Meaningful Use Matrix from HIT Policy Committee

As I first looked over the meaningful use matrix (PDF) that was created by the HIT policy committee I thought that the requirements listed were reasonable and doable. Then, I realized that I was only looking at the first page of a seven page document.

For now, I’ve focused on looking at the 2011 objectives. I wanted to really focus on it since that’s the bar with the most stringent timeline for those wanting to get the EHR stimulus money from ARRA.

I’ll talk in more detail about the various items in a future post. However, as I look through the list of objectives to show meaningful use for 2011, I don’t think any of them sound unreasonable. On their own, each objective listed seems to be something that is completely doable. I might question why some are on the list, but I don’t see any of them individually as too much to accomplish in that time frame.

The problem is that the 22 meaningful use 2011 objectives as a collective whole would be daunting for any practice. I previously wrote about the challenge hospitals face implementing an EHR quickly, but I think this list of objectives would be hard for a practice of any size. I guess some of the reporting could be centralized for a hospital system and save them some time. For a small office, they’d have to do all the reporting themselves and that could be time consuming. No wonder David Blumenthal, ONC head, sent the meaningful use matrix back to the HIT Policy Committee.

I see two other major problems I see with the meaningful use matrix. First, some of the requirements don’t even have established standards yet. Sure, it’s a nice concept to say that doctors should have to “exchange key clinical information.” That’s kind of one of the points of the legislation. Unfortunately, we don’t have any real established standard for sharing key clinical information between providers. CCR seems to have some merit, but is far from becoming THE standard for sharing clinical information. Seems like we’re getting cart before the horse when we ask people to do something for which there is no established and recognized standard.

Second, how is HHS/ONC going to measure accomplishment of these objectives? There not going to go around to each clinic to verify that they actually have an “active medication list” or that they “incorporate lab results in the EHR.” Maybe it’s just the practical side of me. It’s nice to have these objectives, but if we don’t have a way to meaningfully measure that the objectives are being accomplished then it will be abused. I think ONC and HHS might be responsible for deciding how to do this, but I think it would be naive of the HIT policy committee to make these recommendations without good ways to measure them.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

11 Comments

  • The “meaningful use matrix” is a starting place that tries to take the overall policy goals and apply them. They are not the final specification, but instead represent guidelines for creating Certification Criteria for EHRs (the next step in the process). My hope is that the Certificaiton Criteria that will come from these Objectives will be a better set than the ones currently being used by CCHIT (which number nearly 500 line-items). See my blog post on this.

  • Dr. Rowley,
    No doubt there just a guideline, but that doesn’t mean that they shouldn’t seriously consider the implications of their guidelines on the final product. As the matrix currently stands, they could have 500 line items to achieve their goals. Luckily, they’re going through the revision process.

  • Today Mr. Leavitt, in an angry editorial response in The Health Care Blog6 wrote about his feelings about non-certified EMRs, his political enemies, and especially about Dr. Kibbe:

    About non-certified EMRs—“Perhaps they want to bypass the challenge of supplying robust electronic health records and re-educating clinicians to use them meaningfully in transforming care, and just get unfettered access to some stimulus dough.”

    According to Mr. Leavitt we need to be RE-EDUCATED to use EMRs in a meaningful way (probably the way HE defines meaningful).

    I think this is a critical problem with Mr. Leavitt (and the BIG EMR companies and BIG Government (or BIG BROTHER). He thinks that computer programmers and corporate executives NEED to teach doctors how to practice medicine and document their care. Mr. Leavitt thinks that it is more important for doctors to use EMRs meaningfully (his definition which COULD be wrong) even if it means distracting from patient care and adding hours to each doctor’s work day without compensation.

    Mr. Leavitt seems to be the worse possible person to be in charge of certifying EMRs!

    We have a big problem here!!!! Houston, we have a problem …

  • It came from Alberto Borges, MD Blog on mdng:

    http://www.hcplive.com/mdnglive/The_HIT_Realist/Kibbe_Leavitt

    The Kibbe/Leavitt Rumble in the High Tech Jungle!
    Wednesday, May 27, 2009

    Since CCHIT first came onto the scene back in 2006, we’ve usually read numerous partisan rants about the issues of HIT/CCHIT/HIMSS, with an occasional major clash among those of us mere mortals with a strong interest in the matter. Not often do we hear of a heated personal interchange involving two of the best-known experts in the field.

    click this link for more: http://www.hcplive.com/mdnglive/The_HIT_Realist/Kibbe_Leavitt

  • Probably the only thing the goverment does well is to regulate and create a level playing field.

    It is funny that in the case of the EMRs, the government has outsourced the regulating to the big EMR companies via their evil stepchild (CCHIT).

    Through this organization, the big companies can effectively freeze out most of the competition … and innovation … and thereby split up the pie amoungst themselves. In the process they will ruin healthcare while they make “a buck”! Dr. Levitt is a doctor but he sounds like a politician who has been caught with his mistress! He sounds like a CEO who has been caught taking million dollar trips for personal reasons.

    I might act like him if I could make hundreds of thousands of dollars per year by going to lunch (and playing golf) with the “big boys” instead of seeing 30 patients per day, sweating it out in the trenches and earning just enough to support the family and make payroll.

    Dr. Leavitt YOU should be ashamed of youself!

  • Yep, Al is referencing the link I listed above.

    No doubt there’s some serious issues with CCHIT. If they are a non-profit who is about the common good of getting EHR adoption and what’s best for the world, then you have to question some of the decisions they make, no? I can feel another blog post about this subject coming.

  • Great discussion.

    I recently learned that in amongst the ARRA language was a change to the HIPAA laws that raised the fines for violations from a max of $25,000 to $1.5MM. In addition HHS now has the statutory mandate to investigate violations. Further, State attorneys general can now bring suit against both covered entities and their business associates when a HIPAA violation occurs.

    Is anyone else concerned by this???

    Seems to me that this EHR grant money is coming with the same types of strings the government attached to the TARP money.

  • Scott,
    The difference here is that these new measures will apply to you whether you get the ARRA EHR Stimulus money or not. I think generally it’s good to put some teeth into HIPAA since there was no enforcement before. We’ll see if I eat my words down the road.

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