The term "meaningful user" sounds like government-speak gone mad, but those in the healthcare information technology (HIT) industry will have to "get used to it," as was made clear during a session at last month's World Health Care Congress. Those who wondered how that phrase would be defined now have a starting point of sorts provided courtesy of the Healthcare Information and Management Systems Society (HIMSS; Chicago).
HIMSS published two documents last week defining the term for hospitals and non-hospital users. Among the recommendations the documents make is that the Department of Health and Human Services adopt the Certified Commission for Healthcare Information Technology (CCHIT; also Chicago) "as the certifying body" for electronic health records (EHRs), which HIMSS justifies thanks to CCHIT's "demonstrated long-term commitment to an open and transparent process," among other reasons.
HIMSS set up a series of milestones for healthcare providers that the documents recommend should take no longer than two years each to achieve. The first metric, which would commence in 2011, would entail tying together all clinical data systems and linking them to patient accounting systems. HIMSS also recommends for this two-year period that clinical observations be computerized and available to all users throughout the provider entity.
For phase II, which would commence in 2013, HIMSS suggests that "at least 51% of all medical orders are electronically entered" and that all provider prescribing be linked to pharmacies outside the hospital.
As for phase III (2015 as a start date), HIMSS suggests that hospital providers enter 85% of all medical orders into IT systems with the observation that "setting a requirement of 100% is both unrealistic and unachievable." The document for other providers sets a parallel set of standards.
As for why anyone should care about the definition of meaningful user, it's because of the greatest behavior modification tool of all time: money. The federal spending for HIT that is now only trickling – but which will soon begin to gush – will not go to entities that are not certified as "meaningful users."
Blumenthal names committees
David Blumenthal, MD, who holds the post of the national coordinator for healthcare information technology, last week announced the names of those who will sit on two boards that will heavily influence the course of the government's HIT program.
Blumenthal said his office is "totally focused on implementing the President's agenda" for HIT, and that "my personal experience as a physician for many years" validated the power of HIT. He also remarked that his use of HIT "totally transformed my work" and "prevented me from prescribing duplicative testing" and from writing inappropriate prescriptions.
Blumenthal stated that the two committees in question, the Health IT Policy Committee and Health IT Standards Committee, will be more than up to their respective tasks, remarking that the government is "very fortunate to have very distinguished and knowledgeable people" for the panels.
The policy committee will feature Blumenthal and Michael Klag, MD, the dean of the Bloomberg School of Public Health at Johns Hopkins University (Baltimore). Among the members of the standards committee are Jonathan Perlin, MD, chairman of Healthcare Corporation of America (Nashville, Tennessee), John Halamka, MD, chief information officer at Harvard Medical School (Boston), and Dixie Baker, PhD, of government IT contractor Science Applications International (San Diego).
Regarding the phrase "meaningful user," Blumenthal said "those two words are key to the success of the policy over the next few years," but that no definition has been set in stone, although a set of definitions has been offered by the Chicago-based Healthcare Information and Management Systems Society. Blumenthal noted, "We hope to provide a direction as to some specification in late spring or early summer."