A Guide To Achieving CMS ‘Meaningful Use’ Standards

Jonathan J. Key, DPM, FACFAS

In January 2011, I ventured into solo practice after being in a group practice since completing my residency training in 2004. In group practice, charting was for the most part traditional. I utilized voice dictation very efficiently with pre-set “macros” creating a Word document for each patient visit. The system saved, printed and signed the documents for each visit. The staff placed labs, operative reports, discharge summaries and all other faxes in patient charts. Staff pulled charts and re-filed them each day.

   I thought the time to implement an electronic health record (EHR) and go “paperless” would be perfect with starting a new practice. After all, I would avoid a transition and scanning of paper charts to a paperless electronic system. A second advantage of initiating my new paperless venture was that my patient volume would be lower than before and allow more time to concentrate on the implementation of the EHR.

   I asked around for some recommendations from colleagues about their likes and dislikes with the software they were using. After several webinars and demonstrations, I decided upon the CareTracker product offered by Ingenix. Ingenix offered an incentive program with reference to payment, which was attractive, especially with me starting a new practice. My start-up cost and monthly fees were not due to Ingenix until I successfully met “Meaningful Use” and received the first year $18,000 (Medicare) financial incentive from the Centers for Medicaid and Medicare Services (CMS). The CMS financial incentive payments differ depending on which program one decides to participate in. Ingenix sets up clients with a bank that offers a no interest loan to pay the start-up and monthly fees until the practice receives the incentive check after successfully meeting Meaningful Use.

   I thought it was a no-brainer and signed up. The software offered by Ingenix included practice management and EHR components that communicate seamlessly. After little debate from my practice manager, who also participated in the webinars and demonstrations, the deal was done.

What Is Meaningful Use?

I soon learned the two words, Meaningful Use, were more than just using an EHR to chart patient visits. I was well aware there was an EHR incentive program offered by CMS with using a certified EHR technology but otherwise did not know anything beyond that tidbit of knowledge. How quickly I would learn.

   Meaningful Use has three main components:
• using a certified EHR in a meaningful manner like e-prescribing;
• using certified EHR technology for electronic exchange of health information to improve quality of healthcare; and
• using certified EHR technology to submit clinical quality and other measures.

   The CMS website (http://go.cms.gov/hq2zGp ) states: “Simply put, ‘meaningful use’ means providers need to show they’re using certified EHR technology in ways that can be measured significantly in quality and in quantity.”

   I thought even better than CMS saying this was “simple” was the fact that in 2011 and/or 2012, practices only had to meet Meaningful Use for 90 days. This sounded easy enough so I was off and running. I had a new practice, new EHR and practice management software that my staff and I were learning at breakneck speed, and an amazing implementation specialist.

   I was soon introduced to the 25 Meaningful Use objectives. I learned about “core set” objectives, “menu set” objectives, numerators and denominators. The CMS has devised 15 required core objectives while practices may choose the remaining five objectives from a list of 10 menu set objectives.

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