Tuesday, April 28, 2009

HIMSS Publishes 'Meaningful Use' Definitions

On Monday, April 27, HIMSS published its definitions of ‘meaningful use of certified EHR technologies,’ as outlined in the American Recovery and Reinvestment Act of 2009 (ARRA). HIMSS sent a cover letter, plus two definitions: 1) meaningful users of certified EHR technologies and 2) meaningful use for hospitals, to the National Coordinator of Health IT and the Acting CMS Commissioner, within the Department of Health and Human Services (HHS)

ARRA calls for multiple years of Medicare incentive payments to hospitals and physicians who meet the requirements of “meaningful use of certified EHR technology” (an electronic health record). To be eligible for the incentive payments, hospitals and physicians must use the technology in a meaningful manner; to exchange electronic health information to improve the quality of care; and, submit clinical quality measures – and other measures – as selected by the Secretary of HHS. Further, hospitals and physicians must meet the definition within a specified time frame, which as described in ARRA, must be made increasingly stringent over time by the Secretary.

Approved by the HIMSS Board of Directors, the definitions resulted from consensus-building effort with input from HIMSS members (73 percent of which work in end-user settings), and the public at-large. HIMSS represents more than 20,000 individual members and 350 corporate members.

In summary, HIMSS recommends the following:
  1. To ensure continuity, recognize CCHIT as the certifying body of EHRs.
  2. To achieve incremental maturation of “meaningful use,” adopt metrics that can be reasonably captured and reported beginning in FY11/2011,* and then made increasingly stringent using intervals of not less than two years. HIMSS’ definitions include specific metrics to enact, in phases, over a multi-year period.
  3. To bridge existing gaps in interoperability of health information, coordinate with HITSP and IHE to create new harmonized standards and implementation guides.
  4. Reconcile the gap between “certified EHR technologies,” “best of breed,” and “open source” technologies.

As noted in the letter, HIMSS believes that the Act has tremendous potential to improve the quality, safety, and cost-effectiveness of patient care.

*ARRA requires the hospital-focused definition to be effective FY11 (October 1, 2010). For meaningful users (physicians), the definition must be effective January1, 2011.


  1. Defining an acceptable HIE and the level of interoperability will be very important.

  2. At Tuesday's opening of a two-day National Committee on Vital and Health Statistics (NCVHS) meeting on "meaningful use," Carolyn Clancy, director of the Agency for Healthcare Research and Quality, said providers should collect information on two to 20 chronic diseases such as diabetes and heart disease to focus on improving outcomes. Though the government has yet to define "meaningful use" under the American Recovery and Reinvestment Act, providers can prepare by gathering data to show they have improved the outcomes of their patients.

    "We crash more often than we need to in healthcare," Clancy said at the NCVHS executive subcommittee hearing on "meaningful use" of health information technology. "We haven't reached a system-based approach where the right thing to do is the easy thing to do."

    Clancy said improving quality will take more than health IT. "If we merely automate what we are doing now, we won't get what we want," she said. Improving healthcare today, she said, will include connecting all the primary care doctors in small practices with a larger learning network for sharing best practices.

    "Meaningful use is a destination and a journey," she added.