The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator announced today the final meaningful use rule in Washington, D.C. which allows more flexibility for hospitals and clinicians to qualify than the proposed rule did. Through the HITECH (Health Information Technology for Economic and Clinical Health) Act, incentive payments totaling up to $27 billion will be administered over 10 years to create a nationwide system of electronic health records (EHR).
The announcement was made this morning by U.S. Department of Health and Human Services-Secretary Kathleen Sebelius, CMS Administrator Donald Berwick, M.D., National Coordinator for Health Information Technology David Blumenthal, M.D., Surgeon General Regina Benjamin, M.D. and others. Special guest, artist Regina Holiday, shared a particularly poignant personal experience of getting lost in the paper shuffle of health records as her husband died of cancer.
In a drive toward a paperless health system, the final rule took into account 2,000 comments made on the proposed meaningful use requirements issued on January 16. Above all, the ONC added flexibility to the ruling and composed a regulation with two-groups of objectives: a set of 15 core objectives for eligible providers and 14 for hospitals for implementing EHRs (The proposed rule had previously laid out 23 objectives for hospitals and 25 for clinicians.) and a separate a la carte menu of 10 additional important activities from which providers and hospitals will choose five to implement in 2011 and 2012.
The core objectives menu consists of essential functions including entering basic data like patients’ vital signs and demographics, maintaining an active medication allergy list, and creating up-to-date problem lists of current and active diagnoses, and capturing smoking status. In addition to the core elements, the second group lists 10 additional tasks, from which providers can choose any 5 to implement, such as performing drug-formulary checks, incorporating clinical laboratory results into EHRs, and providing patient-specific health education resources.
In 2011 and 2012 clinicians will have to report data on three core quality measures: blood-pressure level, tobacco status, and adult weight screening and follow-up. The clinicians in addition have to choose three other measures from metrics lists to incorporate into their EHR.
“As a physician of a certain age I was forced to learn to use an EHR, and I saw it make me a better doctor. I saw it help me avoid medication errors, I saw it help me avoid duplicative tests, and I saw that those types of changes could bend the quality curve up and cost curve down, without any compromising of the integrity of doctors and nurses,” said Dr. Blumenthal. “That’s why I’m here and doing this work—there are almost no physicians who go back once they start using one.”