the guidelines set forth by CMS. To be considered a certified EHR vendor by CMS, you must meet the criteria set by the Certification Commission for Health Information Technology (CCHIT). The CCHIT was awarded a contract by the US Department of Health and Human Services (HHS) to develop the criteria and inspection process for EHR's and the platforms through which they operate.
Meaningful Use will compel providers to become more tech savvy not only with documenting patient care, but also extracting information from the system in which it was placed. Here is an opportunity for growth. Areas of particular interest for Precision.BI to help meet provider and software vender needs in dealing with MU requirements might include:
• Developing standard models to determine patient payer mix
• Protection of electronic health information
• Providing “syndromic surveillance” data to various public health agencies (influenza outbreaks)
• Electronic submission of lab results and immunization records to public health agencies
• Provide summary care record for each transition of care and referral
• Claims submission to public and private payers
• Reporting quality measures to CMS, HHS, CDC and WHO
• Creation of patient lists by specific condition for use in quality improvement initiatives
• Creation of patient care related task lists
• Indicators for specifying that health conditions were identified in patients i.e. smoking history
• Reporting physiologic variables such as vital signs or weight
We are on the brink of radically changing the way the business side of health care is done. We are now entering into a period where clinical information is co-mingled with financial information. In order to compete, we must develop strategies to cope with the changes that will occur in health care.
