While not everyone who uses EHR may agree on the exact definition, the government hasn't been hesitant to chime in. And why shouldn't they? The whole program has been established to monitor how EHR is improving patient care delivery.
During each year of participation in the EHR Meaningful Use Incentive Program, eligible providers must report on 20 of 25 specific measures if they want to receive incentive payments for meaningful use of their EHR. These include 15 required core objectives and 5 objectives from a list of 10 optional objectives. They must also report on 6 clinical quality measures from a list of 3 required, 3 alternate, and 38 additional measures.
This is where meaningful use can get a bit complicated. Some of the measures and objectives can be difficult to understand, and reporting on them is even more complicated. I'll try to explain, but don't be discouraged if they seem a little unclear. Like I mentioned in my previous post, we could all benefit from a class on meaningful use.
Below are the first 5 of 15 core objectives--those that every EP must report on:
1. Use CPOE (computerized physician order entry) for greater than 30% of unique patients with at least one medication in the medication list. So, "CPOE" threw me for a loop. Simply put, the provider should use a computer or mobile device to order a medication or other order (imaging, lab) and record it for more than 30% of his/her patients (and 'unique' means you can't count the patient more than once). It's not exactly the same thing as e-prescribing, which requires sending the script to a pharmacy. See #4.
2. Implement drug-drug and drug-allergy checks. This one's pretty straight forward. Whichever EHR system the provider uses, it must alert the provider regarding drug-to-drug and drug-to-allergy interactions. As long as it's in place for the entire reporting period, then this objective is satisfied.
3. Maintain an up-to-date problem list of current and active diagnoses for more than 80% of unique patients. Basically, this objective requires that the provider enter active and past problems into the patient's medical record. The information can be obtained either from the previous record, a transferred record, the EP's diagnosis, or from asking the patient. Probably the most important thing to remember about this objective is that SOMETHING has to be documented, even if the patient doesn't have any active problems. When our system is upgraded in March, our providers will be able to easily document "no active problems." Also of note, 'unique', like in #1 above, means a patient can't be counted more than once.
4. More than 40% of permissible prescriptions written by the provider are generated and transmitted electronically. Very similar to #1, but still unique in that these are actually prescriptions that are sent and received electronically, not just ordered and recorded in the system. Keep in mind, depending on state law, scheduled drugs cannot be sent electronically, so these would not count toward the requirement.
5. Maintain an active medication list on 80% of all unique patients. As with #3, something has to be recorded, even if the patient has no active meds, and remember the definition of 'unique'--CMS isn't talking encounters, they mean individual patients.
In my next post, I'll list and define the next five objectives...stay tuned.