As Electronic Medical Records (EMRs), Electronic Health Records (EHRs) and Electronic Prescribing (e-Rx) become increasingly important channels for communicating with healthcare providers (HCPs) and patients, pharmaceutical marketers are beginning to ask about some of the terminology used to describe these systems. I plan to go into detail about several of these terms in the coming months, and wanted to start that dialogue with two of the most asked about and important terms a pharmaceutical marketer needs to know: EHR Certification and Meaningful Use. These two items are part of the foundational knowledge you need to have when creating digital, HCP and patient engagement marketing plans.
Who Grants This Certification?
Before we talk about EHR certification, we need to understand who is granting this certification. EHRs are certified by an organization that is part of the U.S. Department of Health and Human Services, called the Office of the National Coordinator for Health Information Technology. That’s quite a mouthful, so the industry simply refers to this group as “the ONC.” And while the ONC is the certifying arm of the government, the actual process of certification is outsourced to six different organizations known as ONC-Authorized Testing and Certification Bodies. But the important thing to know is that EHR certification ultimately comes from the U.S. government.
Why Would An EHR Need To Be Certified?
As you may be aware, the federal government has made it very attractive for HCPs and hospitals to adopt electronic health records by offering incentive payments that can be as high as $63,750 to an HCP and in the millions for a hospital. However, an HCP or hospital can only qualify for these incentive payments if they use a certified EHR, so certification is a very big deal!
I should also point out that certification can apply to both “complete EHRs” and to “EHR Modules.” A complete EHR wraps all the necessary EHR components into a single package, from a single vendor, sort of like using only the software packages that came with your computer to browse the web, create documents and perform other functions. But many HCPs and hospitals prefer to select specific EHR components from a variety of suppliers based on what they see as the best solutions for their needs, much like the person who chooses to use a different browser and antivirus package than the ones that came with their computer. EHRs created in this way are called “Modular EHRs.” Both types of systems can become certified, and both are in widespread use today.
Certified To Do What? The Meaning of Meaningful Use
Whether you are just starting to learn about EHRs or are an industry expert, you will definitely hear the term “Meaningful Use” used with great frequency. But what does the term actually mean? According to the U.S. government’s HealthIT.gov website, Meaningful Use is “the set of standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs that govern the use of electronic health records and allow eligible providers and hospitals to earn incentive payments by meeting specific criteria.” That’s an official government definition, but in plain English, Meaningful Use is simply the set of objective criteria that demonstrates that an HCP or hospital is using their EHR system to actively manage the way they treat and interact with patients and, in general, manage certain predefined activities as a healthcare provider.
There are volumes written about Meaningful Use, but the key thing to understand is that in order to achieve Meaningful Use, eligible providers and hospitals must adopt certified EHR technology and use it to achieve specific objectives defined by the government.
Those specific objectives are being phased in over the course of several years. This phased-in approach currently has three stages, and the first of these (Stage 1) began in 2011. In Stage 1, providers and hospitals were asked to focus on the process of data capture and data sharing. I’ll talk more about these terms in a future column, but the most important thing for a pharmaceutical marketer to know is that the government explicitly listed “Using information to engage patients and their families in their care” as one of the items that providers and hospitals should focus on. Thus, programs that a pharmaceutical brand sponsors in this area can actually help a provider or hospital meet their Meaningful Use criteria.
The industry is now focused on Meaningful Use Stage 2 criteria, which begins in 2014. This stage “ups the ante” for HCPs and hospitals. There is a greater focus on using EHR systems to “advance clinical processes” in MU2 (as it is often abbreviated), and this stage has increased requirements for e-prescribing and incorporating lab results into the EHR. There is also an expectation of greater provider-patient engagement at this stage. Again, working with EHR systems that offer advanced patient communications platforms means a system is much more valuable to a provider because it can help them meet Meaningful Use criteria and gain their EHR incentive payments for Meaningful Use.
Stage 3 criteria will begin in 2016, and is still being developed. But the government has already noted that at this stage they expect to see EHRs being used to actually improve patient outcomes, and we can expect measurement criteria that focus on this as well.
The Bottom Line
The key thing to remember is that certified EHRs give an HCP or hospital the opportunity to earn Meaningful Use incentive payments, while those lacking certification do not. Working with a supplier that has obtained Meaningful Use certification means that your programs are more likely be part of a growing, well-designed and tested system that the provider or hospital sees as a valuable tool for patient management and engagement.