The meaning of "meaningful use"

Under the HITECH part of the Federal stimulus package, physicians and hospitals will have the opportunity to earn close to $20 billion of bonus payments starting in 2011 for "meaningful use" of "certified" EHR systems. Those terms will need to be defined soon for providers to invest with confidence.Luckily Dr. David Blumenthal, the incoming National Coordinator for Health Information Technology, has written a perspective in the upcoming New England Journal of Medicine that sheds a bit of light on the subject. The article (Stimulating the Adoption of Health Information Technology) is free online.

One of HITECH's most important features is its clarity of purpose. Congress apparently sees HIT — computers, software, Internet connection, telemedicine — not as an end in itself but as a means of improving the quality of health care, the health of populations, and the efficiency of health care systems. Under the pressure to show results, it will be tempting to measure HITECH's payoff from the $787 billion stimulus package in narrow terms — for example, the numbers of computers newly deployed in doctors' offices and hospital nursing stations. But that does not seem to be Congress's intent. It wants improvements in health and health care through the use of HIT...

[CCHIT certifies EHRs today, b]ut many certified EHRs are neither user-friendly nor designed to meet HITECH's ambitious goal of improving quality and efficiency in the health care system. Tightening the certification process is a critical early challenge for ONCHIT. Similarly, if EHRs are to catalyze quality improvement and cost control, physicians and hospitals will have to use them effectively. That means taking advantage of embedded clinical decision supports that help physicians take better care of their patients.

So it's becoming pretty clear:

• Certification will include existing CCHIT functional requirements and ease of use elements
• Providers will need to use the information in EHRs to improve how they take care of patients, not just document the information better. Physicians may be wary of typical embedded decision supports (those annoying popup windows that docs tend to ignore) but there is a big opportunity to take advantage of more advanced add-ons such as those offered by Anvita Health and SimulConsult

Time to get going!