Meaningful Use

There has been a lot of interest in the meaningful use debate surrounding electronic medical records (EMRs) of late, but I read a post by @TedEytan that got me thinking about a different kind of 'meaningful use'. The topic of his post was the differences between mHealth and eHealth, but what really caught my eye was the coined term "Internet's Informant General" (to describe @SusannahFox of Pew Internet). I had not come across the term before and I found it very striking. I have recently been working on a project involving panels of key informants representing their respective countries and the idea of this combined with a 'representative virtual office' like Internet Informant General was oddly compelling for some reason....much more than another in a line of czars (little 'c'). The fact that this office was faux filled by someone on the strength of their research (and ability to communicate/disseminate it) made it even more interesting as an idea.

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The Office of the National Coordinator for Health Information Technology really listens to reasonable comments.  Here is Exhibit A.

One of my comments from the June 16^th round of input was as follows:

Conduct medication administration using bar coding – This objective should not be included until the benefit of bar-code medication administration (BCMA) technology is proven to promote safe and efficient care to patients.  The Committee should consider replacing this 2013 objective with “documenting medication administration with an electronic medication administration record (eMar).” 

Bar-coded medication systems reduce pharmacy dispensing errors.  However, the evidence to date does not suggest that such systems are as effective in reducing administration errors due to design and implementation faults and resulting staff workarounds that mitigate the efficacy of barcoding.  If evidence is produced in the near future to support the claim that BCMA is safe and efficient, this would support the inclusion of BCMA in the 2015 objectives.

The changes they made are:

Meaningful Use Matrix of June 16th

“Conduct medication administration using bar coding”

Changed to:

Matrix of July 16, 2009:

“Conduct closed loop medication management, including eMAR and Computer-assisted administration”.

I just spent more time than I care to admit downloading all of the information on Meaningful Use items just out.  You can download them individually from the HHS site or feel free to use my shared download site.

<a href="http://drop.io/rxinformatics/asset/hit-policy-7-16-09-v2-zip" title="hit-policy-7-16-09-v2-zip">View hit-policy-7-16-09-v2-zip</a> 

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Below are my comments to the Office of the Coordinator for Health Information Technology.    Not intended to be comprehensive, but to supplement the many comments submitted.  I was part of a group the put together comments submitted from Am Soc of Health System Pharmacists, although their statement got a bit watered down to be politically correct.  What say you?  Thanks to Kevin Marvin for tagging the line "Interoperability all the way to the patient".

TO: ONCHIT

Thank you for the opportunity to comment.  I wish to emphasis two points in the definition of meaningful use around the medication use process.

According to this reasonably good blog; an AHRQ exec indicated Meaningful Use will be out on the June 16th. Never has so much been riding on these two words
http://chilmarkresearch.com/2009/06/05/meaningful-use-by-june-16th/