Understanding the Meaningful Use program

Meaningful Use refers to standards established by the Centers for Medicare and Medicaid Services (CMS) to encourage healthcare organizations to use electronic health records (EHR) technology effectively. This is part of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act which improves the quality of healthcare delivery and patient engagement. 

What is the meaningful use program? 

The Meaningful Use program is based on specific objectives that healthcare providers must meet for incentives. There are three stages in the program, each building on the previous one. These stages include: 

• Stage 1 focuses on data capturing and sharing, requiring providers to electronically capture health information and share it with other entities. 
• Stage 2 advances this by improving clinical processes such as e-prescribing and secure electronic health information exchange. 
• Stage 3 improves health outcomes by promoting advanced clinical decision support and patient engagement strategies. 

Each stage includes a core set of objectives that providers must achieve alongside menu options that allow them to select additional objectives relevant to their practice. Each objective of Meaningful Use promotes interoperability among disparate systems. 

The transition into the Promoting Interoperability Program

Initially established under the HITECH Act, Meaningful Use incentivized healthcare providers to adopt EHR technology. The program focused on increasing the use of EHR systems in practices across the U.S. However, merely using EHRs was insufficient; there is an urgent need for these systems to communicate effectively with one another. 

In 2018, the Centers for Medicare and Medicaid Services (CMS) rebranded Meaningful Use as the Promoting Interoperability program. The shift aligns with broader legislative efforts like the 21st Century Cures Act which allows for the flow of information between providers and empowers patients to access their health data. The program retains the foundational goals of Meaningful Use but introduces requirements that focus on reducing administrative burdens. 

The key points of the program include: 

• Emphasizing the ability of different EHR systems to exchange and interpret shared data. 
• Incentivizing a shift to penalties for noncompliance. 
• Providers reporting four objectives: Electronic Prescribing, Health Information Exchange, Provider to Patient Exchange, and Public Health and Clinical Data Exchange. 
• Enhancing patient engagement by promoting patient access to their health data. 
• Requiring providers to engage with public health agencies by reporting data to various registries. 

The long-term impact of the Meaningful Use program 

The initiative has proven to have stimulated widespread EHR adoption with nearly 94% of providers reporting their EHR makes their records readily available and a majority of hospitals now using certified health IT systems. Through the digitization of health records, data exchanges have become seamless. 

As EHR systems integrate easily with communication software like HIPAA compliant email, storage and transmission become effortless. This capability has provided a step in the right direction for data accessibility while also bringing with it exposure to a new world of cybersecurity risk. 

FAQs

Why are meaningful use incentives issued through the CMS? 

CMS oversees Medicare and Medicaid which is critical in the adoption of EHRs as they impact a large portion of the healthcare system. Providing financial rewards they promote the adoption of certified EHRs. 

What are the effects of EHRs on patient care?

EHRs enable better clinical decision-making through features like alerts and clinical decision support systems. 

What are the challenges with implementing EHRs?

The central concern with the use of EHRs is the matter is vendor lock-ins that inhibit the effective use of the technology.