What is “Meaningful Use?"

In February 2009,  the American Recovery and Reinvestment Act (ARRA) was signed into law.  ARRA was designed to stimulate the economy and to spend money in areas where the country needed investment. One of those areas was in electronic medical records. It is an indictment on our system in the United States that if a citizen arrives in an emergency department the doctors and nurses don’t have complete access to the patient’s medical information. The U.S. was lagging and still lags behind many industrialized countries in the use of electronic records.

$27 billion was set aside through the Health Information Technology for Economic and Clinical Health Act (HITECH Act.) The legislation was initiated in the belief that expanded meaningful use of healthcare information technology would improve quality, safety and reduce health care costs.

This initiative covers both hospital and provider practices and is widely known as Meaningful Use (MU). Our medical center and our employed physicians (GBMA) are both participating, and we have successfully completed two years of Stage I requirements. We are now working on Stage II, which has significantly raised the bar on the electronic clinical documentation and exchange requirements.

GBMC has been working toward a complete electronic health record for many years, long before Meaningful Use was initiated. One of the requirements, Computerized Physician Order Entry (CPOE) was already in wide use when we started working toward Meaningful Use.  Medication reconciliation (checking to see that the patient’s medication list is correct at every transition in care) is another component of MU that GBMC has successfully implemented.

Stage II focuses on Patient Engagement and clinical information exchange for transitions of care.  GBMC will soon be implementing a patient portal for the hospital to complement the existing practice (GBMA) patient portal, known as myGBMC. The new portal will allow patients to access, view and download information about their inpatient stay or ED visit. Another challenge is providing a Continuity of Care Document (CCD) to the provider to whom the patient is referred or the transfer facility at discharge. This has required mapping over 27,000  test codes, procedures and other medical terms to standards that can be universally accepted by other health information systems, as well as changes to the discharge process, and will require providers to use problem lists.

Creating an effective medical record system requires a lot of design and implementation work but it is necessary to drive us closer to our vision. We cannot deliver the care we want for our own loved ones to everyone without electronic records.

Thanks to all who are working to develop and use the electronic patient record.