Healthcare Economy

Hospitals will also receive substantial bonuses for meaningful EHR use. A $2 million base payment + their incentives will depend on a formula that includes the number of discharges, the number of inpatient days for Medicare patients, and total inpatient days and hospital charges. Hospitals that don’t adopt will lose a portion of their annual Medicare payment raises.
There are 800,000 clinicians in the US. 17% have EHRs today. This leaves 664,000 who need EHRs. Over the next 5 years the early to mid-adopters will work hard to gain the full stimulus incentive amounts available in 2011-2012. Late adopters will gain the reduced stimulus available in 2013-2014. Resistors will begin receiving penalties in 2015.
The caveat here is that there’s little funding available to acquire the technology and there are two major decisions which the EHR and healthcare world are waiting to learn about: What will be defined as a “certified EHR?” and how will they measure “meaningful use?”
However the broader consensus is that congress apparently sees health information technology(HIT) as a means of improving the quality of healthcare, the health of populations, ease information sharing and the efficiency of health care systems. With this as the goal, meaningful use of EHR would includes showcasing effective use of following to improve the quality of care and outcome.
1. Health care information exchange and Interoperability
Through health care information exchange and interoperability, clinicians everywhere can have a longitudinal medical record with full information about each patient. Patients will have better information about their health status. They can move more easily between and among clinicians without fear of their information being lost. Payers can benefit from the economic efficiencies, fewer errors, and reduced duplication around clinical procedures. Without interoperability, health information will remain in proprietary silos, in which the health care enterprise hopes to gain comparative advantage by imposing high costs on patient switchover and by exercising market leverage over small-niche players such as solo physicians and community hospitals.
2. CPOE & CDSS :
Improving patient safety is the real intent of CPOE. With CPOE, physicians enter orders directly, eliminating clerical intervention along with transcription errors.The CPOE system allows real-time patient identification, drug dose recommendations; adverse drug reaction reviews, and checks on allergies and test or treatment conflicts. Moreover the physician orders are standardized across the organization.

3. Reporting around quality measures:
Electronic exchange of quality measures including process and outcome metrics. Population health data sets submitted to public health departments, and other government agencies.
4. Other:
Tools that support the choice of therapy , that bring evidence-based guidelines to the point of care, that help disseminate best practice, tools that detect HAI in real time and allow for prompt intervention, and tools that allow for monitoring and tracking one's outcomes

What will be defined as a “certified EHR?”
The EHR would be certified by some entity similar to the Certification Commission for Health Information Technology (CCHIT) guidelines. The guidelines will be similar to what is used during CCHIT certification of an EHR.
To Conclude:
It seems intentional that the “meaningful use” and “certified EHR" is not defined by the congress yet and is awaiting for reactions from the healthcare community both big (Hospitals, Payers) and small (Physician practice). Each year, the definition of meaningful use will be expanded, setting the bar higher and requiring more features and more data exchange. I do not believe clinicians should wait for all the details before investing. They should begin EHR implementation now