Reconciliation Of Meaningful Use

The long drawn battle over Health Care reform has concluded alongside a procedure that merged together the wants as well as needs of multiple legislative constituencies. Nobody got just what they started out with, but nosotros straightaway cause got a workable solution. Following the same reasoning, Meaningful Use could produce goodness from Reconciliation alongside Reality.

As diverse provider constituencies analyze the proposed tasks required from a Meaningful User, it appears that Meaningful Use (MU) equally defined past times CMS is rapidly becoming an insurmountable barrier to adoption of EHRs.  The HIT Policy Committee has calling for relaxation, it may live on a proficient fourth dimension to nous passionate calls equally the 1 made past times Dr. David Kibbe on THCB on behalf of the bulk of wellness attention professionals who do inwards modest underfunded settings.

Unlike the ONC IFR for EHR certification criteria which is straightaway final, the CMS MU proposal is only a proposal and, equally such, tin live on altered. Certifying EHR technologies based on the total 25 criteria, per the ONC IFR, is truly a proficient affair equally it ensures available technology equally HIT adoption, as well as meaningful utilization of it, progresses. However, unless nosotros convey on pace dorsum on MU, moving frontwards becomes a real uncertain proposition. We should also proceed inwards nous that the intelligence hither is express to MU Stage 1, which tin live on initiated past times physicians equally slowly equally Oct 1st 2011, as well as Stage 2 is slated to laid out fifteen brusque months thereafter. There may live on a demand for considering the full general fourth dimension lines at or then point.

An Honest Look at Meaningful Use Criteria

Out of 25 proposed criteria, ix are either uncomplicated or a prerequisite to the occupation organisation of medicine as well as at that spot is no enquiry that these should live on required. One would live on hard pressed to abide by a provider disputing the necessity of whatever 1 item below, except mayhap #6 as well as the charting component subdivision of #5, which should live on express past times specialty. In reality, nigh providers already satisfy these requirements inwards electronic format.

Green Light List – All Clear!

1. Maintain an up-to-date occupation listing based on ICD-9-CM or SNOMED CT®
2. Maintain active medication list
3. Maintain active medication allergy list
4. Record demographics
5. Record as well as nautical chart changes inwards vital signs
6. Record smoking status for patients xiii years as well as older
7. Generate lists of patients past times specific weather to utilization for outreach
8. Submit claims electronically to populace as well as someone payers
9. Provide clinical summaries for patients for each operate visit

The minute chunk of vii MU criteria is a fleck to a greater extent than complex as well as volition probable require adjustments to electrical current piece of work flows. However, nigh tin live on achieved alongside uncomplicated way as well as all brand perfect feel from an immediate patient attention perspective. For example, the in conclusion iii could live on achieved only past times adding a Patient Portal to an existing EHR, as well as the get-go 2 could live on satisfied past times incorporating 1 of the many standalone electronic prescribing modules available on the market.

Yellow Light List – Proceed alongside Caution.

10. Generate as well as transmit permissible prescriptions electronically
11. Implement drug-drug, drug-allergy, drug-formulary checks
12. Send reminders to patients per patient preference for preventive/follow-up care
13. Check insurance eligibility electronically from populace as well as someone payers
14. Provide patients alongside an electronic re-create of their wellness information upon request
15. Provide patients alongside electronic access to their wellness information inside 96 hours of availability
16. Provide summary attention tape for each transition of attention as well as referral

The in conclusion ix MU criteria are real hard to implement as well as alongside 1 exception, #25, at that spot is no immediate produce goodness to patient care, although CDS (#20), if done correctly, tin cause got immediate benefits for or then specialties. Interestingly, iii of these criteria are defined equally capabilities. Capabilities belong inwards the vendor Certification realm, non Meaningful Use. Medication reconciliation is utterly useless at this time. I cannot imagine whatever utilization illustration where 2 medication lists be inwards an EHR for a given patient, unless codified central of information betwixt providers is truly happening. Therefore, #21 should live on defined equally a capability as well as moved into the vendor certification area. The other major offender is #19 (quality measures), which especially for primary attention is bewilderingly complex as well as has no immediate outcome on patient care. CPOE as well as structured lab results should truly snuff it together to live on meaningful as well as at that spot are multiple objective hurdles to implementation. The in conclusion item on the list, Privacy & Security, although presenting a huge burden, must live on component subdivision of whatever EHR system.

Red Light List – Stop!

17. Use CPOE
18. Incorporate clinical lab-test results into EHR equally structured data
19. Report ambulatory character measures to CMS or the States
20. Implement five clinical determination back upward rules relevant to specialty  as well as rail compliance
21. Perform medication reconciliation at relevant encounters as well as each transition of care
22. Capability to electronically central cardinal clinical information amidst providers of attention as well as patient-authorized entities
23. Capability to submit electronic information to immunization registries as well as actual submission where required as well as accepted
24. Capability to supply electronic syndromic surveillance information to populace wellness agencies as well as actual transmission according to applicable police push clit as well as practice
25. Protect electronic wellness information created or maintained past times the certified EHR technology through the implementation of appropriate technical capabilities

Reconciliation Proposal

A Meaningful User, must attest adherence to all ix Green Light criteria, at to the lowest degree 3 Yellow Light criteria of their selection as well as at to the lowest degree 1 Red Light touchstone non to exclude item # 25 - Privacy & Security.

This is slightly over 50% of the master copy MU criteria as well as it may real good live on the optimal house to start, optimal inwards the feel of encouraging computerization of medical records.