Meaningful Use: the “North Star”

Meaningful Use - Termed the “north star” to guide key policy objectives, advanced care processes needed to achieve them, and the specific use of IT to enable the desired outcomes and ability to monitor objective, the initial definition of “Meaningful Use” was released by the HIT Policy Committee on June 16, 2009. A revised definition was released on July 16, 2009, and includes measures submitted by the HIT Standards Committee Quality Workgroup for national priorities identified by the National Quality Forum (NQF), to include patient engagement, reduction in disparities, improved patient safety, increased efficiency, coordination of care, and improved population health. A revised definition was approved on July 16, 2009, and includes measures beginning in 2011 and additional measures for 2013 and 2015. The initial definition will be submitted to the Secretary of HHS for consideration and approval. For Eligible Professionals and/or out-patient care, there are 28 stated objectives and 23 measures required to meet the definition of meaningful use by 2011, when Medicare and Medicaid incentives are scheduled to begin. There are an additional 18 objectives and 16 measures to achieve meaningful use by 2013; and, 13 objectives and 10 measures by 2015.

The stated adoption year goals of the definition are:

1. 2011 – Data-capture and data-reporting for key clinical criteria
2. 2013 – Capture and reporting of coded-data for use in tracking key clinical conditions
3. 2015 – Achieve and improve performance, and support care processes and outcomes

The grids set forth below identify the objectives and measures resulting from the July 16, 2009, for Eligible Professionals and/or Outpatient only. In-patient objectives and measures are not set forth on this grid. Readers are invited to visit the HIT Policy committee website for in-patient details.

Additionally, Computer Physician Order Entry (CPOE) as set forth below requires computer-based entry of order, but does not require electronic interfaces to receiving entities in the 2011 objectives and measures.

Meaningful Use By 2011 - 28 Objectives, 23 Measures Goal is to electronically capture in coded format and to report health information and to use information to track key clinical conditions.

^{(Note: EP = Eligible Professional; OP = Outpatient; IP = In-patient; CPOE = Computer Physician Order Entry; Objectives and Measures are independent)}

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Meaningful Use By 2013 - 18 Objectives, 16 Measures Goal is to electronically capture in coded format and to report health information and to use that information to track key clinical conditions.

^{(Note: EP = Eligible Professional; OP = Outpatient; IP = In-patient; CPOE = Computer Physician Order Entry; Objectives and Measures are independent)}

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Meaningful Use By 2015 - 13 Objectives, 10 Measures Goal is to achieve and improve performance and support care processes and on key health system outcomes

^{(Note: EP = Eligible Professional; OP = Outpatient; IP = In-patient; CPOE = Computer Physician Order Entry; Objectives and Measures are independent)}

David Hunt, M.D., Chief Medical Office of the ONC has indicated that electronic, recordable events will be use to document “meaningful use.” These electronic events would include ePrescribing, participation in HIE and submission of quality measures. Federal government is planning fully funded “extension centers” to assist physicians seeking to automate and achieve meaningful use. This is intended to augment training and support initiative beyond vendors. Historically, these contracts have been award to quality improvement organizations (QIOs) within geographic communities.

Comment: EHS will implement and develop systems in accordance with this definition to afford its clients direct access to incentive opportunity and the ability to thrive in the future. The above definition has been created by ONC through the HIT Policy Committee and the HIT Standards Committee to define meaningful use. This term was intentionally left undefined in ARRA to allow ONC latitude on structure for the incentive programs.  The Definition will be submitted to the Secretary of HHS for recommendation, comment, and approval.  A revised definition may be expected.