The Centers for Medicare & Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced two regulations that will help implement the electronic health record (EHR) incentive programs enacted under the American Recovery and Reinvestment Act of 2009 (Recovery Act).
Part of the Obama administration’s push for improved health information technology, physicians stand to gain from $44,000 to $64,000 each by demonstrating ‘meaningful use’ to CMS over a 5-year period, and hospitals may be able to get millions. Beginning in 2015, CMS will financially penalize providers who don’t show meaningful use of EHRs. Incentive payments may begin as soon as October 2010 to eligible hospitals, while incentive payments to other eligible providers are slated for January 2011.
The most anticipated and controversial element of the program has been how CMS would define ‘meaningful use’ so that physicians and hospitals will know that their investments in EHRs will measure up and earn the rewards. The new regulations include a proposed rule that finally defines the central concept of meaningful use of EHR technology. The other regulation, issued by ONC, sets initial standards, implementation specifications, and certification criteria for EHR technology. Both regulations are open to public comment through the end of February.
It will not be easy to meet the definition of meaningful use. The proposed rule requires that the physician or hospital demonstrate use of certified EHRs in a way that improves quality, safety, and efficiency of healthcare delivery; reduces healthcare disparities; engages patients and families; improves care coordination; improves population and public health; and ensures adequate privacy and security protections for personal health information.
The ONC regulation describes standard electronic formats for clinical summaries and prescriptions; standard terms to describe clinical problems, procedures, laboratory tests, medications and allergies; and standards for the secure transmission of this information using the Internet. It also sets forth how an EHR can be certified.
Both agencies noted that regulations will need to be updated over time as technology advances. The CMS proposed rule and fact sheets are available from the CMS website. ONC’s interim final rule may be viewed at the HHS website.