Intechno China understands Meaningful use and the objectives set out by the US Government in relation to how they should be applied to Healthcare Software.

When developing a healthcare software system our development team knows that an important function is to ensure the system includes the objectives and is able to be certified.

In addition we can help with certification of a system, we know that this can be sometimes tedious and time consuming, as we are experienced and cost-effective we can help with the certification process saving time and money for healthcare software providers.

Meaningful Use: Overview

Congress and the Obama administration provided the health care community with a transformational opportunity to break through the barriers to progress. The Health Information Technology for Economic and Clinical Health Act (HITECH) authorized incentive payments through Medicare and Medicaid to clinicians and hospitals when they use EHRs privately and securely to achieve specified improvements in care delivery.

Through HITECH, the federal government will commit unprecedented resources to supporting the adoption and use of EHRs. It will make available incentive payments totaling up to $27 billion over 10 years, or as much as $44,000 (through Medicare) and $63,750 (through Medicaid) per clinician. This funding will provide important support to achieve liftoff for the creation of a nationwide system of EHRs.
Equally important, HITECH’s goal is not adoption alone but “meaningful use” of EHRs — that is, their use by providers to achieve significant improvements in care. The legislation ties payments specifically to the achievement of advances in health care processes and outcomes.

HITECH calls on the secretary of health and human services to develop specific “meaningful use” objectives. With the Centers for Medicare and Medicaid Services (CMS) in the lead, the Department of Health and Human Services (DHHS) has used an inclusive and open process to develop these criteria, providing an extensive opportunity for public and professional input. The department published proposed meaningful use requirements on January 16, 2010. The proposal prompted some 2000 comments. This week, the DHHS is releasing a final regulation for the first 2 years (2011 and 2012) of this multiyear incentive program. Subsequent rules will govern later phases.

The most important part of this regulation is what it says hospitals and clinicians must do with EHRs to be considered meaningful users in 2011 and 2012. In the original proposal, we identified a broad set of objectives, all of which would need to be met. This included 23 objectives for hospitals and 25 for clinicians. The DHHS received many comments that this approach was too demanding and inflexible, an all-or-nothing test that too few providers would be likely to pass.

In the final regulation, we have divided these elements into two groups: a set of core objectives that constitute an essential starting point for meaningful use of EHRs and a separate menu of additional important activities from which providers will choose several to implement in the first 2 years

Meaningful Use: Objectives

Core objectives comprise basic functions that enable EHRs to support improved health care. As a start, these include the tasks essential to creating any medical record, including the entry of basic data: patients’ vital signs and demographics, active medications and allergies, up-to-date problem lists of current and active diagnoses, and smoking status.

Objective 1: Record patient demographics (sex, race, ethnicity, date of birth, preferred language, and in the case of hospitals, date and preliminary cause of death in the the event of mortality)

Measure 1: More than 50 percent of patients' demographic data recorded as structured data.

Objective 2: Record vital signs and chart changes (height, weight, blood pressure, body mass index, growth charts for children)

Measure 2: More than 50 percent of patients two years of age or older have height, weight and blood pressure recorded as structured data

Objective 3: Maintain up-to-date problem list of current and active diagnoses

Measure 3: More than 80 percent of patients have at least one entry as structured data

Objective 4: Maintain active medication allergy list

Measure 4: More than 80 percent of patients have at least one entry recorded as structured data.

Objective 5: Record smoking status for patients 13 years of age of older

Measure 5: More than 50 percent of patients 13 years if age of older have smoking status recorded as structured data

Objective 6: For individual professionals, provide patients with clinical summaries for each office visit; for hospitals, provide an electronic copy of hospital discharge instructions on request

Measure 6: Clinical summaries provided to patients for more than 50 percent of all office vsits within three business days; more than 50 percent of all patients who are discharged from the inpatient department or emergency department of an eligible hospital or critical access hospital and who request an electronic copy of their discharge instructions are provided with it

Objective 7: On request, provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication list, medication allergies, and for hospitals, discharge summary and procedures

Measure 7: More than 50 percent of requesting patients receive electronic copy within three business days

Objective 8: Generate and transmit permissible prescriptions electronically (does not apply to hospitals)

Measure 8: More than 40 percent are transmitted electronically using certified EHR technology

Objective 9: Computer provider order entry (CPOE) for medication orders

Measure 9: More than 30 percent of patients with at least one medication in their medication ordered through CPOE

Objective 10: Implement drug-drug and drug-allergy interaction checks

Measure 10: Functionality is enable for these checks for the entire reporting period

Objective 11: Implement capability to electronically exchange key clinical information among providers and patient-authorized entitities

Measure 11: Perform at least one test of EHR's capacity  to electronically exchange information

Objective 12: Implement one clinical decision support rule and ability to track compliance with the rule

Measure 12: One clinical decision support rule implemented

Objective 13: Implement systems to protect privacy and security of patient data in the EHR

Measure 13: Conduct or review a security risk analysis, implement security updates as necessary and correct identified security deficiencies.

Objective 14: Report clinical quality measure to CMS or states

Measure 14: For 2011, provide aggregate numerator and denominator throught attestation; for 2012, electronically submit measures

In addition to the core elements, the rule creates a second group: a menu of 10 additional tasks, from which providers can choose any five to implement in 2011–2012. This gives providers latitude to pick their own path toward full EHR implementation and meaningful use.

Objective 15: Implement drug formulary checks

Measure 15: Drug formulary check system is implemented and has access to at least one internal or external drug formulary for the entire reporting period

Objective 16: Incorporate clinical laboratory test results into EHRs as structured data

Measure 16: More than 40 percent of clinical laboratory test results whose results are in positive/negative or numerical format are incorporated into EHRs as structured data

Objective 17: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach

Measure 17: Generate at least one listing of patients with specific condition

Objective 18: Use EHR technology to identify patient-specific education resources and provide to the patient as appropriate

Measure 18: More than 10 percent of patients are provided patient-specific education resources

Objective 19: Perform medical reconciliation between care settings

Measure 19: Medication reconciliation is performed for more than 50 percent of transitions of care

Objective 20: Provide summary of care record for patients referred or transitioned to another provider or setting

Measure 20: Summary of care record is provided for more than 50 percent of patient transitions or referrals

Objective 21: Submit electronic immunization data to immunization registries or immunization information systems

Measure 21: Perform at least one test of data submission and follow-up submission (where registries can accept electronic submission)

Objective 22: Submit electronic syndromic surveillance data to public health agencies

Measure 22: Perform at least one test of data submission and follow-up submission (where public health agencies can accept electronic submission)

Additional choices for hospitals and critical access hospitals

Objective 1: Record advance directives for patients 65 years of age or older

Measure 1: More than 50 percent of patients 65 years of age or older gave an indication of an advance directive status recorded

Objective 2: Submit of electronic data on reportable laboratory results to public health agencies

Measure 2: Perform at least one test of data submission and follow-up submission (where public health agencies can accept electronic data)

Additional choices for eligible professionals

Objective 1: Send reminders to patients (per patient preference) for preventative and follow-up care.

Measure 1: More than 20 percent of patients 65 years of age or older or five years if age or younger are sent appropriate reminders

Objective 2: Provide patients with timely electronic access to their health information (including laboratory results, problem list, medication lists, medication allergies)

Measure 2: More than 10 percent of patients are provided electronic access to information within four days of it being updated in the EHR.