The subject of compliance conjures an image of a massively fragmented arena where technologies, workflows and processes are intertwined to address economic, legislative and vertical industry mandates. Because healthcare is one of the thorniest industries on the planet (and fraught with considerable legislative hurdles), its complexities are significant.
“Meaningful Use” has been in the press of late, and is one of a host of significant compliance initiatives impacting clinical reporting requirements in healthcare. As part of the American Recovery and Reinvestment Act of 2009, Congress included up to $34 billion in incentives for eligible hospitals and physicians to implement and use certified electronic health record (“EHR”) solutions. Known as HITECH, the provision requires that providers achieve meaningful use through a staged roll-out of the program through 2015. While the exact parameters of the program have not been established, the following broadly outlines the objective of each stage:
Stage 1 criteria focus on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating that information for care coordination purposes, and initiating the reporting of clinical quality measures and public health information (for more on the proposed Stage 1 meaningful use criteria see the Appendix).
Stage 2 expands on Stage 1 criteria in the areas of disease management, clinical decision support, medication management, support for patient access to their health information, transitions in care, quality measurement & research, and bi-directional communication with public health agencies.
Stage 3 will focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.
The roll-out of meaningful use requirement sets varies depending on the provider’s initial payment year. For example, providers can satisfy Stage 1 meaningful use standards as late as 2014, but must adhere to Stage 3 requirements in 2015 to receive the incentive payment.
Meaningful use has far reaching implications for providers and remains an area within reform that our team is watching. Two recent articles that touch on the topic can be found here and here.
In the coming weeks, look for our team to write more on these pages about the four sub-sectors within the Compliance landscape: Clinical Auditing, Consumer Engagement, Anti-Fraud & Recovery and the emergence of ICD-10.
Until then, let us know if you have any questions and have a great week!