New Rules Lay Out ‘Meaningful Use’ Requirements for Electronic Health Records

The U.S. Department of Health and Human Services has released its final version of rules that define the parameters under which physicians and hospitals can qualify for funding to upgrade their electronic medical records systems. Included are new definitions for what will constitute “meaningful use” of electronic records to meet objectives of the programs.

Changes have been made to previous drafts of the meaningful use criteria, which received comments from healthcare providers and other interested citizens numbering in the thousands. The new rules include more flexibility, Joseph Kuchler, spokesperson for the U.S. Department of Health and Human Services, told TechNewsWorld. This was the primary area of concerns for those who had objections to earlier versions of the criteria.

Economic Stimulus and Healthcare Reform

Two companion final rules were announced this week. One regulation, issued by the Centers for Medicare & Medicaid Services, defines the minimum requirements that providers must meet through their use of certified electronic health records (EHR) technology in order to qualify for payments under the Health Information Technology for Economic and Clinical Health Act of 2009, better known as the “HITECH Act.”

The other rule, issued by the Office of the National Coordinator for Health Information Technology (ONC), identifies standards and criteria for the certification of EHR technologies. The first rule will thus have a greater impact on healthcare providers themselves, while the second will more greatly affect the makers of EHR systems.

Compliance is no small matter to healthcare professionals experiencing an increase crunch in this difficult economy. As much as US$27 billion may be expended in EHR incentive payments over 10 years. Eligible healthcare professionals may receive as much as $44,000 under Medicare and $63,750 under Medicaid, and hospitals may receive millions of dollars for implementation of certified EHRs under both Medicare and Medicaid.

Unintended Consequences

Simpler rules are crucial to achieving the government’s stated goals for the program, Bruce Carlson, publisher of Kalorama Information, told TechNewsWorld.

The first set of meaningful use criteria seemed unnecessarily complicated and perhaps a bit rigid, he noted. While the federal government must, of course, take leadership in pushing forward the efficiencies and cost savings promised by HER systems, overly difficult regulations can have the unintended consequence of providing disincentives rather than encouraging healthcare providers to upgrade their systems.

The final rule for meaningful use divides the objectives EHR use must meet into a “core” group of required measurements and a “menu set” of procedures from which providers may choose any five to defer, said the Department of Health and Human Services.

The incentive payment will be implemented over a multi-year period, phasing in additional requirements that will raise the bar for performance on IT and quality objectives in later years. This will allow physicians and hospitals, along with their IT staffs and consultants, to assess where they stand currently, so they can then tailor their upgrade process to individual practice situations.

It’s an important change, said Carlson, because healthcare providers vary widely in their current use of EHR technology.

Less than 40 percent of the overall population of physicians currently use EMR technologies, based on recent surveys, he noted. However, even among those who do, only a very small percentage are using the kind of advanced, integrated EMR processes that the federal government would like to see adopted across the board in the U.S. healthcare system.

About 10 to 15 percent of physicians routinely do the majority of their tasks using electronic records, Carlson stressed. Thus, software companies, consultants and IT professionals have their work cut out for them as they seek to bring widely divergent business processes and levels of automation up to universal federal standards.

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