What is the Meaning of “Meaningful Use” Anyway?

In my last blog, I spoke of the many changes that have altered the American healthcare landscape in
recent years. I then spoke about the benefits of a robust EHR to a practice such as ours. In this blog,
I will address the very big “strings” that come attached to government aid being offered to practices
for adopting an EHR. This set of strings (or practice guidelines) that are simultaneously driving doctors
across the country crazy and making quality improvement junkies giddy, is called “Meaningful Use”.

While Meaningful Use may sound nebulous at first blush, it is actually a pretty effective safeguard
against the abuse of a novel government program. If physicians or offices were not mandated to
use their new EHR’s meaningfully, there would be nothing stopping them from adopting simple data
collection EMR’s without regard for quality improvement or cost savings just to cash in on the subsidy
being offered. My original ambivalence (or depending on my mood that day, annoyance) about
Meaningful Use, has been replaced with a healthy respect for what these guidelines will achieve for
healthcare – over the long haul. In the short term though it sure seems like a big pain in the neck.

This blog is a timely one, since we at Our Family Doctor have just begun our initial 90-day attestation
period. During these 3 months, we will collect data and then submit it to the government demonstrating
that we have been using our EHR meaningfully, and that we are worthy of our first installment of the
HITECH Act’s subsidy funds, (that will help defer the costs of our very expensive new EHR system).

Meaningful Use is made up of 15 mandatory core objectives and a menu-set of 10 procedures in which
physicians must choose 5 to perform. Oh, but it can’t be that simple could it? No, of course not, we are
talking about legislation inspired by the US government and the Centers for Medicare and Medicaid
Services. No, this is just Phase I. Phase II and Phase III have yet to be fully defined. But I digress…..

The 15 core objectives that must be fulfilled with a practice’s EHR are: (1) Recording patient
demographics, (2) Recording vital signs with each visit, (3) Maintaining current and active diagnoses
lists, (4) Maintaining active medication lists, (5) Maintaining active allergy lists, (6) Recording adult
smoking status, (7) Providing patient clinical summaries (when asked for), (8) Providing electronic
health information on demand, (9) Generating and transmitting prescriptions electronically, (10)
Using computerized physician order entry for drug orders, (11) Implementing drug-drug and drug-
allergy interaction checks, (12) Be capable of electronic information exchange (such as with a lab),
(13) Implementing at least one clinical decision support rule, (14) Protecting patient data privacy and
security, and (15) Reporting clinical quality measures to Medicare or Medicaid.

Did you get all that? While much of this stuff is already being done by practices, few have been doing all of these things. Furthermore, physicians now must show that they are doing this work most of the time.
Many practices are struggling to meet these requirements, but at OFD we are committed to achieving all of these objectives, and early EHR testing suggests that we are hitting these marks with flying colors.

If this last paragraph has left you yearning for more Meaningful Use minutia, then you’re gonna really
love the menu of 10 items that I WON’T be listing at this time. Naturally you can always Google this
riveting list if you are finding yourself dying to know what us doctors get to worry about these days.

So, in the coming months and years when your OFD physician asks you about your smoking status (when you come in for that ankle sprain), or an OFD medical assistant double checks your med list (during a visit for poison ivy) you’ll know why we are being so thorough. Not only would we have become super attentive clinicians and assistants through this process, but we will be “meaningfully using” our Electronic Health Record and improving the quality of your health care at the same time – at least that is what we are banking on.