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Understand InfoGard's EHR Certification Process

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InfoGard, an ONC-ATCB authorized Certification Authority, certifies EHR Technology in accordance with the standards and certification criteria established for Meaningful Use. To further understand Meaningful Use, InfoGard has provided an overview of Meaningful Use and certification.

The final rule from the Centers for Medicare and Medicaid Services (CMS) published on July 28, 2010 detailed the requirements requiring Hospitals and Eligible Professionals to demonstrate Meaningful Use. On the same day, the Office of the National Coordinator (ONC) published a companion final rule that describes the standards, specifications, and certification criteria for electronic health records (EHRs) that qualify for the Meaningful Use Program. Together, these two documents make up the basis for the incentive program established under the American Recovery and Reinvestment Act of 2009 (ARRA).

Hospitals and Eligible Professionals qualify for incentives by becoming Meaningful Users of EHRs in the following way:

  • Utilize certified EHR technology;
  • Utilize certified EHR technology in a meaningful way in the delivery of patient care and for the exchange of information
  • Report on clinical quality measures

Hospitals and Eligible Professionals may begin participation in the incentive program January 2011, with the first payments expected to be in May.

Certified EHR Technology

ARRA specifies that a condition of “Meaningful Use” is the adoption of a certified EHR system. The Department of Health and Human Services has established the certification criteria managed by the ONC.

“Certified EHR Technology” as defined in the ONC rule is:

  1. “A Complete EHR that meets the requirements included in the definition of a Qualified EHR and has been tested and certified in accordance with the certification program established by the National Coordinator as having met all applicable certification criteria adopted by the Secretary; or
  2. A combination of EHR Modules in which each constituent EHR module of the combination has been tested and certified in accordance with the certification program established by the National Coordinator as having met all applicable certification criteria adopted by the Secretary, and the resultant combination also meets the requirement included in the definition of a Qualified EHR.“

“Qualified Electronic Health Record (EHR)” is defined as an electronic record of health-related information on an individual that:

  1. Includes patient demographic and clinical health information, such as medical history and problem lists; and has the capacity to:
    1. Provide clinical decision support
    2. Support physician order entry
    3. Capture an query the information relevant to health care quality
    4. Exchange electronic health information with and integrate such information from other sources

A “Meaningful EHR User” is an Eligible Professional or Eligible Hospital who demonstrates Meaningful Use of certified EHR technology in the form and manner consistent with CMS’ standards. Ineligible Professionals are:

  • Hospital based physicians
  • Psychiatric hospitals
  • Rehabilitation hospitals
  • Long term care facilities
  • Home care
  • Hospice care

Meaningful Use Defined

The definition of Meaningful Use consists of a series of criteria designed to meet Congress’ requirements for use of certified EHR technology. The measures are grouped into two categories: health IT functionality and clinical quality measures. Measures in Stage 1 emphasize the importance of establishing functionalities in the electronic record that emphasize continuous quality improvement and ease of information exchange. Stage 1 measures focus on:

  • electronically capturing health information in a structured format, which can then be used to track clinical conditions, and communicating that information for care coordination purposes
  • implementing decision support tools to facilitate disease and medication management
  • using EHRs to engage patients and families
  • reporting clinical quality measures and public health information

It is anticipated that the definition of Meaningful Use will mature over time. In an effort to provide flexibility for Eligible Professionals during Stage 1, the objectives (functionality), measures (how to achieve compliance), corresponding certification criteria (system capabilities), content exchange standards/implementation specifications, and vocabulary standards have been divided into two categories: a “core set” and a “menu set”

The core set represents those measures that must be met by Eligible Professionals, and the menu set consists of those measures where Eligible Professionals can choose five to achieve compliance. The requirements differ for Eligible Professionals versus Eligible Hospitals; however, participants in the program must report both health IT functionality measures and clinical quality measures to demonstrate their Meaningful Use of certified EHR technology.

InfoGard will test and certify EHR systems in accordance with certification criteria defined by the Department of Health and Human Services, i.e., those technical specifications that qualify EHR systems to be certified to support Stage 1 Meaningful Use objectives. The requirements are outlined in the Vendor Application.