After a long period of conjecture and speculation, this month marks the official start of the government's electronic health records (EHR) incentive program. Now that the program is underway, it is up to physicians to demonstrate meaningful use of EHR by adhering to the minimum criteria and core requirements, as set forth by CMS. (For more information on meeting the criteria, see the “Technology Connection” from the December issue, available at

Physicians who wish to receive a maximum return on incentive funds should familiarize themselves with the fine print of guidelines, which are available through both CMS and the AAD. However, apart from the strict verbiage of the established guidelines, physicians should also be considering the logistic elements of adopting and implementing EHR within their practices. Following is a brief survey of some of these considerations and ways physicians can more smoothly integrate EHR.

The Logistics
Prepare Your Staff. Having a knowledgeable and informed staff is one of the most important components of getting your practice off to the right start with EHR. This may mean holding regular staff meetings to allow staff members to have a forum for any questions they may have and to provide regular updates. No matter how you decide to address your staff regarding use of EHR, it is important that they are kept informed and up-todate, as they will be using the systems as much as physicians.

Note Software Certification Status. When selecting software, it is important to ensure that both the brand as well as the specific version of the software are ARRA-certified. Some vendors may have certified software, but sometimes only specific versions are compliant with the certification guidelines. Therefore, whether you are making your first EHR software purchase or have had one for some time, check to make sure that it is certified for eligibility of meaningful use.

Establish Routines for Logging Patient Information. Ensure that your staff is aware of additional patient demographic information that must be noted on your EHR. Information such as preferred language, race, ethnicity, and smoking status are all now mandatory in order to qualify for meaningful use under the new guidelines. This may require your staff to establish new routines regarding how they handle new patients.

Seek Out Additional Information. When selecting a EHR system, it helps to see the product in action before trying to use it. Therefore, seek out videos, webinars, and other media (perhaps on the company's website) that will allow you to visualize how you might incorporate it into your practice, in addition to strengthening your knowledge of the product.

Note Changes to E-prescribing. In order to complywith meaningful use standards, 40 percent of all prescriptions, as opposed to just those through Medicare, must be done with e-prescribing. Keep in mind that even if you are e-prescribing for 100 percent of your Medicare patients and none of your other patients, you must still reach 40 percent for total prescriptions written, or you will not qualify for EHR incentive dollars.

Provide Education Information and Patient Portal. Certain criteria for meaningful use suggest that the EHR must be able to provide patients information in a timely manner. This requirement can be satisfied through education pamphlets and a patient portal. While they do not have to be used to a great extent, it is important that they are consistent and active in order to qualify for meaningful use. Education pamphlets may follow any format, provided that they are created via your EHR. As for the patient portal, which allows patients to follow labs and limited chart information, the portal must be activated on your EHR, as opposed to simply having an EHR that offers a patient portal.

Informed and Involved
These tips certainly don't address the range of details that you must consider if you are applying for meaningful use incentives. They do, however, highlight the importance of communication within your practice, as well as providing up-to-date information to your staff. Adjustments may be difficult initially, but keeping your staff informed and involved in the implementation and use of EHR may significantly ease the transition and aid in adhering to meaningful use guidelines.

For more information on EHR incentives, visit or Previous coverage of EHRs is available at

Mark Your Calendar: October 1 Deadline
If you hope to qualify for incentives in 2011 but will not get underway with your EHR until later in the year, note that October 1 is the last day you can begin meaningful use in order to qualify for the year.
CMS indicates that physicians must demonstrate meaningful use for 90 continuous days within a calendar year in order to qualify for that year. Therefore, if you start after October 1, not only will you fail to qualify for incentive dollars in 2011, but you will have to start fresh at the new year in order to qualify for benefits in 2012.