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It took 6 long months, but the ONC has finally released the final definition of meaningful use. The final definition reflects a compromise between those who are anxious to get the technology in place and those who are reluctant to change the way they practice. On one side, the government sees major benefits of having EHR software in a majority of physician practices. These benefits encompass such things as having access to the whole patient health record from any location, decreased duplication of tests or prescriptions, increased follow up and preventive care reminders for both physician and patient and increased information available for CMS to see what is working for different populations. Of course on the other side, the physician practices see large obstacles in the transition from paper to electronic. In the end, the ONC felt it was best to strike a happy medium between the two sides. After all, what good is all of this technology if no one will agree to use it! The major differences between the initial definition and the final definition are that physicians now only have to complete 20 out of 25 of the measures to qualify and instead of prescribing 75% of their prescriptions electronically, providers must now only prescribe 40% of their prescriptions electronically during the 90 day qualification period. While some will still complain that the objectives are still to stringent to be realistic, overall, the final definition is being accepted as the best step forward in this endeavor and marks a milestone in this country's journey toward moving healthcare into the Information Age.

With all of the changes coming concerning how patient information will be handled. Its important that we keep the goals in mind. Below is a letter from Director David Blumenthal about what direction we are headed in.

A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology

As the many activities mandated by the HITECH Act move forward, I want to take a moment to share my vision of the overarching goal and some of its implications. Our goal, above all else, is to make care better for patients, and to make it patient-centered. Information policy and health IT policy should serve that goal. A key premise: information should follow the patient, and artificial obstacles – technical, business related, bureaucratic – should not get in the way. As a doctor, I have many times wanted access to data that I knew were buried in the computers or paper records of another health system across town. Neither my care nor my patients were well served in those instances. That is what we must get beyond. That is the goal we will pursue, and it will inform all our policy choices now and going forward. This means that information exchange must cross institutional and business boundaries. Because that is what patients need. Exchange within business groups will not be sufficient – the goal is to have information flow seamlessly and effortlessly to every nook and cranny of our health system, when and where it is needed, just like the blood within our arteries and veins meets our bodies’ vital needs. If we are to reap the benefit of information exchange, Americans must also be assured that the most advanced technology and proven business practices will be employed to secure the privacy and security of their personal health information, both within and across electronic systems, and that persons and organizations who hold personal health data are trustworthy custodians of the information. We must have comprehensive, clear, and sustainable policies that strengthen existing protections, fill gaps as they emerge, fortify new opportunities for patients’ access to and control of their information, and align with evolving technologies. I will devote a separate letter to this critical issue and the many activities mandated by the HITECH Act that we are developing.

Although there is still alot of logistical decision making that needs to be done to advance the mass adoption of EMR software, the goals of this mass adoption are starting to become more clear. They are divided into 3 sets. The first set of goals, to be implemented in 2011, will be focused largely on just getting offices to actually use the software. This will entail things like workflow readjustment and the complete elimination of paper in the charting process. The second series of goals, set for 2013, will deal mostly with processes within a practice. This will revolve around things like lab ordering and review of data from outside sources like hospital PET scans etc. This is said to be where the interoperability aspect will really start to crystallize. Interoperability is a very important goal of the HITECH legislation which aims to allow a patient's medical information to follow them from practice to practice. While each physician is attempting to meet these small goals with their EHR software, the government will be setting up a national infrastructure aimed at total Health Information Exchange. The final goal of Meaningful Use is closely related to the ultimate goal of this whole movement: increased quality of patient care. The "outcomes" goal is where physicians will be able to use their EHR software to not only get a whole picture of the patient's total health, but to be able to utilize that information to garner a favorable outcome. This will include two separate measures. First, on a small scale, a reminder function in the software that will be able to prompt the physician to take certain preventative steps toward decreasing negative outcomes. For example, a software that reminds a physician to screen older female patients for osteoporosis will significantly decrease the number of hip fractures seen each year. Second, on a large scale, the goal is to have the software report the outcomes of specific treatments to a national database that will be able to measure the effectiveness of specific treatments on specific conditions. In essence, the use of nationally linked EHR software will make each patient a case study, allowing the medical community to get a better understanding about which interventions are working and which aren't! For more information about the initial measures needed to accomplish the first set of goals, please see the Meaningful Use Measures link on the left side navigation menu.

Welcome to How To EMR: the one stop site to find out everything you need to know when buying new medical software. If you are looking at this page, you are probably interested in investing in some new technology for your practice. If you are wondering which ones are right for you, which ones will offer the greatest return on investment, and which ones are just a pile of programming trash, you are not alone.

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