First Steps to Reach Meaningful Use, by Roswell Goris

Meaningful Use until 2011 will be based on an honor system from both Medicaid and Medicare. The system will be regulated through federal audits set to randomly select practices to verify if they are meeting their Meaningful Use claims.

At the beginning, attestation or an honor system will automate electronic data collection to report and show if Meaningful Use is being met. But practices will need to collect plenty of documentation to be able to show Meaningful Use if audited. Practices are allowed at first to use paper to report their EMR implementation.

Only when the actual reporting of digital data for quality assurance begins, will practices have to initiate collection and mining the data to report Meaningful Use.  Practices will need to have Structure Data,  available. This is data that consist of characters, numbers, words which can be searched as oppose to scanned images.  A few samples in the proposed rules are listed below:

• Lab Results that are entered as Structure Data. For example, a Comp Panel Lab where you find glucose, sodium, choloride, carbon dioxide, urea nitrogen, creatine, the results will need to be entered manually into the EMR if it's not electronically interfaced with the laboratories to meet the Structure Data requirement. The good news is that laboratories have already developed interfaces.

• Clinical Summaries of patients' histories can be accomplished using flow charts. Flow Charts can allow practices to create a chronological history of the patient based on patient medical conditions, once the Structure Data becomes available. Patients' Clinical summaries can be setup mapping the patients' Structure Data to a particular condition, for example Diabetes, fresh updated charts will becomes available in real time as the data comes in to the health care providers.

• Eligibility should be checked using the EMR.

• Establishing work flows to track who is requesting health records information on a patient. One possible solution is creating a data entry for each phone call at time of the request.

• ePrescribing, Health care providers will also need to order medications and to do consultations using electronic medical records.

These are a few criteria and the logistics to obtaining Meaningful Use can be daunting. The practices will need to develop effective work flows during the practice's daily operation that are efficient and cover key points listed in the Meaningful Use rule .

Roswell Goris Notes on Meaningful Use Incentive Payments

Under the American Recovery and Reinvestment Act for Medicare and Medicaid, a new rule was proposed at the end of 2009. The rule is called Meaningful Use. Medicare and Medicaid incentive payments will be offered under this rule physicians who are implementing an electronic medical record that is used to meet the requirements defined in this rule.

To reach the Meaningful Use criteria is beginning to look difficult if not impossible for practices that do not have the human resources or the IT expertise to ensure the electronic medical records are utilized according to the guidelines.

Roswell Goris says that practices, that want to apply for the incentive payments which can be substantial, will probably need to hire an external consulting firm to help them meet the criteria.

Many Medical Practices have purchased the necessary equipment and installed competent electronic medical records, but lack the IT expertise and support to use system to meet rules expectations as proposed. Using an electronic medical record does not automatically ensure qualification. Also the Meaningful Use proposed rule is not final. It's undergoing revisions. The Centers for Medicaid and Medicare, are still deciding on what has become a multimillion dollar question, what is Meaningful Use?

The idea is to improve the quality of patients' health through the continuum of care, more efficiency, coordination, fewer errors and in the future perhaps create a seamlessly electronic connection, where patients' medical records can be easily and securely shared with other health care providers with a click of a button.