The HITECH stimulus program reimburses physicians up to $44,000 under the Medicare program and up to $64,000 under the Medicaid programs for purchasing and implementing Electronic Health Records (EHR). Meaningful Use (MU) is a set of standards that applies to the use of EHR software. Eligible professionals (EPs) must meet MU standards in stage one of the Medicare program and stage two of the Medicaid program.

MU standards guarantee EPs must actually use their EHR software instead of just buying it and shelving it in order to obtain stimulus funds. EPs have 25 objectives, 15 core which they must meet in stage one, and ten menu objectives, of which they can choose five. They range from simple tasks, like capturing race, ethnicity, and preferred language, to more complicated items like computerized provider order entry (CPOE), electronic prescribing, and submitting electronic data to immunization registries.

The objectives have two parts: a function and a measure. Some of the requirements are calculated as a percentage. For instance, the CPOE measure requires the EP to enter medications for more than 30% of all their unique patients. The percentage is calculated based on a numerator and denominator. The denominator consists of the number of unique patients with at least one medication in their medication list during the reporting period. The numerator is the number of patients in the denominator which have at least one medication entered by CPOE.

Does this sound confusing? It certainly can be. 16 of the 25 measures compute using a numerator, denominator, and resulting percentage. The remaining measures compute using a simple yes/no response. Medicare participants must use their EHR according to the measures for a period of 90 days. EPs must comply with all of the measures in order to receive payment. The incentive reimbursements are all-or-nothing. EPs that fail even one of the measures will have to restart their 90 day reporting period and try again.

It is critical to track compliance with the measures. We recommend a one-week MU pretest. If your practice can fulfill the requirements for one week, there should be no problem with the 90 day reporting period. Certified EHRs are required report your MU measure compliance. We strongly recommend reviewing your reports on a daily basis. That way, if you notice that one of your providers is slipping, you should have ample time to correct the issue.

XLEMR produces a daily score card that lists each provider and their compliance with the 16 calculated measures. Our EHR software creates the report automatically and emails it to the practice manager along with each of the providers. You can view an example of our MU score card at: http://www.xlemr.com/content/mu_scorecard.pdf. Please let us know if you have any questions about meaningful use measures or compliance.

Ryan Ricks
Security Officer
www.XLEMR.com