HIMSS Preemptively Publishes EHR "Meaningful Use" Definition
Feds are meeting this week to delineate a 'meaningful use' standard for EHRs (electronic health records).
These will be weighty words...upon this definition hinges a company/provider's ability to secure funding and/or incentives (or lack thereof) from the ARRA and HITECH pot of stimulus dollars.
This morning HIMSS released 2 'meaningful use' definitions - one for hospitals, and one for EHRs overall.
The gospel of 'meaningful use' according to HIMSS includes 4 main provisions (HITs eNewsletter summary, my commentary):
1. EHR is CCHIT (Certification Commission for Healthcare Information Technology) certified. Oh boy - here we go...we're putting one pseudo-agency in charge of universal certifications that are used to judge whether a hospital or doc can secure incentives?
2. "Demonstrate abilities to exchange clinical and administrative patient data." Ok. Sounds good. But where is the patient's ability to modify, contest, or add to administrative data that may be erroneous, such as the upcoding found in @ePatientDave's BIDMC/Google Health PHR transfer?
3. ePrescribing (awesome. No argument here...)
4. "Electronically report quality and safety data." Ok. But what data sets? And to whom? Where is my clinical and administrative data going? To insurers? What if this loophole enables people to deny claims or insurance based on faulty information like upcoding? Oh wait, that's already happening with our current paper-based system. It will be interesting to see how HIMSS believes a change in the transmission method alone can improve quality and safety for each patient.
Here's how HIMSS summarizes key tenets of 'meaningful use:'
In summary, HIMSS recommends the following:
- 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.
That last one is a real doozy. If HIMSS has the answer to reconciling 'certified' technologies, 'best of show' and 'open source,' why the hell haven't they done this already? I have slightly more faith in IIW's User-Centric Healthcare working group, founded under the impetus of Polka's @mikekirkwood. Mike - the timing of Patient Zero use case creation yesterday in your attic could not have been more fortuitous. This needs released into the wild. As in NOW.
This bears watching folks. And if you're part of a healthcare reform group (read: ePatients PLEASE jump on this), I'd recommend releasing your own postulated "meaningful use" standard.
Bet you $50 bucks the AMA and potentially the AARP release one in the next 48-72 hours....
