Jan 7, 2011

Wondering About EMR Meaningful Use and How to Get Paid?


I recently received a request to help decipher this thing called "Meaningful Use", which has the health care community all abuzz. It's an incentive program that has been laid out by the federal government to promote the transition from paper medical records to electronic medical records and will pay either $44,000 or $63,750 over a five year period to those who meet certain requirements.

EMR has long been touted as the holy grail of cost containment and was a big part of the federal health care reform debate. Now it's just being touted because going electronic is always better! And after a little research I came across this short description of how quality measures need to be reported from an EMR system (one of several requirement to meet Meaningful Use requirements and get paid). The blurb below is how the Centers for Medicare and Medicare (CMS), who is coordinating the national health IT movement, describes the endeavor. 

Good luck deciphering this one and good luck to all the future 'meaningful users' out there!


Eligible Professional Clinical Quality Measures
Instructions for Reporting Numerators, Denominators & Exclusions

Each clinical quality measure includes specifications for the numerator, denominator and also indicates if there are any exclusions for the measure as described in the measure specifications. Each measure requires reporting one or more numerators and one or more denominators. Although the denominator population may not change for a measure, when there is more than 1 numerator, it is required to report the denominator each time. Conversely, when the denominator population is stratified but there is only 1 numerator in the measure, the numerator must be repeated for each subset of the denominator population. See attached table which depicts the number of numerators and denominators required for reporting. This table also identifies if exclusions may be reported and the field type required for each numerator, denominator and exclusion, if applicable.

The following measures require reporting more than one numerator (NQF Numbers 0064, 0027, 0421, 0024, 0033, 0036, 0038, 0075, 0004, and 0105). If a measure has more than one numerator, than all numerators must be reported and there must also be a denominator reported for each numerator (even if the denominator population remains the same for the measure). Therefore the number of numerators reported will always equal the number of denominators needed for reporting regardless of whether the denominator remains the same for a measure or it changes (e.g., denominator population is stratified by age) and results in more than one denominator for the measure.

(Table not included, but not useful anyway.)