Gary Mellon,
DPM |
|
Meaningful use (MU) is a term created by CMS that describes the use of medical information technology that furthers the goals of information exchange among health care professionals.
The Meaningful Use concept evolved in 2008 when the National Quality Forum released a report titled ”National Quality Priorities and Goals,” which was used to create the framework for “Meaningful Use.”
- Patient Engagement
- Reduction of Racial Disparities
- Improved Safety
- Increased Efficacy
- Coordination of Care
- Improved Population Health
- Use of certified EHR in a meaningful manner (e.g. E-prescribing)
- Use of certified EHR technology for electronic exchange of health information to improve quality of health care
- Use of certified EHR technology to submit Clinical Quality Measures (CQM) and other such measures selected by the Secretary.
- Must meet “15 core set” but can defer 5 from optional “menu set”:
- Eligible Professional (EP) has to report 20 of 25 MU Objectives
- Measure thresholds range from 10% to 80% of all orders
- Stage I (2011 or 2012) “Eligible Professionals” doctors in CMS must use “Computerized physician order entry or EHRs for at least 80% of all orders
- Reporting Period 90 days for first year
The federal government has provided an incentive for eligible professionals to adopt EHR. That incentive is $44,000 which is broken down with $18,000 in the first year, $12,000 in the second year, $8,000 in year three, $4,000 in year four and $2,000 in year five. To receive the full amount you must adopt EHR in 2011 or 2012.
One of the primary reasons to adopt EHR is to evaluate Clinical Quality Measures (CQM). Currently, the Secretary of the Health and Human Services selects these measures. Eligible Professional doctors can select CQMs for his or her own practice besides the CQMS required by the Secretary. These additional CQMs would not be used for meeting meaningful use.
Patients present to podiatry offices with a multitude of foot problems that can be treated in a variety of ways. It would be nice to look at the treatment protocols for each condition we encounter in our practice and be able to determine the protocol that gives us the best outcome for these conditions being treated.
We could start with the diabetic patient who has a history of ulcers. Once we treat the ulcers and they are no longer present, we would then put the patient in the diabetic shoe program. We would then compare the diabetic patients a year later and see if the patients in this program have a lower re-occurrence of developing an ulcer during that year.
Another example is the patient who presents with heel pain. Once we get the patient asymptomatic, we would dispense orthotics to the patient. At the end of a year, we would look to see if the patients who were dispense orthotics had a lower re-occurrence of developing heel pain for the second time.
As reimbursement moves toward evidence based medicine, it is imperative for us to select the best practices for each condition we treat.
We have the information in the EHR to move us in the direction of evidence based medicine. It is incumbent upon us to utilize EHR in a format that allows us to select the best practices for the conditions we treat.
One should select the top ten or twenty conditions they treat and review the treatment protocols for that condition. This review should be done on a yearly basis, as newer technology is developed to treat various conditions. Upon completion of this review, you should be able to determine the best practice for that condition.
Let’s embrace EHR for more than meeting meaningful use in order to qualify for the incentive. The data in the EHR can make you a better practitioner if you chose to use it to its full potential.
