The Health IT Policy Committee, which makes recommendations to the National Coordinator for Health Information Technology (HIT) on policy development for a nationwide health information infrastructure, held a public meeting of workgroups on issues of HIT infrastructure. One of the most anticipated issues is a definition of the term "meaningful use."

The recent American Recovery and Reinvestment Act's inclusion of reimbursement incentives (by Medicare and Medicaid) for physician and hospital providers who become "meaningful users" of Electronic Health Records has led to much speculation as to what will be required for "meaningful use." The other two issues under advisement are Certification/Adoption and Information Exchange.

The U.S. Department of Health and Human Services says the meeting is a "first step" for the department in investigating possible definitions for meaningful use. "We are moving fast to achieve the President's goal to improve the health and well-being of every American through the on-going use of health information technology," stated HHS' National Coordinator for Health Information Technology David Blumenthal, M.D., M.P.P. in an HHS press release. "The work of the policy committee is a first step toward assuring that technology -- the electronic health record -- is used in a meaningful way to provide better patient care."

No Formal Definition Yet

Currently, there is no formal definition of meaningful use. The workgroup concerned with meaningful use presented initial recommendations of what should be required by 2011 when the incentive reimbursement commences. Revised recommendations should be presented within the coming months.

The workgroup's initial recommendations of meaningful use include the goal of electronically capturing and reporting in coded format health information, and to use the information to track key clinical conditions. Specific recommendations for 2011 meaningful use goals include:

--To use computerized physician order entry for all order types including medications
--To implement drug-allergy, drug‐[<2010>]formulary checks
--To generate and transmit permissible prescriptions electronically
--To maintain active medications and medication allergy lists
--To record patient primary language, insurance information, and demographics (race, gender, ethnicity)
--To record vital signs
--To incorporate the most recent lab results into an electronic health record (EHR)
--To record clinical documentation in an EHR
--To manage chronic conditions using patient lists and decision support
--To provide clinical decision support at the point of care
--To report to external disease (e.g., cancer) or device registries
--To conduct medication administration using bar coding
--To send reminders to patients per patient preference for preventive /follow up care
--To document a progress note for each encounter

The full Matrix of recommendations is available on the website http://healthit.hhs.gov. The Office of the National Coordinator for Health Information Technology is now seeking public commentary on the preliminary definition, by email or written remarks. The website says that the comments on Meaningful Use are due by June 26, 2009, and should be no longer than 1000 words.

Electronic responses are preferred and should be addressed to: MeaningfulUse@hhs.gov with the subject line "Meaningful Use."

Written comments may be submitted to:
Office of the National Coordinator for Health Information Technology
200 Independence Ave, SW
Suite 729D
Washington, DC 20201
Attention: HIT Policy Committee Meaningful Use Comments

This report is based upon the documents on the Office of the National Coordinator for HIT Policy Advisory Committee's website, and a HHS press release.

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