David Blumenthal, MD, National Coordinator for Health Information Technology, told attendees of the eHealth Initiative in Washington, DC, on Thursday that "we have now officially entered the age of meaningful use."

Blumenthal said that since Jan. 3, when registration opened for providers to attest to meaningful use, some 13,000 providers have signed up to qualify for incentives for electronic health record adoption, and ONC is receiving hundreds of calls a day from providers asking questions about the process.

"You are part of making this happen," he told the healthcare IT stakeholders attending the conference. "We stand on your shoulders in this effort."

Yet Blumenthal said there is still an enormous amount of work left to do and the need for a major education plan to pull providers – physicians in particular – onto the meaningful use bandwagon. Many doctors still don't know what this effort is about, he said.

"It's within our collective grasp to use healthcare IT to launch a new era in American healthcare," said Blumenthal. "I think that meaningful use is a transformative concept."

According to Blumenthal, meaningful use has multiple dimensions. The Medicare and Medicaid EHR meaningful use funding under HITECH is the incentive part of the plan, but "it's only the tip of the spear," he said. Setting up a national infrastructure for developing electronic health records in the U.S. is another dimension. "It's easy to forget that without healthcare IT, the suite of changes called for under the Affordable Care Act wouldn't be possible," he said.

By the end of January, the regional extension centers – funded under the stimulus package – should have some 40,000 providers working toward meaningful use, Blumenthal said.

Blumenthal went on to outline other signs of progress made in the past year toward ushering in the era of meaningful use. The ONC has continued to work on standards, developing more and more every day in a wiki-type collaborative process, he said.

Twenty-five states have had their healthcare information exchange grant projects approved by ONC. Blumenthal called the projects, "creative, demanding and new." Each state has to work to find the path that makes the most sense for them, he said.

Certification of EHRs for meaningful use has also taken some drastic steps forward, said Blumenthal. "Six months ago, we had no certification process. Now there are 6 temporary certification bodies with a total of 251 certified products" (166 complete EHRs and 85 modules), he said. Fifty-six percent of the EHR products that have been certified were developed by small companies, while 22 percent were products made by large companies with more than 200 employees. In addition, there are six products that are available at no or minimal cost. "All of this is indicative of the explosion in the (EHR) marketplace," he said.

In the era of meaningful use, When it comes to privacy and security, trust and interoperability are paired concepts, Blumenthal said. ONC is working hard to develop the public's trust in EHRs and interoperability. The office has established a new privacy tiger team to advise the HIT Policy Committee and is working with the White House "cybersecurity czar" Howard Schmidt to help the U.S. create flexible, dynamic reliable systems.

Blumenthal said in his travels abroad he has become aware that no country has a handle on EHR exchange. When dealing with personal information, it is hard to build a system that requires that information to be shared with strangers, he said. The best exchanges are built by developing the trust locally, then expanding.

The U.S. has the largest model of EHR exchange in the world, he added, involving some 10 million people in the Veterans Health Administration and Kaiser Permanente programs, "yet these systems seem small compared to our country's size." Just because we don't have exchanges greater than this doesn't mean it can't happen; it just hasn't evolved yet, he added.

Meaningful use and exchange are inseparable, according to Blumenthal. Use of EHRs has to include exchange, when providers and consumers are ready for it, he added. Standards for meaningful use should never be the maximum required; they should be the minimum of what is required to accomplish quality care, he said.

In closing, Blumenthal offered: the meaningful use era is not about technology. It's about quality healthcare.