You have heard it so often it has almost become the Mantra of the EHR community. In order to qualify for federal incentives in the HITECH Act physicians must implement EHRs that demonstrate “meaningful use”. The quest to discover the definition of “meaningful use” for EHRs has been as elusive as the search for the Holy Grail or the Treasure of Sierra Madre. But there may finally be a light starting to shine at the end of the tunnel. Last week a work group for the Department of Health and Human Services (HSS) put forth recommendations for defining “meaningful use.” 

Reporting to the Health IT Policy Committee, the work group fell short of officially defining “meaningful use” – but rather released 22 objectives that EHRs need to reach by 2011. Among the included objectives EHRs must:

  • Use Computerized Physician Order Entry (CPOE) for all types of orders including medications
  • Implement drug interaction and allergy checks
  • Maintain an up-to-date problem list
  • Generate and transmit permissible prescriptions electronically
  • Maintain an active medication allergy list
  • Implement a method to send reminders to patients for preventive and follow-up care
  • Document a progress note for each patient encounter with a healthcare provider
  • Provide patients with access to clinical information
  • Provide patients with summaries for each encounter
  • Exchange key clinical information among all providers of care
  • Submit electronic data to immunization registries as required
  • Provide electronic submissions of reportable lab results to public health agencies
  • Provide electronic surveillance data to public health agencies according to applicable law and privacy guidelines
  • Comply with all federal and state privacy/security laws  

National Coordinator for Health IT, David Blumenthal, has said these recommendations, “… are the beginning of a conversation that is going to last for some time” 

By the end of this year HHS must publish an initail draft rule for standards, implementation specifications, and certification criteria for EHRs that will qualify for financial incentives  Ultimatly, the Centers for Medicare and Medicaid Services (CMS) is tasked with developing the formal and final definition of “meaningful use” per the incentive programs. CMS intends to go through the full administrative rules process, which means a proposed rule, a period for public comment, and then a final rule. At present, CMS has not released their timetable to do so. 

The HIT Policy work group released a matrix detailing all 22 of the meaningful use objectives. The matrix and the complete report to the committee can be accessed at: