The Health and Human Services Department has released long-awaited, proposed “meaningful use” criteria for providers interested in receiving bonuses of up to $64,000 for installing or upgrading electronic health information systems.
“We've tried to build in flexibility in these standards and certification criteria as well as providing necessary guidance,” Dr. David Blumenthal, the agency's national coordinator for health information technology, said in a Dec. 30 conference call. “We hope we've provided a pathway toward more uniform standards over time, while at the same time making it possible in 2011 for well-intended providers and health professionals who want to become meaningful users to become so, and for the industry to create technology that will support that.”
Under the Health Information Technology for Economic and Clinical Health Act (HITECH), a part of 2009's federal stimulus law, physicians who treat Medicare patients can get up to $44,000 over 5 years for the meaningful use of a certified health information system. Physicians whose patient populations are made up of at least 30% Medicaid patients can earn up to $64,000 in incentive payments for their use of the technology.
The regulations include a definition of meaningful use and outline other criteria for obtaining the full incentive payments.
HHS issued two rules: one that outlines proposed provisions governing the incentive programs and an interim final regulation that sets initial standards, implementation specifications, and certification criteria for electronic health record (EHR) technology. Both regulations are open for 60 days of public comment.
For stage 1, which begins in 2011, meaningful-use requirements include:
▸ Use of computerized entry for 80% of all patient orders.
▸ Use of electronic prescribing for 75% of all permissible prescriptions.
▸ Maintenance of active medication and medication-allergy lists as part of the EHR for at least 80% of patients.
▸ Inclusion of demographic data (language, gender, ethnicity, insurance type, and date of birth) in the EHR of at least 80% of patients.
▸ Inclusion in the EHR of at least 50% of the lab results that can be recorded as either positive or negative or can be recorded with numerical data.
There are also requirements dealing with reporting quality data, filing claims electronically, encouraging patients to be more active in their care, improving care coordination, and ensuring privacy.
In 2012, the rules tighten for submitting quality data. While providers are allowed to report quality data to the Centers for Medicare and Medicaid Services through attestation in stage 1, data must be reported directly through certified EHR technology in stage 2.
The Medical Group Management Association said in a statement that the proposed criteria “are overly complex and … medical groups will confront significant challenges trying to meet the program requirements.” It cites “unreasonable thresholds” for some criteria, including CPOE and electronic claims submission; “potentially difficult meaningful use attestation after the first year;” and a requirement that physician offices provide patients and others with electronic copies of medical records among its objections.
The proposed regulations, fact sheets, and instructions on how to comment on the proposed regulations can be found at www.cms.hhs.gov/Recovery/11_HealthIT.asp