On July 16, updated definitions of Meaningful Use were presented and approved by the HIT Policy Committee of the Office of the National Coordinator for Health IT (ONC).
While this does not constitute the final definition which ultimately will be decided through rules issued by CMS, endorsement by ONC is a major step forward. Expect the CMS draft rules this fall and final rules this winter.
The three adoption year progression of meaningful use includes:
- establishing a lower 10% threshhold for hospital CPOE adoption
- accelerating the intial use of clinical decision support (“Implement one clinical decision rule relevant to high clinical priority”)
- accelerating (to 2011) patients' access to their health information
- improving outcomes measures for care coordination by including a (2012 to 2013) measure of a 10% reduction on 30-day hospital readmissions
- withholding Medicare incentive payments until any HIPAA violations are resolved (and for state privacy and security violations, withholding incentives under Medicaid)
Of particular interest is the Meaningful Use Workgroup's concern over Health Information Exchange. They questioned how health information exchange was to be accomplished in 2011 when HIE organizations do not currently exist or do not connect all clinical trading partners. The workgroup deferred to the HIE workgroup for specific requirements and recommended that the 2015 targets include required participation in nationwide health information exchange.
The Meaningful Use Workgroup presented a 10 page Meaningful Use Matrix which summarizes the health outcomes policy priorities, care goals, objectives and measures by adoption year.
The Workgroup established 5 Health Outcomes Policy Priorities and documented the related Care Goals including:
1. Improve quality, safety, efficiency and reduce health disparities
2. Engage patients and families
3. Improve care coordination
4. Improve population and public health
5. Ensure adequate privacy and security protections for personal health information
Objectives and Measures
For each of the Health Outcomes Policy Priorities, the Workgroup established related objectives and measures. The objectives were set separately for providers and hospitals
Providers' objectives for 2011include:
Improve quality, safety, efficiency and reduce health disparities