What does “Meaningful Use” Mean? - LAFP

LAFP News6.of “meaningful use” iare still indevelopment. Requirementsfor interoperability, the abilityof any provider to send clinicaldata to other providers forpurposes of coordinatedquality care should beincluded. EHR vendors mustcontractually agree to meetall interoperability standards,both currently and in thefuture. At a minimum, thesoftware must be at HealthLevel 7 (“HL7”) standard of datamodels, and preferably able topush a “CCD” (Continuity CareDocument). Any interfacesor interoperability charges orconditions must be detailed inthe contract.Privacy and Security Standards:Privacy and Security Standardswere developed, and continueto be developed, at both theFederal and state levels. Thevendor must warrant that itssoftware and system will meetall current and future privacy andsecurity standards and laws atboth the Federal and state levels.7. Cost of Upgrades: The vendorshould typically incur the costof any upgrades to the softwareduring the term of the contract.If the provider is required undercontract to pay for upgrades, thecontract should state the cost.8. License Ownership: Thecontract should unambiguouslystate that, at the conclusionof the contract, the license foruse of the software belongs tothe provider. A statement thatthe vendor “may” transfer alicense makes license transferpermissive. The statementthat the vendor “shall” transferlicense makes it obligatory.Obligatory language clearlyrequires the transfer of thelicense.9. Additional Providers: Thecontract must address the costfor adding other physicians/users to the system. A contractstating, for example, that thevendor is “authorized to adjustfees to take into accountadditional providers using thesoftware” is not acceptable.10. Assignment: The contractmust require that the physicianapprove (in writing) of anyassignment of all or part ofthe contract. The physicianhas selected the vendor afterconducting due diligence.Assigning the contract toanother vendor without his orher express consent defeats thephysician’s efforts to select aknown high quality vendor.11. Indemnification: There shouldbe a provision requiring thevendor to indemnify thephysician for actions broughtagainst him or her arising out ofthe breach of the agreement bythe vendor or any other actionsby vendor.12. Limitation of Liability: Theagreement should not containa provision limiting the liabilityof the vendor or limitingwarranties implied by law.13. Dispute Resolution: Preferably,the contract should contain aprovision permitting a speedyresolution of any dispute arisingout of the agreement throughmediation or arbitration.14. Transfer of Data at ContractConclusion: The contractshould specifically address thetransfer of the data back to thephysician, in useable form, atthe conclusion of the contract.If the vendor intends to chargefor the conversion of data intouseable form, the charges mustbe delineated in the agreement.It is unacceptable for thecontract to state “chargeswill be paid by the physician”or the physician will pay all“reasonable” charges associatedwith the transfer of the medicalrecords back to him or her,unless the contract specificallystates that any disputes overcharges will not delay thetransfer of the medical recordsin usable form back to thephysician.Barbara Hensleigh, a former NICUnurse, has practiced law for more than20 years. Her statewide practice is withthe law firm of Andrews & Hensleigh,LLP, in Los Angeles, California. Ms.Hensleigh’s practice is devoted to therepresentation of physicians, physiciangroups and health care entities inlitigation, arbitration and administrativeproceedings. She may be reached athensleighlaw@earthlink.net.Ms. Hensleigh thanks Kiki C. Nocella,PhD, MHA for her contribution to thisarticle. Ms. Nocella is the CEO of BelieveHealth, LLC. Believe Health is one oftwelve AHRQ Master Contractors forAHRQ’s HIT Portfolio and NationalResource Center. It provides EHR andHIE consultation throughout the UnitedStates and internationally.DISCLAIMERThe articles provided in PracticeManagement News are general. Theydo not constitute legal, practicemanagement or coding advice in anyparticular factual situation or create anattorney-client relationship. Consult yourattorney or other professional for advicein your particular situation.Copyright © 2010 The CaliforniaAcademy of Family Physicians - SanFrancisco, CA, USA.All rights reserved.Louisiana Family Doctor | 27