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The Pharmacist’s Guide to Meaningful Use

What is Meaningful Use?

At the legislative level, Meaningful Use(MU) is a proposed rule created by CMS to implement the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA). It establishes criteria to promote the adoption of meaningful use of technology in healthcare. The primary goals are to improve the quality and value of healthcare in the United States through the use of technology such as electronic health records (EHR), computerized provider order entry (CPOE), medication reconciliation tools, and clinical decision support (CDS). It should be noted that as of 3/8/2010, the rule is not final. In addition, there may be incentives from CMS if your organization chooses to implement these criteria. More information on Health Information Technology is available at the CMS website (http://www.cms.hhs.gov/Recovery/11_HealthIT.asp).

Improving quality, safety, efficiency, and reduce health disparities

Objective: Use of CPOE for orders (any type) directly entered by authorizing provider (for example, MD, DO, RN, PA, NP) 
Measure: CPOE is used for at least 10 percent of all orders
The RPh: Implementation of CPOE, building and maintenance of medication orders and order sets to support its use by physicians. This can require a significant number of pharmacy resources that are trained to configure the EHR for use.

Objective: Implement drug-drug, drug-allergy, drug- formulary checks
Measure: The eligible hospital has enabled this functionality.

Meaningful Use from a Pharmacy Perspective
Comments on the Jan 2010 Notice of Proposed Rule Making (NPRM) establishing the Electronic Health Record (EHR) Incentive Program, commonly referred to as the Meaningful Use of an EHR, and the Interim Final Rule (IFR) establishing the Initial Set of Standards, Implementation Specifications and Certification Criteria for EHR Technology.

John Poikonen
UMass Memorial Health Care

Joan Kapusnik-Uner
FirstDataBank

George Robinson
Partners Healthcare

Posted via email from RxDoc.Org

The Office of the National Coordinator for Health Information Technology really listens to reasonable comments.  Here is Exhibit A.

One of my comments from the June 16^th round of input was as follows:

Conduct medication administration using bar coding – This objective should not be included until the benefit of bar-code medication administration (BCMA) technology is proven to promote safe and efficient care to patients.  The Committee should consider replacing this 2013 objective with “documenting medication administration with an electronic medication administration record (eMar).” 

Bar-coded medication systems reduce pharmacy dispensing errors.  However, the evidence to date does not suggest that such systems are as effective in reducing administration errors due to design and implementation faults and resulting staff workarounds that mitigate the efficacy of barcoding.  If evidence is produced in the near future to support the claim that BCMA is safe and efficient, this would support the inclusion of BCMA in the 2015 objectives.

The changes they made are:

Meaningful Use Matrix of June 16th

“Conduct medication administration using bar coding”

Changed to:

Matrix of July 16, 2009:

“Conduct closed loop medication management, including eMAR and Computer-assisted administration”.

I just spent more time than I care to admit downloading all of the information on Meaningful Use items just out.  You can download them individually from the HHS site or feel free to use my shared download site.

<a href="http://drop.io/rxinformatics/asset/hit-policy-7-16-09-v2-zip" title="hit-policy-7-16-09-v2-zip">View hit-policy-7-16-09-v2-zip</a> 

Posted via email from RxDoc.Org

Below are my comments to the Office of the Coordinator for Health Information Technology.    Not intended to be comprehensive, but to supplement the many comments submitted.  I was part of a group the put together comments submitted from Am Soc of Health System Pharmacists, although their statement got a bit watered down to be politically correct.  What say you?  Thanks to Kevin Marvin for tagging the line "Interoperability all the way to the patient".

TO: ONCHIT

Thank you for the opportunity to comment.  I wish to emphasis two points in the definition of meaningful use around the medication use process.

According to this reasonably good blog; an AHRQ exec indicated Meaningful Use will be out on the June 16th. Never has so much been riding on these two words
http://chilmarkresearch.com/2009/06/05/meaningful-use-by-june-16th/