“Meaningful Use” Recommendations from Selected Groups
Leading Associations Weigh in on Meaningful Use Requirements
Healthcare Information and Management Systems Society (HIMSS) recommends:
- To ensure continuity, recognize CCHIT as the certifying body of EHRs.
- To achieve incremental maturation of “meaningful use,” adopt metrics that can be reasonably captured and reported beginning in FY11/2011, and then made increasingly stringent using intervals of not less than two years. HIMSS’ definitions include specific metrics to enact, in phases, over a multi-year period.
- To bridge existing gaps in interoperability of health information, coordinate with HITSP and IHE to create new harmonized standards and implementation guides.
- Reconcile the gap between “certified EHR technologies,” “best of breed,” and “open source” technologies.
College of Healthcare Information Management Executives (CHIME) recommends:
- The use of quality metrics and outcomes regardless of technology in place
- A phased approach to encourage early adoption without raising the bar too high too early
- Exploring alternative means to connectivity in the short term and connection to an HIE over time
- Consideration of alternative means to use of CCD for exchange of health data
Alliance for Nursing Informatics (ANI) recommends:
- Include patient-centered documentation from all disciplines within the definition of “meaningful use”; initially focus on patient summary data at transitions of care;
- Collect standardized clinical performance measures as a byproduct of care delivery and clinician documentation
- Submit quality measures to the Department of HHS and other reporting entities, by using processes and infrastructure defined by HITSP; initially focus on a subset of existing NQF-endorsed measures, and include nursing sensitive measures
- Use existing initatives such as HITSP and IHE to guide standards use within all systems that record, transmit, collect and share information for care delivery
- Expand the definition of “meaningful user” to encompass support of all healthcare professionals, including RNs and APRNs.
American Medical Informatics Association (AMIA) recommends:
That while the volume of health data collected and stored in electronic health records (EHRs) will dramatically increase, EHRs have the potential both to support and enhance clinical care and decision-making and at the same time to foster public health activities such as surveillance, measurement of outcomes and performance, research, and public policy. However, AMIA noted that implementing an EHR does not necessarily equate with effectively using the systems’ available functions, nor does simple adoption necessarily achieve actual changes in either clinical practice or patient outcomes. AMIA’s comments offered specific recommendation in four major areas:
- “Meaningful use” Focuses on Process and Care Improvements over Time
- Develop and Implement a Robust Definition and Application of “Meaningful Use”
- EHRs Functionality and Capability
- Establish Approaches to, and Measures of Meaningful Use
The Markle Foundation recommends:
That HHS initially define “meaningful use” of electronic health records as the demonstration that “the provider makes use of, and the patient has access to, clinically relevant electronic information about the patient to improve medication management and coordination of care.”
American Hospital Association (AHA) recommends:
That the requirements to achieve “meaningful use” should consider first the quality, safety and efficiency components, and allow the technology to continue to evolve incrementally. Meaningful use should start with what already works, using the capabilities of currently certified systems. The AHA recommends that the NCVHS avoid adding new, required capabilities that cannot be in place by 2011. While the ARRA provides incentives for implementing the technology, physicians and hospitals should be measured and rewarded for the way the technology is used to transform health care, not for simply having implemented it. “Meaningful use” must be allowed to enable new ways of achieving our goals. Definitions that are too deeply rooted in specific technologies or functions could easily become outmoded given the rapid pace of technological change. While there is variation in hospitals, the definition of “meaningful use” should be consistent for all hospitals, and should address the larger safety and efficiency goals. A consistent definition moves everyone forward in a measurable way.