In the News

July 13, 2010 - CMIO.net

The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) issued the final rules on Meaningful Use and Standards and Certification, which providers must follow in order to benefit from the approximate $27.3 billion in financial incentives over 10 years, authorized under the HITECH Act’s EHR incentive program.

Those who joined in the announcement were Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services, Donald Berwick, MD, new CMS Administrator, David Blumenthal, MD, the National Coordinator for Health IT and Regina Benjamin, MD, MBA, Surgeon General

The department published proposed meaningful use requirements on Jan. 16. The proposal prompted some 2,000 comments. Today, the HHS released a final regulation for the first two years (2011 and 2012) of this multiyear incentive program.

“Electronic health records are the foundation of a high performing and high quality health system,” said Sebelius. “When the record is properly designed and implemented, it is a powerful force for increasing physician and patient satisfaction.  We hope that other provider groups will embrace these standards.” She noted that only 20 percent of hospitals and 10 percent of physicians use basic EHRs.

The centerpiece of the program begins in 2011, when doctors and providers can receive incentives for the use of IT. “In order to receive these incentives, providers will need to embody these standards, as it was never our goal to use technology for technology’s sake,” Sebelius said.

Likewise, Blumenthal wrote in an editorial that was simultaneously released in the New England Journal of Medicine: “HITECH’s goal is not adoption alone but ‘meaningful use’ of EHRs—that is, their use by providers to achieve significant improvements in care. The legislation ties payments specifically to the achievement of advances in healthcare processes and outcomes.”

The final regulation is divided into two groups: a set of core objectives that constitute a starting point for meaningful use of EHRs and a separate menu of additional important activities from which providers will choose several to implement in the first two years, Blumenthal explained.

June 18, 2010 - CMIO.net

The Office of the National Coordinator for Health IT (ONC) today issued a final rule to establish a temporary certification program for EHR technology, which established processes that organizations will need to follow in order to be authorized by the National Coordinator to test and certify EHR technology.

Use of "certified EHR technology" is a core requirement for providers who seek to qualify to receive incentive payments under the Medicare and Medicaid EHR Incentive Programs provisions authorized in the Health IT for Economic and Clinical Heath (HITECH) Act, according to the Department of Health and Human Services.  HITECH was enacted as part of the American Recovery and Reinvestment Act (ARRA) of 2009.

HHS also reported that the Centers for Medicare & Medicaid Services will soon issue final regulations to implement the EHR Incentive programs.

Certification is used to provide "assurance and confidence" that a product or service will work as expected and will include the capabilities for which it was purchased, the agency said.  EHR certification should make those assurances to healthcare providers, according to HHS, that the EHRs they adopt have been tested and includes the required capabilities they need "to use the technology in a meaningful way."

In March, HHS issued a notice of proposed rulemaking (NPRM) entitled Proposed Establishment of Certification Programs for Health IT.  The NPRM proposed the establishment of two certification programs for purposes of testing and certifying EHRs - one temporary and one permanent.  The temporary certification program final rule issued today will become effective upon publication in the Federal Register.  The final rule for the permanent certification program is expected to be published this fall.

"By purchasing certified EHR technology, hospitals and eligible professionals and hospitals will be able to make EHR purchasing decisions knowing that the technology will allow them to become meaningful users of electronic health records, qualify for the payment incentives and begin to use EHRs in a way that will improve quality and efficiency in our health care system," said David Blumenthal, MD, national coordinator for health information technology.  "We hope that all health IT stakeholders view this rule as the federal government's commitment to reduce uncertainty in the health IT marketplace and advance the successful implementation of EHR incentive programs."

This final rule is issued under the authority provided to the National Coordinator for Health Information Technology in section 3001(c)(5) of the Public Health Service Act (PHSA) as added by the HITECH Act.

For more information about the temporary certification program and rule, click here. 
Click here to download the Final Certification Rule. 

December 30, 2009 - Jack Beaudoin, VP, Content, Healthcare IT News

WASHINGTON - On Dec. 30, the Centers for Medicare and Medicaid Services issued a notice of proposed rulemaking that outlines provisions governing the Medicare and Medicaid EHR incentive programs, including a proposed definition for the central concept of "meaningful use" of EHR technology.  In order for professionals and hospitals to be eligible to receive payments under the incentive programs, provided through the Recovery Act, they must be able to demonstrate meaningful use of a certified EHR system.

The following list of 25 Stage 1 Meaningful Use criteria for eligible providers was taken from the proposed rule: "Medicare and Medicaid Programs; Electronic Health Record Incentive Program."

Click here to read the list and the rest of the article

Click here to read the list of criteria for Eligible Hospitals

January 4, 2010 - John Halamka, MD, CIO, CareGroup Health System, Harvard Medical School, Healthcare IT News

Now that the Interim Final Rule (Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology) and the Notice of Proposed Rulemaking (Medicare and Medicaid Programs Electronic Health Record Incentive Program) have been published, we can all finalize our policy and technology strategies for achieving Certification and Meaningful Use in our organizations and communities.

It's important to use these two documents together to understand what is required for Certification and to achieve Meaningful Use stage 1 measures (2011) by professionals and hospitals.

Certification is a guarantee of software capabilities and Meaningful Use describes the way software features should be implemented in actual workflows.  Certification and Meaningful Use are related but different concepts.  For example, Certification requires that a complete EHR or EHR module have the capability of recording, retrieving, and transmitting immunization information using HL7 2.3.1 or HL7 2.5.1 with the CVX vocabulary.  The Meaningful Use stage 1 measure is to perform at least one test of the certified EHR technology's capacity to submit electronic data to immunization registries if local public health agencies are capable of receiving them.  Thus, for 2011, actual submission of immunization data is not required, just the capability and a single test of the capability.  Of course, by Stage 2 (2013), I expect that actual data submission will be part of every patient immunization.

How should you prepare for Meaningful Use in your organization?

Click here to read the rest of this article

Decemeber 30, 2009 - David Burda, Editor of Modern Healthcare

HHS issued two sets of much-anticipated federal regulations that significantly further the government's healthcare information technology adoption agenda.  The first set of regulations lists the "meaningful use" criteria that healthcare providers must meet to qualify for federal IT subsidies based on how they use their electronic health records.  The second set of regulations lays out the standards and certification criteria that those EHRs must meet for their users to collect the money.

Between $14.1 billion and $27.3 billion is at stake, which was made available under the Health Information Technology for Economic and Clinical Health Act provisions of the American Recovery and Reinvestment Act of 2009.

The meaningful use regulations are proposed regulations subject to a 60-day public comment period after which HHS would issue final regulations.  The EHR certification regulations are interim final regulations that take effect in 30 days with a 60-day public comment period.  HHS said final regulations will be published in 2010.

Under the proposed meaningful use regulations, eligible healthcare providers must use their EHRs to: improve the quality, safety and efficiency of healthcare services; reduce healthcare disparities; engage patients and their families; improve the coordination of care; improve population and public health; and ensure the privacy and security of personal medical information.

Under the interim final EHR regulations, EHRs must be able to securely exchange information among providers and between providers and patients using standardized data elements and technologies.  the regulations outline standardized formats for such things as clinical summaries; medical descriptions of clinical conditions and test results; and how that information is exchanged over the Internet.