What is ARRA?

The American Recovery and Reinvestment Act (ARRA), also referred to as the Stimulus Plan came into existence on February 17, 2009 when President Obama passed it as a law. The act sets aside $59 billion for healthcare initiatives, including $19 billion in Healthcare Information Technology (HITECH).

What is HITECH?

This part of the ARRA legislation stands for Health Information Technology for Economic and Clinical Health Act. This act calls for the physicians to earn up to $64,000 in case of Medicaid and $44,000 in case of Medicare over a period of 5 years, if they 'Meaningfully Use' an EHR.

What is Meaningful Use?

ARRA Meaningful Use has become one of the most commonly used expressions in the healthcare industry since 2009. On July 13, 2010, the Centers for Medicare and Medicaid (CMS) announced the final ruling for the EHR Incentive Program based upon Stage 1 of Meaningful Use.

ARRA Meaningful Use is not a destination in itself; instead it is an ongoing process involving the use of EHRs to achieve advanced care coordination and delivery within the following Meaningful Use guidelines:

  • Improve the quality, safety and efficiency of care while reducing inconsistencies.
  • Involve patients and families in their care.
  • Encourage public and population health.
  • Develop and improve care coordination.
  • Promote the privacy and security of EHRs.

Meaningful Use attestation refers to a set of Ambulatory Certification criteria that medical providers must meet in order to prove that they are using their EMR as an effective tool in their practice. There are Ambulatory Clinical Quality Measures additional criteria out of which minimum nine needs to be demonstrated by the medical provider. In total, each provider must complete both Meaningful Use criteria to qualify for stimulus payments during stage one of the EHR incentive program. These criteria's are:

Ambulatory Certification Criteria (170.314) Ambulatory Clinical Quality Measures
(a)
  1. Computerized Provider order Entry
  2. Drug-drug, drug - allergy interaction checks
  3. Demographics
  4. Vital signs, body mass, Index and Growth Charts
  5. Problem List
  6. Medication List
  7. Medication Allergy List
  8. Clinical Decision Support
  9. Electronic Notes
  10. Drug Formulary check
  11. Smoking Status
  12. Image Results
  13. Family Health History
  14. Patient List Creation
  15. Patient - Specific Education Resources
  16. Optional - Computerized Provider Order Entry - Medications
  17. Optional - Computerized Provider Order Entry - Laboratory
  18. Optional - Computerized Provider Order Entry - Diagnostic Imaging

EP_CMS50v3_NQFXXXX_Closing_Referral_Loop

EP_CMS68v4_NQF0419_Current_Meds_Documented

EP_CMS69v3_NQF0421_BMI_and_Follow_Up

EP_CMS122v3_NQF0059_Diab_HbA1c_Ctrl

EP_CMS125v3_NQFXXXX_Breast_Cancer_Screen

EP_CMS127v3_NQF0043_Pneu_Vacc_Status

EP_CMS138v3_NQF0028_PREV_Tobacco

EP_CMS156v3_NQF0022_HighRisk_Med_Elderly

EP_CMS165v3_NQF0018_High_Blood_Pressure

EP_CMS166v4_NQF0052_Low_Back_Pain

(b)
  1. Transitions of care - Receive , Display and incorporate Summary Care Records
  2. Transitions of care - Create and Transmit Transmission of care\referral summaries
  3. Electronic Prescribing
  4. Clinical Information Reconciliation
  5. Incorporate Laboratory Test and values\results
  6. Data Portability
(c)
  1. Clinical Quality Measures - Capture and Export
  2. Clinical Quality Measures - Import and Calculate
  3. Clinical Quality Measures - Electronic Submission
(d)
  1. Authentication, Access Control, and Authorization
  2. Auditable Events and Tamper Resistance
  3. Audit Reports
  4. Amendments
  5. Automatic Log Off
  6. Emergency Access
  7. End User Device Encryption
  8. Integrity
(e)
  1. View download and Transmit to 3rd Party
  2. Clinical Summary
  3. Secure Messaging
(f)
  1. Immunization Information
  2. Transmit to Immunization Registries
  3. Transmission to Public Health Agencies - Syndromic Surveillance
  4. Optional – ambulatory setting only—transmission to public health agencies – syndromic surveillance
(g)
  1. Automated Measure Calculation
  2. Safety Enhanced Design
  3. Quality Management System

A MU attested EMR means that it is adhering to the above set of healthcare quality measures and is aiding the provider towards improved quality, safety, efficiency, care coordination, ensuring privacy and security for personal health information.

What is ONC?

ONC refers to the Office of the National Coordinator for Health Information Technology, also known as ONCHIT. The ONC was founded in 2004 as part of the department of Health and Human Services (HHS), and received a massive boost in funding under the stimulus plan, 2009. The office has been set up to coordinate the implementation and use of health information technology under the EHR incentive plan.