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Meaningful Use of Electronic Health Records and ADPH

The American Recovery and Reinvestment Act of 2009 (ARRA) enacted the Health Information Technology for Economic and Clinical Health (HITECH) Act to accelerate the adoption of health information technology.  The ARRA offers incentives to eligible providers and hospitals to adopt health information technology and use it in a “meaningful” way.  Meaningful Use is defined in a specific way, requiring fifteen "core" and ten "menu" criteria.  Of the ten menu options, three require reporting to public health:

  • Submit electronic data to public health immunization registries/systems.
  • Provide electronic submission of reportable lab results to public health agencies
  • Provide electronic syndromic surveillance data to public health agencies

In August 2012, the Health and Human Services Centers for Medicare and Medicaid Services published Meaningful Use Stage 2 (MU2) rules. MU2 mandates all providers to implement electronic reporting through the use of acceptable health information technology and use such reporting to support the MU policy priorities by the defined time period, regardless of what MU phase the provider is in during this time period. Meaningful use attestation, in a health information technology (HIT) context, is a process that documents that an organization or individual has successfully demonstrated meaningful use and is successfully fulfilling the requirements for electronic health records (EHR) and related technology.

In general, attestation is the process of validating that something is true. A healthcare organization must demonstrate meaningful use in order to be eligible for payments from the federal government under either the Medicare or Medicaid EHR incentive program. The Office of the National Coordinator for Health IT along with the Center for Medicare and Medicaid Services have compiled a list of Electronic Health Record products used for the attestation of meaningful use under the CMS Medicare and Medicaid EHR Incentive Program. According to the provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, organizations eligible for the Medicare EHR incentive program must attest to meaningful use by 2014 to be eligible for EHR incentive payments. Providers must attest to meaningful use stage 1 for two years before moving onto stage 2, and attest to stage 2 for two years before tackling stage 3. The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) establish all criteria. Those eligible for the Medicaid program must demonstrate meaningful use by 2016 to receive payment.

Alabama Department of Public Health Declaration of Readiness

Additionally, MU2 increased objective requirements for both eligible providers and hospitals.

  • Eligible Professionals (EPs) must complete 17 core objectives and 3 of 6 menu objectives to obtain incentive credits. New menu objectives have been added for EPs. These optional objectives are described as: the reporting of cancer cases to the public health agencies, syndromic surveillance reporting, and the reporting of cases to other specialized registries.
  • Eligible Hospitals (EHs) must complete 16 core objectives and 3 of 6 menu objectives. EHS may qualify for exclusions for MU.

ADPH is working with providers, hospitals, and electronic health record (EHR) vendors to accept immunization data, electronic laboratory reports for notifiable diseases and conditions, and syndromic data in a meaningful manner to improve public health. ADPH will work with vendors and hospitals after they have obtained EHR certification.  It is important providers select an EHR company that meets HL7 messaging standards and the federally mandated vocabulary standards for Immunizations, electronic lab reporting, and syndromic surveillance.  ADPH accepts HL7 version 2.3.1,  2.5.1 and CDA format (cancer reporting only).

In order for this process to be effective, the following steps need to occur:

  • Vendors obtain EHR certification using the Office of National Coordinator’s (ONC) process.
  • Vendors, hospitals, and providers register with ADPH on the Security Portal.  First-time registers will need to do the following:
  • Select "New User" and complete the information
  • Select the check box beside "ADPH Meaningful Use"
  • Scroll to the bottom of the page and submit the information to ADPH
  • Bookmark or save the link to the ADPH Security Portal for future access
  • · New users will receive two emails during part one of the registration process: email validation request and notification that an application role has been assigned. ADPH will notify new users with a user name and password via email.
  • Enter this access information into the ADPH Security Portal to enter the ADPH Meaningful Use site. New users are required to provide profile information and click the “Add Registration” button before having full access to the Website.  The Website will guide vendors and hospitals to organizational/ technical information and provide a way to exchange necessary documentation such as trading partner agreements, memoranda of understanding, and implementation guides.
  • Vendors and hospitals will send test data to be validated.
  • Once the message is validated by ADPH in the test environment, data may proceed to production.

Certified EHR technology assures users that the EHR system or module offers the necessary technological capability, functionality, and security to meet Meaningful Use criteria.  Certification also ensures that patient data may be shared with other systems confidentially.  For more information about which EHR systems and modules are certified for the Medicare and Medicaid EHR Incentive Programs, visit The Office of the National Coordinator for Health Information Technology Certification Programs.

For more information on how ADPH will work with EHRs, click on the following links:

Additional Resources

For more information from ADPH, send an email to MeaningfulUse@adph.state.al.us.

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