The HITECH Act of the American Recovery and Reinvestment Act of 2009, signed by President Obama on February 17, 2009, provides an electronic health record (EHR) adoption incentive program for healthcare providers who adopt certified electronic health records and use them in a meaningful way to improve patient care. The incentive program begins in January 2011 and terminates at the end of 2014 for new adopters of certified electronic health record technology.
HHS’ Health Information Technology (IT) Policy Committee released on June 16, 2009, two documents pertaining to the definition of “meaningful use” for public comment by 5 PM ET, Friday, June 26, 2009. These documents are the Meaningful Use Preamble and Meaningful Use Matrix. Information on providing public comment is available online at the HHS website, along with other information on the HIT Policy Committee and its activities.
HIPAA.com outlines the draft recommendation on meaningful use in two postings, and recommends that its site visitors read the 3-page Meaningful Use Preamble: Meaningful Use: A Definition-Recommendations from the Meaningful Use Workgroup to the Health IT Policy Committee, June 16, 2009, prior to examining the Meaningful Use Matrix.
In this posting, we take a high level view of the content of the matrix, reproducing Health Outcomes Policy Priorities, embedded Care Goals, and summary Objectives for each of the years 2011, 2013, and 2015, and Measures for tracking objective performance in each of those years. In the next posting, HIPAA.com reproduces Objectives and Measures for 2011, the first year for which healthcare providers will be eligible for incentives under Medicare.
Meaningful Use Matrix
The meaningful use matrix outlines in Column 1 of eight columns five Health Outcomes Policy Priorities (P), and for each priority, in Column 2, Care Goals (G):
(P) Improve quality, safety, efficiency, and reduce health disparities
» (G) Provide access to comprehensive patient health data for patient’s health care team
» (G) Use evidence-based order sets and CPOE [computerized physician order entering] » (G) Apply clinical decision support at the point of care
» (G) Generate lists of patients who need care and use them to reach out to patients (e.g., reminders, care instructions, etc.)
» (G) Report to patient registries for quality improvement, public reporting, etc.
(P) Engage patients and families
» (G) Provide patients and families with access to data, knowledge, and tools to make informed decisions and to manage their health
(P) Improve care coordination
» (G) Exchange meaningful clinical information among professional health care team
(P) Improve population and public health
» (G) Communicate with public health agencies
(P) Ensure adequate privacy and security protections for personal health information
» (G) Ensure privacy and security protections for confidential information through operating policies, procedures, and technologies and compliance with applicable law
» (G) Provide transparency of data sharing to patient.
For each set of priorities and embedded goals, there are three combinations of objectives and measures for three years:
» 2011: To electronically capture in coded format and to report health information and to use that information to track key clinical conditions
» 2013: To guide and support care processes and care coordination
» 2015: To achieve and improve performance and support care processes and on key health system outcomes.
The Meaningful Use Preamble from the Health IT Policy Committee recognizes that meaningful use will evolve over time as “considerable gaps in EHR-generated measures available to monitor key desired policy outcomes (e.g., efficiency, patient safety, care coordination)” are closed. Hence, the objectives and measures for 2013 build on those of 2011, and those of 2015 build on those of the preceding years.
The Centers for Medicare & Medicaid (CMS) expects to issue a notice of proposed rulemaking (NPRM) relating to the EHR adoption incentive program and definition of meaningful use late in 2009.