Born in 2009 as part of the American Recovery and Reinvestment Act (ARRA), the Medicare/Medicaid EHR Incentive Program has forever changed American healthcare. Provided they begin attestation by 2016, eligible professionals can receive up to $63,750 in incentives for adopting and making ‘meaningful use’ of an electronic health records (EHR) software solution.1
As a result of the legislation, the medical software marketplace exploded, seemingly overnight. Whereas there previously had been a handful of companies working on electronic records and related software, now hundreds, even thousands of companies operate in the healthcare IT space, in an ever-increasing number of software categories. There are software solutions for managing just about any and every aspect of your medical practice — billing, practice management, patient engagement, and yes, tracking Meaningful Use attestation.
If you’re just now looking into Meaningful Use (MU), you may have heard it’s too late for you to receive any incentive payments. If you were only eligible for the Medicare version of the EHR Incentive Program, that’s unfortunately — as of 2015 — true. However, if you’re eligible for the Medicaid version of the EHR Incentive Program, you can begin attestation as late as 2016 and still receive the full schedule of incentive payments ($63,750). The Medicaid version of the Meaningful Use Incentive Program is administered by individual state governments, so be sure to check into resources available in your area.
While the specifics of the Meaningful Use Incentive Program — program eligibility, clinical quality measures, payment schedules, reporting, etc. — are extremely complex, at its core, the program is a relatively simple concept: the classic carrot and stick. Providers that treat Medicare or Medicaid patients are incentivized to adopt and use certified EHR software, in three discrete stages, with the aim of capturing a higher quality and quantity of data on population health, better health maintenance, increased health information exchange, and improved health outcomes; to help offset the expense of adoption, providers that can “demonstrate meaningful use” of their software — check all the boxes — are offered a series of incentive payments — the carrot. Eligible providers who fail to begin the process and start checking boxes by 2015 will have their Medicare/Medicaid reimbursements reduced by one percent per year, to a maximum of five percent — the stick.
If you’d like more information on Meaningful Use and the current state of affairs, see our comprehensive Meaningful Use overview.
Defining ‘Meaningful Use Software’ can be tricky, as the term can mean many things to many people.
The most likely scenario is that you’re here because you’re considering a switch in EHR vendors, and you want to do your due diligence before selecting a new EHR/EMR system. You want to make sure that any replacement EHR you select offers the same — or better — functionality than your previous system, supports your selected clinical quality measures (CQMs), is certified as either a modular or complete EHR system, and if it’s modular, that its modules support all the required functionality for successful attestation. Whether you’re attesting for the first time, or you’ve already attested to multiple stages, if you’re looking for Meaningful Use-certified medical software you may be better served by our various medical subcategories tailored to a specific software need:
For the purposes of this buyer’s guide, ‘Meaningful Use Software’ shall be defined as software designed for tracking MU compliance, incentive payments, and/or other Meaningful Use-related information. Usually targeted at hospitals or large physician groups managing Meaningful Use attestation and incentives for hundreds or thousands of physicians, these systems can also be useful for smaller, growing provider groups looking for a scalable solution that lets them standardize MU attestation for each provider and/or location. Furthermore, many of these systems also offer a modicum of protection — they can archive your Meaningful Use documentation for easy retrieval in the event of a Meaningful Use audit.
Besides the aforementioned instance where some have referred to certified EHRs as ‘Meaningful Use Software’, there are two main types of MU software systems:
The first type of Meaningful Use software developed, standalone systems usually can integrate with a wide variety of electronic health records, practice management, hospital information systems, and/or medical billing software, though usually these integration interfaces must be custom-developed, increasing the implementation costs. These systems capture relevant data for the various formulas required for reporting EHR usage, patient engagement, health information exchange, etc. Standalone Meaningful Use systems automatically pull reports and track results, allowing you near real-time information on the status of your various measures, objectives, etc. The data can be organized in myriad ways — by measure, patient, provider, facility, etc. — making it easy to recall information in case of an audit.
As a (usually) lower-cost alternative to standalone tracking systems, EHR vendors are increasingly including a Meaningful Use dashboard, or sub-section of the program that tracks information critical to attesting for core measures and your selected CQMs. Integrated MU tracking may be a better solution than standalone Meaningful Use software, particularly for smaller organizations for whom tracking Meaningful Use eligibility isn’t as complex, and who likely cannot spare the additional expense of yet another medical software solution. Regardless of whether you choose an EHR with integrated MU tracking or a standalone Meaningful Use tracker, your organization will find it easier to reconcile incentive payments and will be better prepared in the case of an audit than if you were relying on an in-house method of cobbled together spreadsheets, electronic forms, paper backups, etc.
When selecting a MU software system, there are a number of considerations that must be made. First, if your EHR provider doesn’toffer an integrated Meaningful Use tracking solution, you may need to purchase a standalone system, or consider a switch in EHR vendors. As the latter choice is unlikely — due to sunk costs, in most situations it would be unwise to switch medical software ecosystems over something so minor — the decision then becomes a choice between a turn-key software purchase, or the development of a custom tracking solution and the additional personnel required in order to do so: health informaticists, software developers, etc. When making the decision between an in-house Meaningful Use software solution or a turn-key system, you’ll need to assess what resources you already have available to you within your organization.
Organization: Mecosta County Medical Center (MCMC)2
Solution: Iatric Systems’ Meaningful Use Manager
Mecosta County Medical Center (MCMC) is a 74-bed acute-care hospital in Michigan. In order to meet its goal of attesting for Meaningful Use in 2012, the hospital’s informatics team looked for a solution that would make it easier to qualify for incentive payments while improving delivery of patient care.
