Feds finalize ‘meaningful use’ requirements for electronic health records.
The U.S. Department of Health and Human Services has finalized the long-awaited “meaningful use” requirements that healthcare providers must meet to qualify for government reimbursements for their expanded use of electronic health records (EHR).
Announcement of the regulations marks the completion of multiple steps laying the groundwork for the incentive payments program under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. With “meaningful use” definitions in place, EHR system vendors can ensure that their systems deliver the required capabilities, providers can be assured that the system they acquire will support achievement of “meaningful use” objectives, and a concentrated five-year national initiative to adopt and use electronic records in health care can begin.
“This is a turning point for electronic health records in America, and for improved quality and effectiveness in health care,” said David Blumenthal, M.D., 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.”
As much as $27 billion may be expended in incentive payments over 10 years. Eligible professionals 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.
HHS also announced two companion 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.
“For years, health policy leaders on both sides of the aisle have urged adoption of electronic health records throughout our health care system to improve quality of care and ultimately lower costs,” Health and Human Services (HHS) secretary Kathleen Sebelius said in a statement. “Today, with the leadership of the President and the Congress, we are making that goal a reality.”
More Flexibility
The new rules were finalized after a three-month public comment period during which more than 2,000 recommendations were received by HHS. Although the final document is 864 pages long, key changes appear to have created greater flexibility with respect to how providers meet and report certain objectives for demonstrating meaningful use.
For example, it had initially been proposed that doctors meet 25 specific requirements (23 for hospitals) in their use of EHRs. However, the final rules only establish a “core” group of EHR requirements that must be met, plus an additional “menu” of procedures from which providers may choose. This two-track approach is designed to ensure that the most basic elements of meaningful EHR use will be met by all providers qualifying for incentive payments, while at the same time allowing latitude in other areas to reflect providers’ needs and their individual path to full EHR use.
Other requirements were eased as well. Providers must only write 40 percent of their prescriptions electronically to qualify for funding, instead of the 75 percent initially proposed. And physicians now have three working days to provide patients with e-copies of health information, instead of the original 48-hour timeline.
Phased Approach
Requirements for meaningful use incentive payments 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. The final CMS rule specifies initial criteria that eligible professionals (EPs) and eligible hospitals, including critical access hospitals (CAHs), must meet. The rule also includes the formula for the calculation of the incentive payment amounts; a schedule for payment adjustments under Medicare for covered professional services and inpatient hospital services provided by EPs, eligible hospitals and CAHs that fail to demonstrate meaningful use of certified EHR technology by 2015; and other program participation requirements.
As part of this process, HHS is establishing a nationwide network of Regional Extension Centers to assist providers in adopting and using certified EHR technology in order to meet the “meaningful use” requirements.
“Healthcare is finally making the technology advances that other sectors of our economy began to undertake years ago,” Dr. Blumenthal said. “These changes will be challenging for clinicians and hospitals, but the time has come to act. Adoption and meaningful use of EHRs will help providers deliver better and more effective care, and the benefits for patients and providers alike will grow rapidly over time.”
Medical images, scanned documents, e-mail and advances in electronic medical records (EMR) are causing an upsurge in healthcare data that is already challenging hospitals and is set to grow further in the foreseeable future, according a recent global survey.
The survey from BridgeHead Software found that over two-thirds (69 percent) of healthcare organizations expected their data volumes to increase this year. Less than six percent expected data volumes to stay constant and one percent expected data volumes to decrease.
Significantly, 84 percent of respondents said more than half their healthcare organizations’ data was more than six months old. Yet only 26 percent claimed to have a full archiving capability that migrated content to the appropriate storage tiers as dictated by their pre-defined policies. The research also discovered that over 44 percent of hospitals were managing more than 5TB on a primary store. Only 12 percent said they were managing less than 1TB on a primary store.
“The evidence speaks for itself,” said John McCann, director of marketing at BridgeHead Software. “Data volumes are increasing as the world of healthcare continues to embrace the digital age. A troubling trend we’ve noticed, however, is that some healthcare organizations are not paying due attention to their data management and storage solution strategies.”
