“Market pressure is expected to become relatively extreme as CMS plans to publish lists of Meaningful Users. There will be multiple private insurers who will only work with Meaningful Users,” Dr. Warren said. The goal of Meaningful Use is to collect structured data on patients, including information like medications, allergies, or smoking status, and to use that data to support and coordinate patient care, he noted. “Are you going to focus your practice on care improvement by implementing Meaningful Use and implementing feasible processes? You can get incentives and avoid penalties by doing one or both. Every certified electronic health record system ought to make this relatively easy.”
You Might Also Like
Also By This Author
During Stage One, physicians are required report only three out of six clinical quality measures, such as blood-pressure measurement, tobacco-use assessment and cessation intervention, and adult weight screening and follow-up, said Dr. Warren. “Rheumatologists are feeling the pain because none of the additional clinical quality measures have specific relevance to rheumatology,” he noted. However, rheumatologists might choose to track measures that are meaningful for their practices and their patients and are easy to achieve. One example: preventive care and screening for influenza. The disease can be dangerous for people with autoimmune diseases, and CMS counts screenings for all patients six months or older toward reporting goals. Providers may report measures through either attestation or eReporting pilots.
“All CMS really wants to know now is that you got the data, not that you are showing valuable outcomes. In Stage One, it’s not about performance,” Dr. Warren said. In Meaningful Use Stage Two, standards will become more complex: Providers will have to report on nine of 64 approved measures.
Rheumatologists who have not yet adapted their practices will have a tough time getting the full $44,000 incentive for 2013 because they must achieve a 365-day reporting period, Dr. Warren said. If a practice has not yet made the switch, it may be wise to sign on next year in time for Stage Two, which will require only a 90-day reporting period in 2014, he said.
Not all practices that have installed EHRs have achieved Meaningful Use, said Craig Carson, MD, a rheumatologist at the Oklahoma Arthritis Center in Edmond, Okla., who shared his experiences. His six-provider practice handled 14,311 patient visits in 2011 and has used electronic systems since 2006.
Dr. Carson spoke highly of the benefits of electronic prescribing and clinical lab-test results recordkeeping but pointed out that the systems have their pitfalls. One is matching patient demographics to set definitions provided by the government. Another is tracking other measures that don’t seem relevant, he said. “The government’s idea of meaningful may not match what you or I see as meaningful,” he added. However, it’s important to enter data so a practice may get credit for their work, achieve incentives, and avoid future penalties, Dr. Carson stressed.