Technology in HealthcareOne of the major challenges that healthcare practitioners and hospitals face as they move toward implementing interoperable electronic health record (EHR) systems involves federal Meaningful Use (MU) regulations.

In 2018, the requirements that eligible providers are expected to meet through the existing MU program will be intensified from the current Stage 2 to Stage 3. This means that even those Medicare and Medicaid providers who are using EHRs and meeting current requirements will face new challenges on the road ahead.

We recently published a white paper, "Get Ready; Healthcare Is Speeding into the Digital Age," discussing interoperability, the challenges it presents, and some of the solutions available to providers. This blog covers aspects of the MU program, which is also a focus of the white paper.

The federal MU program applies to Medicare and Medicaid providers. For a limited time, it provides incentive payments to eligible providers who meet program requirements. The program recently began imposing financial penalties on Medicare and Medicaid providers who have not adopted EHRs.

It is unclear how recent political changes in Washington will affect the MU program. Shortly after the general election, the American Hospital Association asked that the Trump Administration move to cancel Stage 3 requirements. For the time being, at least, that has not happened.

The MU program was created in 2009, when the Health Information Technology for Economic and Clinical Health (HITECH) Act was signed into law as part of the American Recovery and Reinvestment Act. The federal government has been using the MU program to encourage health providers, technology providers, and payers to adopt EHRs through federally funded incentives.

The basis of the MU program is being rolled into the Medicare Access and CHIP Reauthorization Act (MACRA), a law passed in 2015. MACRA is expected to expand the population of practitioners eligible for incentive payments beginning this year (2017).

To receive annual monetary awards, providers must meet timelines and other requirements established through the program. In 2015, the federal government in 2015 began taking 1% payment adjustments from entities that collect Medicare and Medicaid payments but haven't made the transition to EHRs. This means that 1% of the federal funding that would have been provided to such practitioners or hospitals is now deducted from the payment. The adjustments are scheduled to increase 1% a year, up to a total of 5 percentage points.

The program is based on a series of building blocks, including vocabulary/code sets, content, structure, transport, security, and services. Within each of these areas, the federal government has set standards that practitioners and hospitals must meet to achieve Meaningful Use. While implementing a standard EHR solution will help providers meet many of these standards, several hurdles will remain.
For example, providers today frequently email or fax patient information to specialists, so that the specialists can have the information for review when patients arrive. With MU, that method of communication will not meet security standards, and changes in the communication process must be made.

Professionals will be required to meet 20 total objectives (and eligible hospitals, 19 objectives) to be eligible for MU incentives. An example of an objective is that smoking status must be recorded for 80% of a practitioner's patients. Another example is that a practitioner must e-prescribe for 50% of his or her patients. These requirements will increase over time.

The appendix of the white paper includes a list of all objectives that must be met to achieve Stage 3 certification in 2018.

Meeting all requirements will be challenging. One key to achieving Stage 3 certification is working with a technology partner that has experience with interoperability as well as the technical and regulatory issues it presents. CapTech has the proven strategy, experience, and resources to help practitioners and hospitals meet these challenges and succeed in the digital age.

To request a copy of the white paper, click here.