Health IT 'meaningful use' framework proposed

A national vision of  "meaningful use" of health information technology should be linked to outcomes such as reducing by half the number of preventable hospitalizations and medical errors by 2015, according to a framework presented to a federal advisory panel today. That definition will help decide how billions in federal funds for health IT will be distributed.

The federal Health IT Policy Committee began considering a three-tiered structure for defining and setting benchmarks for meaningful use of health IT that was presented by a workgroup of the panel.

Congress set up the committee to help create standards and criteria for health IT adoption and certification under the economic stimulus law. The law allocates $17 billion in incentive payments for doctors and hospitals who buy and meaningfully use electronic health records.

One of the first activities of the policy panel is to define "meaningful use." The panel is advising the Health and Human Services Department's National Coordinator for Health IT; rule-making on meaningful use is expected by year's end.

Under the framework presented today, meaningful use would be a combination of goals for 2011, 2013 and 2015.

The goals would include criteria for data sharing and capture starting in 2011; establishing care processes, which are aimed to achieve desirable population health outcomes, in 2013; and measuring and achieving those outcomes by 2015.

One of the points of the health IT framework was a list of desirable outcomes in population health for 2015, including reducing by a million the number of annual heart attacks and strokes,  improving health so that heart attacks are no longer the leading cause of death, cutting in half the rate of racial and ethnic disparity in diabetes rates, making patient care data available to patients and achieving real-time public health situational awareness based on public health data.

Dr. David Blumenthal, national coordinator for health IT, encouraged the committee to contribute ideas about the outcomes desired for 2015.

"We rarely stop to look at what we could achieve," Blumenthal said. "It requires us to look into the unknown."

Some of the suggested changes are to include outcomes related to a broader range of chronic diseases, women's health issues and children's health concerns. Other panelists suggested a sharper focus on patient involvement and education, on privacy and security of the medical records, and on achieving efficiency in the system.

The workgroup leaders said the proposed framework strikes a balance between meeting urgent needs for change and setting realistic schedules for implementation based on the available technology and how quickly providers can use it.

The framework sets out the principal goal of improving population health. "We want to focus on outcomes, not software," said Dr. Farzad Mostashari, assistant commissioner of the New York City Health Department, and a co-chairman of the workgroup.

Also, health IT's successful adoption will, to some extent, be dependent on the success of broader health care reforms, especially in payment systems, he said.