The road to establishing electronic medical record (EHR) standards for U.S. health care settings was a tedious undertaking fraught with delays and technical issues. However, since their widespread implementation, EHRs continue to provide accurate, up-to-date patient information, secure and efficient records sharing, and reduced costs through decreased paperwork.
Establishing the Standards for Compliance
The pursuit for an EHR standard began when the Centers for Medicare and Medicaid Services (CMS) Meaningful Use (MU) provisions were developed in 2009 as part of the Health Information Technology for Economic and Clinical Health Act (HITECH). The provisions detail how eligible providers participate in the federal incentive programs for health information technology. The MU provisions include requirements for the use of certified EHR technology, as well as for the exchange of health information. Providers and hospitals can earn incentive payments for the “meaningful use” of certified EHR technology.
CMS developed the MU program to enable health care companies to become compliant through the following three stages:
- Stage 1 (2011-2012): Established the base requirements for providers to adopt EHRs
- Stage 2 (2013-2014): Encouraged using EHRs for exchange of medical information and quality care improvement.
- Stage 3 (2015): Finalized the process as providers used EHRs routinely to improve health outcomes and standardize reporting requirements with government health programs.
While CMS has since renamed the program to Promoting Interoperability Programs with a new phase of EHR measurements, many providers still refer to the standards as meaningful use.
Why Is It Important to Be MU Compliant?
By achieving this compliance, healthcare companies demonstrate their commitment to providing high-quality, interoperable healthcare IT solutions. In addition, MU compliance ensures that your healthcare IT company is able to exchange data with other MU-compliant organizations. This interoperability is essential for coordinating care and reducing duplicate tests and procedures. As a result, working with an MU-compliant healthcare IT company can help to improve the quality of care and reduce costs.
EHR technology that is not compliant with MU cannot be used to meet this objective, and as a result, the provider would not be able to receive incentive payments for adopting it. Furthermore, providers who do not demonstrate MU are subject to financial penalties.
How Do Healthcare Companies Become MU Compliant?
In order to be considered MU compliant, healthcare companies must use technology, including complete EHR systems and individual modules, certified by the U.S. Department of Health and Human Services (HHS). These systems can be purchased as a package from a single vendor or as separate components from multiple vendors.
Patient Engagement Is Key
Patient engagement is a core requirement for stage one and stage two. In these stages, MU mandates that 50 percent of the facility’s patients be given access to their health information online. Additionally, five percent of patients need to log in through the EHR portal to view their health data online and send a secure message to their provider. It’s essential that providers encourage patients to use the portal by demonstrating how to set up a log-in, send messages, view lab results, and set up appointments.
Demonstrating Additional EHR Tasks
In 2016, the objectives and measures for the EHR incentive program were updated. Health care providers are required to successfully demonstrate the following EHR tasks to be MU compliant and qualify for incentives through the Medicaid or Medicare EHR program.
- Protect electronic health information through security risk analysis and implementation of security updates
- Use clinical decision support to improve high-priority health conditions
- Use electronic order entry for medications and lab and radiology orders
- Use the EHR for health information exchange for referrals
- Use the system to identify and provide the patient with educational resources that suit their needs.
- Identify the list of patient medications upon referral from another health care setting or care provider.
- Provide patients with the ability to view, download, and transmit their health information within four business days of it being available to the eligible medical professional
- Use the EHR system for secure messaging with patients
- Actively engage in public health reporting by submitting electronic patient data from the EHR.
CMS updates the above policies yearly to keep pace with the advancement of EHRs, increase interoperability, and increase patient access to health information. Updated policies can be found on the CMS.gov webpage.
How to Prepare for a CMS Audit
Audit is a scary word for anyone running a business. Unfortunately, some providers will be chosen at random by CMS for an audit. How can you be prepared? The first rule is to assume you will be audited. Clearly document all the steps taken throughout the process. When did your registration/attestation take place? MU started back in 2011. So, providers across the country are at various stages of implementation. Don’t assume CMS has accurately recorded who began when. Take a screenshot that includes a date stamp on the day functionality was turned on. If you do receive an audit letter, respond immediately. Auditors will be looking for contradictions between the documentation submitted and what was actually done. Ensure that the staff responsible for certain pieces of MU actually did what you think they did at the right time. Lastly, work with your EHR provider to give CMS the proper certification documentation.
EHR Adoption: Where We Stand Today
According to a 2019 HealthIT.gov report, three-quarters of office-based physicians and nearly all non-federal acute care hospitals had adopted a certified EHR system. The Centers for Disease Control and Prevention reported that the highest EHR adoption rates by specialty are by office-based cardiologists and neurologists, at 95.6 percent and 94.5 percent, respectively.
While financial incentive was the biggest factor, many physicians listed reasons for conversion such as board certification requirements, recommendations from peers, and the capability to exchange information with other physicians.
The benefits of EHR go far beyond the financial incentives. Doctors attest to benefits, including:
- Improved coordinated care. The ability to share information with patients and other physicians improves collaboration.
- Safer care through reduced errors. EHR technology not only records data, it alerts physicians to medications, allergies or other conflicts in care. For example, an emergency room doctor can access data recorded by a primary care physician that alerts the ER staff to life-threatening allergies.
- Enhanced patient/provider interaction. Patients feel like their physician is more accessible through enhanced communication methods provided by EHRs.
- Quicker diagnosis. The comprehensive picture of patient health provided by EHR technology enables physicians to find problems faster.
Don’t let the lack of technical assistance or knowledge stop your practice from reaping the benefits of EHR technology. For Medicare and Medicaid providers, avoiding implementation directly affects your bottom line. The same can be said for other providers as well. As EHR improves efficiency in your office, productivity increases, making EHR a valuable tool. Improve patient care and run a more productive office by exploring EHR solutions provided by professionals dedicated to helping you improve your healthcare IT strategy, while complying with healthcare reform legislation.