The final rules on the meaningful use of electronic health records (EHRs) are out, and they are expected to help improve Americans’ health, increase safety and reduce health care costs through expanded use of EHRs. The regulation defines the “meaningful use” objectives that providers must meet to qualify for Medicare and Medicaid incentive payments. This commences a five-year national initiative to adopt and meaningfully use electronic health records for health care.

To assist in understanding the various meaningful use (MU) criteria, the Health IT (HIT) Policy Committee’s Meaningful Use Workgroup held a series of hearings on the MU criteria as outlined in the final rule. The HIT Policy Committee and ONC are both interested in receiving extensive public input to the MU criteria, particularly as we begin to formulate Stage 2 and Stage 3 of the MU criteria.

The last two MU criteria hearings were on Population Health and Care Coordination , and a series of questions were posed to the panelists for consideration and comment. We would welcome any further comments from the public on those questions and/or criteria.

Population Health Hearing – July 31, 2010  

Testimony from the Population Health hearing will help the Meaningful Use Workgroup formulate recommendations to the HIT Policy Committee and National Coordinator on what effects public health agencies might expect on population health as the nation moves toward meaningful use (MU) of certified EHRs.  

The focus of the testimony revolved around two primary questions:  

• What population health effects should public health agencies expect as the nation moves toward meaningful use (MU) of certified EHRs?
• How can governmental public health agencies leverage these MU efforts and investments and the goals of a learning health system to improve population health?  

In addition, the Population Health panelists specifically addressed the following:  

Panel 1:  Achieving population health through meaningful use:  How do governmental public health (PH) agencies view the process to date?  

• What are the current electronic data systems, are they interoperable and do they connect to any EHRs for mandated electronic reporting?
• From your unique jurisdictional view, does your PH agency have the capacity to use the 3 types of data to be sent under Stage 1 meaningful use (MU) criteria in a way that impacts population health?
• What do you perceive as barriers to MU of PH data and information to achieve desired population health outcomes?
• How are governmental public health agencies planning to leverage increasing access to community HIT assets (e.g., EHR data, chronic disease registries and MU criteria) or other ONC efforts (e.g., health information exchange, Regional Extension Centers, nationwide health information network, Beacon communities, Strategic Health IT Advanced Research Projects) to support improved population and public health outcomes? 
• Based on your experience, how is PH working toward a more integrated, enterprise approach to data and information sharing and interoperable infrastructure promoted through MU criteria and measures to support improved population health outcomes?  

Panel 2:  Experiences and current status of MU-like projects:  How do governmental public health agencies use MU-like criteria or measures to achieve population health?  

• What MU-like data and public health applications and/or public health-EHR projects have you developed in your jurisdiction? How do they impact on public health surveillance, care coordination or other essential public health services?
• How might the results of your public health-EHR project inform and be learning opportunities for: 1) other public health jurisdictions, 2) HIT policy development, 3) evaluation of Stage 1 MU criteria, and 4) considerations for Stages 2 and 3 MU criteria?
• What are your next priorities for the described public health-EHR project? 
• What should be logical next steps for MU criteria development?

Panel 3:  Potential areas where the HIT Policy Committee consideration:  Where should the committee focus its attention to support MU measure and criteria that complement the public health mission?  

• What policy, legal and/or technical issues do you perceive as barriers to getting to improved population health outcomes? 
• Are there any specific approaches to data standards, aggregation and/or infrastructure that would help achieve better population health outcomes?
• How should PH contribute to the concept of a learning health system?
• What future state might we envision as public health agencies gain access to population health information to drive improved health outcomes?

Please make your comments on the original FACA blog on the ONC site about these Population Health MU Criteria.

Care Coordination Hearing – August 5, 2010

The Meaningful Use Workgroup’s Care Coordination hearing focused on the specified functionalities beginning in Stage 1 of Meaningful Use, which involves electronically capturing health information, and communicating that information for the coordination of care.  

The Care Coordination panelists specifically addressed the following questions:  

Panel 1:  Current HIT Support of Care Coordination

• What are the key care coordination needs that are being, or could be addressed using health information technology (HIT) today?  
• How has the electronic health record (EHR) supported, or not supported, your medical home to date, and what are potential implications for future meaningful use requirements (e.g., stage 2 or 3)?   

Panel 2:  Transitions and Care Coordination

• What issues and deficiencies in care transitions can be effectively addressed by HIT?  
• How is HIT being used, or will be used, within care to expedite referrals with a team, referrals outside a team, and transitions between settings?  
• How can HIT assist with care coordination in chronic disease management?  

Panel 3:  Care Coordination in the Ambulatory Environment

• What is the evidence for effective use of HIT to support coordination of care in the ambulatory environment? 
• What might EHRs do in the future to assist with care coordination?  
• How can the electronic record help reduce readmission rates, and unnecessary emergency room visits?  
• How do privacy and trust issues affect these areas?

Please make your comments on the original FACA blog on the ONC site about these Care Coordination MU Criteria.