FEATURE: Forum stimulates dialogue on meaningful use

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AHRQ Director Carolyn Clancy, MD. Image Source: www.ahrq.gov

Physicians and industry representatives convened in Washington, D.C., this week to discuss the role of health IT as part of healthcare reform, as well as to generate ideas and considerations on the definition of "meaningful use."

In his introductory remarks, David Blumenthal, MD, national coordinator for health information technology, suggested that the definition put forth from the department of health and human services (HHS) this year will shape President Barack Obama's strategy for health IT adoption. He stressed that deciding what health IT functions make up "meaningful use" of EHRs will set the stage for providers and physicians seeking to qualify for health IT funding under the stimulus law.

After Blumenthal's kick-off, key stakeholders gave testimony throughout the two-day meeting spearheded by the National Committee on Vital and Health Statistics executive subcommittee. The conference was broadcast live over the internet.

"Everyone is aware that this is a unique opportunity and it is important to get broad input," said Carolyn Clancy, MD, director of the Agency for Healthcare Research and Quality (AHRQ). Clancy was a member of the first panel discussion on Tuesday.

One recommendation Clancy offered for practices and health systems while the definition is being fleshed out, is the creation of health registries with health IT vendors that will collect information on chronic diseases such as diabetes and heart disease, Clancy said.

The reasoning behind health registries is that the capacity to identify all patients with a given condition would be helpful, particularly in the instance when a drug is taken off the market or a study is published reporting a risk from a particular medication.

"If you had a registry where you could pull up all the patients taking those drugs, you could easily notify them," she said. "It would also be helpful to assess how you are improving quality of care by identifying the people having the most trouble."

For example, for diabetic patients, physicians could monitor how they are controlling the cardiac risk factors. The problem with current commercial records systems is that they don't make that easy. "They were designed to support fee-for-service and payments," she said. Clancy noted during the hearing that claims data obtained from billing systems will be the standard, at least for a while until pulling clinical data from EHRs to meet the meaningful use criteria is worked out.

The executive committee said it is now working to consolidate the two-day testimonies for submission to the Office of the National Coordinator for Health IT for consideration in its rulemaking.

"It is a new moment--it's show time," Clancy said. Given the context of healthcare reform, and a lot of new resources, "now is the time to show the work that has been done."

"But we need to look at right sequence of steps in implementing the provision of the Recovery Act, to make sure we are charting a path to healthcare that is consistently high value, high quality," she concluded.