Final electronic health record ‘meaningful use’ rules released

The United States Department of Health and Human Services announced Tuesday their final rules for the expanded use of electronic health records.

The Health Information Technology for Economic and Clinical Health Act of 2009 established that eligible health care professionals and hospitals could qualify for Medicare and Medicaid incentive payments by adopting certified electronic health record (EHR) technology to achieve specific objectives. The Tuesday announcement defines those “meaningful use” objectives and identifies the technical capabilities required for certified EHR technology.

“For years, health policy leaders on both sides of the aisle have urged the adoption of electronic health records throughout our health care system to improve quality of care and ultimately lower costs,” stated Health and Human Services (HHS) secretary Kathleen Sebelius in a release. “Today, with the leadership of the president and the Congress, we are making that goal a reality.”

Companion rules

HHS also announced two companion final rules: one from the Centers for Medicare & Medicaid Services (CMS) that defines the minimum requirements providers must meet through their use of certified EHR technology to qualify for the payments, and one from the Office of the National Coordinator for Health Information Technology that identifies the standards and certification criteria for the certification of EHR technology.

“The AMA will carefully review the rule to see if the requirements have been reduced to allow more flexibility than the proposed rule, as AMA urged,” Steven J. Stack, MD, a board member with the American Medical Association (AMA), stated in a press release.

Changes in the final CMS rule include:

Greater flexibility with respect to meeting and reporting certain objectives for demonstrating meaningful use. This is accomplished through dividing the objectives into a “core” group of required objectives and a “menu set” of procedures from which providers may choose any five to defer between 2011-2012;
An objective of providing condition-specific patient education resources for both eligible professionals (EPs) and eligible hospitals – as well as the objective of recording advance directives for eligible hospitals – in line with recommendations from the Health Information Technology Policy Committee;
A definition of a hospital-based EP as one who performs substantially all of his or her services in an inpatient hospital setting or emergency room only, conforming to the Continuing Extension Act of 2010; and
Critical access hospitals within the definition of acute care hospital for the purpose of incentive program eligibility under Medicaid.

Still work to be done

“This is certainly a needed clarification step,” Douglas W. Jackson, MD, an orthopedic surgeon in Long Beach, Calif., told Infectious Diseases in Children. “It will take a while to interpret it completely. Which EMR systems will eventually qualify is important. Purchasing EMR systems is a business decision and these incentives are important.

“I still feel that those with less than 10 years remaining in practice will probably never recoup their financial investment without other subsidies or significant cost reductions for any new system,” he added. “Individuals and individual practices will have to study the clarifications and see if it makes financial sense for them at this time.”

The release also noted that HHS will establish a nationwide network of Regional Extension Centers to assist providers in adopting and using certified EHR technology in a meaningful way.

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