During the last week of December, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced a proposed rule that moves us closer toward a final definition of the term "meaningful use" of Electronic Health Records (EHRs).

According to the CMS website, The American Recovery and Reinvestment Act of 2009 (Recovery Act) was signed into law by President Obama on February 17, 2009. The law includes the Health Information Technology for Economic and Clinical Health Act, or the "HITECH Act," which established programs under Medicare and Medicaid to provide incentive payments for the "meaningful use" of certified electronic health records (EHR) technology.

• Under the HITECH Act, CMS administers the EHR incentive programs under Medicare and Medicaid. CMS prepared a proposed rule on the EHR incentive programs and has made that rule available for public comment.  See link below.

(Note: Click on "Show Details" to view the proposed rule; Click on "Submit Comment" if you would like to provide your feedback/opinion of the proposed rule.)

• Under the HITECH Act, ONC has responsibility for developing standards, implementation specifications, and certification criteria for EHR technology. See link below to view the Interim Final Rule and to submit a public comment.

THE BASICS:

1. CMS has identified three proposed stages of meaningful use criteria as follows:
   1. Stage 1 focuses on the electronic capture and tracking of codified health information, use of data for the coordination of care, and on the reporting of clinical quality measures and health information to CMS. For Stage 1, which begins in 2011, CMS proposed 25 objectives for eligible professionals and 23 objectives for hospitals that must be met to be considered a "meaningful user" of EHR technology.
   2. Stage 2 (which will be finalized at a later date thereby making meaningful use somewhat of a moving target), will expand upon Stage 1 in the areas of disease management, clinical decision support, medication management and support for patient access to their health information among other areas.
   3. Stage 3 (which will also be finalized at a later date), will focus on achieving improvements in quality, safety and efficiency.
   4. The interim final rule from ONC describes an initial set of standards for secure health information exchange in the areas of prescriptions, procedures, labs etc.

Both of these proposed rules are subject to change after the 60-day public comment period. Our initial research seems to indicate that many healthcare providers and professionals consider the 25 objectives mentioned above to be overly burdensome and complex and, in some cases, a deterrent to EHR adoption. For more information, see link below:

Link to EHR Incentive program:

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Link to Interim final rule:

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