Final ‘meaningful use’ standards easier to meet

PROVIDENCE – Local health care IT leaders are welcoming the final “meaningful use” standards issued last week for electronic health records, which still set a high bar but are more lenient than a draft version released in January, with several components now made optional.
Providers had been anxiously awaiting the EHR rules so they could better target their efforts to meet the standards. A recent survey by PricewaterhouseCoopers LLP found 8 in 10 hospital chief information officers worried they wouldn’t make the 2015 deadline for their industry.
On Tuesday, U.S. Department of Health and Human Services Secretary Kathleen Sebelius unveiled the final rules, which will also determine how the federal government disburses up to $27 billion in incentive payments over the next 10 years.
Doctors who meet the “meaningful use” standard may receive as much as $44,000 under Medicare and $63,750 under Medicaid, and hospitals may receive millions of dollars for implementation and meaningful use of certified EHRs under both Medicare and Medicaid.
Ultimately, all providers must meet the standard or else face federal penalties.
Along with the standards, HHS issued a regulation identifying the technical capabilities required for certified EHR technology – crucial information for EHR developers and vendors.
“This is a turning point for electronic health records in America, and for improved quality and effectiveness in health care,” said Dr. David Blumenthal, national coordinator for health information technology. “In delivering on the goals that Congress called for, we have sought to provide the leadership and coordination that are essential for a large, technology-based enterprise. At the same time, we have sought and received extensive input from the health care community, and we have drawn on their experience and wisdom to produce objectives that are both ambitious and achievable.”
The final rule scales back the requirements in the January proposal, responding to a slew of requests from providers and groups that represent them. Originally, doctors had to meet 25 requirements, and hospitals, 23, to qualify; now there is a “core” group of requirements that must be met, plus an additional “menu” of procedures from which providers may choose.
Over time, the requirements become more stringent, both for IT performance and for the related quality objectives to be met.
Dr. Yul Ejnes, an internist at Coastal Medical Inc. in Cranston, vice chairman of the Rhode Island Quality Institute board, and chair-elect of the American College of Physicians board, welcomed the release of the final rules, noting that “physicians now know what they need to do in order to qualify for federal funds to promote EHR adoption.”
The new criteria also “offer more flexibility in meeting the criteria than the earlier versions,” he noted, and that “should make it easier for physicians with a certified EHR to qualify for the incentives.”
“Achieving meaningful use of EHRs will help physicians improve health outcomes for their patients and achieve workflow and administrative efficiencies,” said Laura Adams, president and CEO of the institute. “This is particularly important here in Rhode Island, where the majority of physicians are solo practitioners in small practice settings, and often face many barriers to successful adoption and meaningful use.”
The institute is encouraging providers to avail themselves of the services of the new, federally funded Rhode Island Regional Extension Center, a vendor-neutral service devoted to helping providers with all the decisions related to adopting EHRs and successfully implement them.
The center also runs a website, DocEHRTalk.org, through which physicians can share their experiences and learn from one another. (The site also provides information about the center itself, and explains how to enroll.)
On a national level, response to the rules was mixed. The American Hospital Association noted that the reduced requirements will help, but still expressed concerns.
“Unfortunately, [the Centers for Medicare & Medicaid Services] continues to place some barriers in the way of achieving widespread IT adoption by our nation’s hospitals and physicians,” said AHA President and CEO Rich Umbdenstock.
Individual hospitals in multi-campus settings still can’t qualify for the incentives, he noted, and hospitals are required to immediately implement computerized provider order entry, “which can be complicated, costly to implement, and takes time to do right.”
The American Medical Association, meanwhile, issued a statement by board member Dr. Steven J. Stack noting the AMA’s previous warnings that the earlier version of the rule “was too aggressive and would prevent many physicians from participating,” and saying the AMA would review the new standards to see how well its input was taken into account.
“The AMA is committed to EHR adoption that streamlines the clinical and business functions of a physician office and helps physicians provide high-quality care to patients,” he added. “It is critical that barriers to implementation are removed so physicians can successfully adopt new technology.”
Adams said the Rhode Island Regional Extension Center’s goal is to get providers to achieve meaningful use “as quickly as possible,” so everyone in the state “can begin to benefit from the quality, efficiency and safety improvements that will be achieved.”