Meaningful Use Regulations and Legislation

It was more than three years ago that President Obama pledged a five year promise to computerize the nation’s health records in an attempt to lower costs, cut medical errors, and improve patient care. A number of significant events have unfolded since this bold statement was made during his first Weekly Presidential Address.

In early 2009, just four days after he took office, Congress passed the American Recovery and Reinvestment (ARRA) Act of 2009, a $787 billion piece of legislation that now tops $840 billion, which President Obama quickly signed into law. Out of this new legislation came a sizable carve out: the Health Information and Technology for Economic and Clinical Health (HITECH) Act, designed to promote the adoption and meaningful use of health information technology. From this, a significant amount of funds were set aside to modernize healthcare IT systems through the CMS EHR Incentive Programs.

Two federal agencies working together

CMS and the ONC, both under the Department of Health and Human Services (HHS), hold joint responsibility for the development and implementation of the incentive programs. Under regulations of the HITECH Act, both federal agencies were initially responsible for creating a set of complementary final rules to support the implementation of the EHR Incentive Programs. CMS and ONC released the final rules of Stage 1 Meaningful Use in July 2010. In the months following the final rule issue, HHS announced the initial set of EHR testing and certification groups—Certification Commission for Health IT (CCHIT), Drummond Group (DGI), InfoGard Laboratories, ICSA Labs, SLI Global Solutions and Surescripts – the groups responsible for certifying the technology that health care professionals are required to use for this government program.

Meaningful use ascension path

Meaningful use will follow an ascension path over time. In other words, each stage of meaningful use will affect subsequent stages through a multi-layered and interconnected approach to health care improvement. In effect, Stage 1 Meaningful Use forms the baseline of the program by promoting electronic data capture and information sharing. Stage 2 Meaningful Use focuses on advancing care processes while Stage 3 Meaningful Use emphasizes leveraging the information collected in the first two stages of meaningful use to improve outcomes. Stage 2 and 3 both build on the foundation of Stage 1 Meaningful Use and will be developed over the next few years through a series of future rulemakings.

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