How to Demonstrate Meaningful Use: CMS Process Revealed

With the final rules for demonstrating "meaningful use" of certified EHRs now months old, attention has turned to the process by which practices and other providers will actually follow the rules so that they can get paid the hoped-for stimulus dollars.

In government-speak, that's called the "attestation process," and on Tuesday at the HIMSS11 convention in Orlando, the CMS officials who have been building that process unveiled their baby to a packed room.

The "attestation module" - simply a Web-based questionnaire that takes users through the first-stage requirements - seemed remarkably simple to use. No formal documentation is required beyond the mere assertion that enough of the 25 meaningful use elements have been met, though CMS will eventually introduce an auditing program, according to Elizabeth Holland, director of the agency's health IT initiatives group.

Physicians can register for the program now. The attestation module will become available soon, though CMS urges physicians to register for the program now, even if they aren’t ready to meet the requirements (or don’t yet have an EHR system installed), as earlier registration will help speed payment once the attestation is complete.

At stake is the opportunity for practices to collect as much as $44,000 per eligible physician, provided the practices bill at least $24,000 in Medicare-allowable charges in the relevant calendar year. Each physician is eligible for payment individually, but each must demonstrate meaningful use. To be eligible, at least 80 percent of a provider's patients must have records in a certified EHR.

CMS officials noted that the whole purpose of the stimulus money the government has set aside to encourage EHR adoption is to ensure that they are being used in a way that will improve public health and care coordination while ensuring patient privacy. "Meaningful use is the reason we're interested in EHRs," said Travis Boone, a CMS special assistant. "We're not in this to save the trees."

The Stage One requirements include 25 specific measures-15 "core" and 10 "menu" measurements, of which five can be deferred. More information about the specific requirements can be found here and here. And here's a tool that takes you through each requirement, one at a time.

CMS' attestation module simply asks users to declare whether or not they meet each requirement, sometimes with a simple yes/no question. For example, one requirement concerns computerized provider order-entry (CPOE): More than 30 percent of patients who are on at least one medication must have had at least one of their medications ordered via CPOE. The attestation questionnaire simply asks whether that was the case - yes or no.

In other cases the module asks users to input their total number of eligible patients and the number for which the requirement was met. For the requirement that more than 80 percent of eligible have at least one entry in their problem list, or an indication that there are no problems, the module asks the user to input the total number of patients the provider has seen, and the number for which the problem-list measure has been met.

Bob Keaveney is editorial director for Physicians Practice. He can be reached at bob.keaveney@ubm.com.

Check out the rest of our HIMSS 2011 coverage here.