MCMC uses MEDITECH as its Hospital Information System (HIS). The time required to create, run and examine MEDITECH reports to assemble Meaningful Use data would have meant hiring an additional full time employee (FTE) — out of the question for a small facility like MCMC. MCMC chose Iatric Systems’ Meaningful Use Manager™ to automatically extract Meaningful Use data from its HIS, calculate numerators, denominators and percentages and present the results on an easy-to-use dashboard.
When administrators and staff at MCMC started to investigate the requirements for Meaningful Use, they were alarmed at how much time would be needed to build and run MEDITECH reports used to measure compliance.
“We have one NPR report writer who is already very busy. We realized we would probably have to add an FTE just to manage this project. We realized early on that Meaningful Use Manager would provide our best chance at meeting Meaningful Use measures. It’s simple to use, convenient for our core measure owners and a huge time-saver.” — Beth Langenburg, Clinical Informatics Coordinator at Mecosta County Medical Center.
By simplifying Meaningful Use compliance, Meaningful Use Manager allows Mecosta to save their resources for other pressing needs. Having Meaningful Use information readily available was an eye-opener. For example, the usage requirement for CPOE is 30 percent, and the on-screen dashboard showed that Mecosta’s CPOE compliance was in the 60 percent range — a nice surprise. However, Meaningful Use Manager also revealed that the BMI component of Vital Signs Monitoring (Objective 7) was not always captured.
“Nursing wasn’t doing anything wrong; we just weren’t giving them the right assessment tools. Meaningful Use Manager made it very obvious where we had an issue so we could address it.” — Beth Langenburg, Clinical Informatics Coordinator at Mecosta County Medical Center.
Point and click simplicity means that Meaningful Use information is available to anyone who needs it. “It can be used to simply learn about Meaningful Use and view our progress, while directors responsible for individual core measures know how to get behind the scenes,” Beth adds. She brings up another important point about simplicity — in addition to saving time, it helps avoid disruptions. If someone changes departments, Meaningful Use Manager is so easy to use that a new person can take over immediately. This same convenience is also available in the event of an audit, with all results and supporting data available instantly, for any date range.
Beth and her colleagues now have Meaningful Use information at their fingertips — and don’t have to know how to build reports in order to get it. She’s also delighted with the service she gets from Iatric Systems. “When I have a question about Meaningful Use, I have an expert on call. Iatric Systems availability is top notch; it’s another area where they shine over other vendors.” “If we didn’t have Meaningful Use Manager, I’m not sure we could meet our 2012 deadline,” Beth concludes. “I’ve spoken with other hospitals struggling to meet Meaningful Use, and told them they should get Meaningful Use Manager. It’s a real time-saver.”
Iatric Systems’ Meaningful Use Manager was a great fit for Mecosta County Medical Center, but it may not be the best fit for your organization. Assuming your EHR vendor doesn’t offer integrated Meaningful Use tracking, the following standalone systems are among the best options for organizations looking to manage clinical data for the purposes of Meaningful Use reporting:
If you’re considering a switch in EHRs, your options are much greater. The following EHR vendors offer a robust Meaningful Use dashboard, checklist, or some other form of MU tracking module as part of their core system:
Additional expenditures towards health IT systems can be difficult to sell in today’s healthcare environment. Your hospital or physician group has likely already spent a significant amount of money in recent years getting systems up-to-date and personnel trained and used to the new electronic workflows; many hospital administrators, physicians, nurses, and other stakeholders in your organization will hear “new software”, and immediately be against the decision, without knowing a single detail. The following are a few points tailored for the perspectives of various key decision-makers in your organization — you’ll need them on board if you have any hope of success.
Your CFO is likely the most vital — and toughest — person to convince of the importance of the software you’re advocating. They’ll be concerned almost exclusively with the dollars and cents of this decision: how much will it cost, how long will it take to see ROI, what is the ongoing financial liability of the organization — recurring expenses, hidden fees, implementation and/or training expenses, etc. — and how it will impact bottom-line profitability. Any software vendor should be able to help provide you with cost estimates and case studies — like the one above — to help you prepare your argument. Thankfully, the importance of Meaningful Use incentives to most large medical organizations makes it easy to argue for software that helps track compliance and ensure continued payments.
Your hospital administrator or other non-medical executives are concerned primarily with the big picture aspects of your facility; they’ll want to know how much it costs, but more than most, they’ll want to know that the rest of the hospital staff is on board with the decision. You can also point out the archiving capabilities of these systems that protect your organization in case of an audit.
It’s important to note that some smaller hospitals or physician groups may not have a separate CFO and administrator, so in those cases, you’ll need to dive deeply into the financials with your administrator so they know exactly how much money Meaningful Use software can save your organization.
Your CMO is concerned almost exclusively with how this will impact the day-to-day life of your organization’s physicians. As such, he or she should be an easy sell. Meaningful Use software’s automation of compliance tracking means that — when properly implemented and integrated with your organization’s EHR/EMR — your physicians will have less work and reduced responsibility for tracking of objectives/clinical quality measures. Furthermore, the centralization of data means they won’t be responsible for archival of their own Meaningful Use-related metrics.
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If you’d like to know more about any of the Meaningful Use or other medical software solutions in our product database, we’d love to talk to you. Call to speak with one our in-house Technology Advisors for a free consultation on your specific requirements, or use the Product Selection Tool on our website to get a personalized recommendation.