ONC Releases “Meaningful Use” Draft Definition

ONC released a draft definition for the “meaningful use” of EHRs today, prepared by a workgroup of the Health IT Policy Committee.

The definition will in part determine which providers are eligible to receive incentive payments for the use of health IT under the American Recovery and Reinvestment Act. Providers who are “meaningful users” of health IT can receive up to $44,000 in increased Medicare and Medicaid payments over five years.

Public comments are due June 26.

The proposed definition features a series of evolving objectives and measures for 2011, 2013, and 2015. The objectives are keyed to five healthcare outcomes policy priorities identified in a 2008 report from the National Priorities Partnership, convened by the National Quality Forum.

The workgroup recommends meaningful use support the following five goals:

  • Improve quality, safety, efficiency, and reduce health disparities
  • Engage patients and families
  • Improve care coordination
  • Improve population and public health
  • Ensure adequate privacy and security protections for personal health information

The policy committee workgroup highlights several aspects of the proposal for feedback in particular. In a preamble to the draft, it writes:

“We seek specific stakeholder feedback on whether the recommended timeline of requirements is overly aggressive based on the current state of technology and the demands on new provider workflows, or not challenging enough to result in significant transformation, in light of the declining level of Medicare incentives in future years.”

The draft recommends that the definition of meaningful use vary by setting. Thus “some features and capabilities will be recommended as required in an ambulatory setting before similar functions are expected to be widely used in the hospital.”

The group also singles out measures reporting for feedback, noting that there are currently “considerable gaps in EHR-generated measures available to monitor key desired policy outcomes.”

The workgroup’s proposal will not be the final word on meaningful use. In fact, it won’t be its own final word—the group has already been asked to present revisions at the full committee’s next meeting on July 16. Ultimately ONC and the Centers for Medicare and Medicaid Services will weigh a range of input and develop a proposed rule later this year. That proposal will be open for public comment for 60 days.

updated June 17


  1. We are an ambulatory care facility on a college campus, that serves the student population and the community. We accept all insurance except for Medicaid and Medicare. Will we be eligible to receive incentive payments under the American Recovery and Investment Act? We are currently a paper medical record and moving towards electronic medical record.

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  2. It appears that incentives will not be made available to long term care provers and nursing facilities that are utilizing EHRs according to the definitions. Is AHIMA advocating for these providers? Is there any recognition of the need for these providers to also be able to obtain these financial incentives? LTC providers, especially county owned facilities struggle with adequate reimbursement from Medicaid and often do not have the extra funds available to invest in EHR. Thank you

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  3. As the HIM consultant in the long term care sections of continuing care retirement communities (CCRCs), I am also interested in a response to Lori Gjertsen’s question and concerns. Would appreciate AHIMA’S thoughts on this. I also wonder how many others in the LTC sector have similar concerns. Thank you.
    Dee-Dee Ritter, RHIT

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  4. I don’t believe that Behavioral Health centers are eligible for incentives, either. Do you know if there is any discussion to change this decision.

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  5. I also work in LTC and am interested in a response to Lori’s question. We have paper records at the present and as stated funds for an EHR would be difficult to obtain.
    Thank you.

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  6. I think all of your comments reflect a common thread – what is the plan for healthcare organizations that fit outside of hospitals and physician offices? In talking with ONC staff they are focusing on only hospitals and physician practices because the law limits incentive payments to just those two areas. One course of action is to submit comments to your Congressman regarding the narrow scope. Ultimately, hospitals and physicians will have difficulty achieving meaningful use of EHRs if the rest of healthcare isn’t equally as connected.

    Since a number of comments were directed at LTC I wanted to speak directly to our activities. AHIMA is a participant on a collaborative of LTC and Post Acute associations (AHCA, AAHSA, NAHC, AMDA, NASL, etc.) to advocate for HIT. The collaborative has been pushing the LTC agenda and has been meeting/commenting on the issues you raised. Unfortunately, the focus of the law on physicians and hospitals has made it difficult, but we are pointing out the huge number of patients and the high costs (third most costly for the US government) and the criticality of interoperability to include LTC and post acute settings.

    Your comments and feedback to your Congressman, ONC and others will help to keep LTC and the other settings mentioned in the posts above on the radar screen. Keep advocating!!

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