In the 18 months since the HITECH Act was passed, I have experienced some blank stares when discussing the expected impact on RDs—and more importantly—our patients. That is understandable—the major focus of the HITECH Act is to provide financial incentives to certain eligible providers who adopt (and effectively use) electronic health records AND to provide an infrastructure which supports “meaningful use”. The vision for HITECH’s impact on health care, however, is apparent to many. ADA has been commenting on proposed regulations for several years and the impact has been subtle-- until now. Just this month, two new final rules produced requirements for those receiving incentive payments. For those of us following the evolution of HIT through the HITECH, the “Meaningful Use” regulation took center stage. Let’s take one piece at a time and envision the impact on dietetics.
All eligible providers receiving incentive payments for adopting EHRs must report on three core measures for their patients.
- Hypertension: Blood Pressure Measurement (using NQF 0013 to report)
- Preventive Care and Screening Measure Pair: a)Tobacco Use Assessment and b) Tobacco Cessation Intervention.
- Adult Weight Screening and Follow-Up (using PQRI 128/NQF 0421 to report)
Related Alternate Measure: NQF 0024 Title: Weight Assessment and Counseling for Children and Adolescents
Kudos to ADA’s HITECH team recommendation to use PQRI 128/NQF 0421 as a measure—as no nutrition related measures were included in the core set until that time. What does this mean?
- Eligible Providers will report height/weight on their patients.
- Certified EHRs must calculate BMI—and hopefully in a consistent way. For all reporting to be easily combined, it would be best to have height in feet and inches as a drop-down choice—rather than free text. Otherwise, matching values into a combined set to compare across facilities and states will be chaos.
- Dietitians need to prepare for an increase in referrals related to this Weight Screening.
- As professionals, we need to collaborate with a host of programs and credible weight reduction venues. There are approximately 100,000 Registered Dietitians (many of whom work outside of clinical care) and over 72 Million Obese in the U.S. I keep coming back to that phrase—“It takes a Village!”
Coming Tomorrow: Ripple Effect Part II