While the latest rule clarification for CMS on the use of EHRs answers some questions for physicians, there are plenty remaining.
The current environment of meaningful use of EHRs might best be described as both good news and bad news.
“The goal of the meaningful use program I think was achieved of getting EPs to buy the EHR technology and start using it,” said Robert Tennant, director of health information technology policy for the Medical Group Management Association's (MGMA's) government affairs office. “That’s the good news.”
Tennant spoke on the recent rule announcements to the EHR Incentive Programs at this year's MGMA Annual Conference in Nashville, Tenn., on Tuesday (Oct. 13).
“The bad news is as the industry shifted to Stage 2 there was a drop-off of significant proportions and very quickly the incentives are going away,” Tennant said. “Only 60,000 have attested so far and CMS has closed the attestation website so there will be no new attestations for Stage two this year.”
According to CMS, as many as 250,000 EPs will receive financial penalties due to meaningful use program requirements.
However, Tennant said, having the modifications to the final rule announced Oct. 6 means practices can begin to work with their vendors to identify a pathway forward to attestation. “They [EPs] will still need to deploy a portal and secure messaging, but the lowered measure thresholds will reduce the administrative burden and increase the likelihood of success,” he said.
“The challenge for a lot of groups have been the public health reporting measures,” Tennant said. “This was one measure where CMS deviated in the proposal from the original [rules] and they deviated in the final rule from both the proposal and the original [rule]. They’re saying all that you need to is be actively engaged with a public health agency, so all that you need to do is register.”
Tennant said risk analysis is also an overlooked component of meaningful use. In fact, he said, the leading cause of failing a meaningful use audit is not having a security risk analysis completed. “What CMS is saying is you must do a security analysis and you must address encryption,” he noted.
Another hindrance that has affected practices is many EHR vendors haven’t spent a lot of time on usability, Tennant said. “There’s been a lot of backlash about the fact that a lot of EHR vendors in their efforts to try to meet meaningful use have maybe not spent as much time on the interface side of the technology. So, physicians get the technology and it meets the meaningful use requirements, but they’re cumbersome and not any fun to use. So there is a lot of discussion about the technology not really helping.”
Moving forward, Tennant recommends that physicians get as many of the free or low-cost resources available on optimizing EHRs and leverage their colleagues about best practices.
“Practices should focus on identifying, implementing, and optimizing EHR technology that not only meets the minimum government standards for meaningful use but, more importantly, is a system that effectively and efficiently supports the clinical and administrative work flow of the practice,” Tennant said.