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MEANINGFUL USE

WHAT IS MEANINGFUL USE?

    Meaningful use is the component of the Patient Care and Affordability Act (AKA Obamacare) that mandates the requirements to qualify for full reimbursement from Medicare.   What this means is that in order to qualify you have to have an EHR and use it in a meaningful manner as specified by Health and Human Services. The specific requirements are detailed at CMS.GOV and are too diverse to discuss here so we will only deal with how it effects transcription.

ELECTRONIC HEALTH RECORD (EHR) VS ELECTRONIC MEDICAL RECORD (EMR)

    Obamacare mandates that to receive reimbursement for Medicare Patient Encounters you have to have an EHR.  The name EHR and EMR are often used interchangeably when they are different things.  The primary difference is that an EMR is designed to be used by a single practitioner or group and stores records locally with no outside access available.  Whereas as an EHR is designed to allow remote access of the patient records to other care providers and the patients themselves.  As well  as providing the patient information to Medicare and Centers for Disease Control in a format that allows them to facilitate faster, more accurate reimbursement and manage public health concerns.  Additionally an EMR stores  a patient encounter in a single entry while an EHR stores the patient encounter information in separate sections i.e. SOAP  note.  There are numerous other differences but the gist is that an EMR does not meet Meaningful Use requirements.

MEANINGFUL USE AND TRANSCRIPTION

    There is a misconception that meeting Meaningful Use does not allow the use of dictated reports and that you have to use a Computer Physician Order Entry (CPOE) templated system or combination of CPOE template and voice recognition.  This is not correct.   To meet Meaningful Use the patient encounter information has be broken into specific categories and put into specific sections of the EHR.  This can be accomplished by the information from the transcribed report being manually entered into the appropriate sections or via an Intelligent Interface.

     A good example is the SOAP note format.  This is the most common format in use for non specialty Medical Reports.  SOAP - Subjective, Objective, Assessment and Plan.  A clinician can dictate without changing their manner of dictation and the Medical Transcriptionist then breaks the  report into the appropriate sections (with guidance from the clinician and staff).  Then the report is delivered via Intelligent Interface directly into the appropriate sections based upon the SOAP sections.  This allows the meeting of Meaningful Use requirements without forcing the clinician to change their workflow.  For more information on Intelligent Interfaces see our Intelligent Interfaces.

MEANINGFUL USE AND CPOE TEMPLATED SYSTEMS.

    Center for Medicare Services (CMS) , the branch of HHS responsible for overseeing Medicare, on Dec 10th 2012 updated the Meaningful Use requirements to specify that a purely CPOE templated system i.e. the clinician can only use templates or multiple choice questions to create a report DOES NOT meet Meaningful Use requirements.