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The HITECH Act provides financial incentives for US healthcare providers to adopt electronic medical records (EMRs) but requires “significant use” of EMRs to receive payment. Providers must meet 15 key objectives and report clinical quality measures to receive incentives, while those who choose not to implement these measures will face penalties in Medicare and Medicaid reimbursements. Sanctions will begin in 2015 for vendors who have not implemented EMRs by that date.
Electronic Medical Records (EMRs) are digital, computerized reports containing the medical and demographic data of patients in clinics and hospitals. The Health Information Technology for Economic and Clinical Health (HITECH) Act passed by US Congress in 2009 provides financial incentives for eligible physicians and hospitals to convert to electronic health records, but the HITECH Act requires providers to demonstrate a “significant use” of EMR to receive incentive payment. In order to realize “meaningful use” of EMR, providers must meet 15 key objectives designed to improve coordination of patient care, improve quality and efficiency of care, prevent medical errors, ensure privacy protection, and proactively involve patients in education and prevention strategies. In addition, providers will be required to meet at least five additional criteria from a list of 10 goals involving the implementation of preferred practice standards or “clinical decision support rules” that trigger certain tests, assessments and management choices when certain clinical circumstances exist . Finally, “significant use” of EMR involves reporting clinical quality measures (CQM) to the Center for Medicare and Medicaid Services, the government agency that regulates such programs.
Most EMR software programs can achieve 10 or 15 milestones for “meaningful use” of EMR. For example, nearly every well-designed EMR system includes protection for electronic health information. Many systems allow providers to electronically transmit prescriptions to pharmacies while checking for drug interactions and allergies. Recording and maintaining patient demographics and lists of patient medications, allergies, problems, and tobacco and alcohol use meet five other goals. An ultimate fundamental goal involves charting growth, blood pressure, height, weight, and body mass index, but a practice to which these data are generally not relevant may simply state this fact and still achieve the goal.
Slightly more challenging for existing EMR systems, “significant use” requires reporting of a variety of MQCs to state and federal agencies for public health surveillance and quality control measures. These CQMS include immunization status, tobacco use and cessation, weight changes, and blood pressure measurements. Providers who choose not to implement these measures will face an escalating penalty in Medicare and Medicaid reimbursements, which can go up to five percent. Sanctions will begin in 2015 for vendors who have not implemented the EMR by that date. Additionally, the incentive period for establishing “meaningful use” for EMR extends for just five years.
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