Reactions to Meaningful Use Rule

July 14, 2010

So CMS listened to your comments and concerns and relaxed the EHR meaningful use requirements. But are some choice and a little flexibility enough to open the flood gates for implementation? Maybe not entirely, but it may encourage some procrastinators to get there more quickly.

So CMS listened to your comments and concerns and relaxed the EHR meaningful use requirements. But are some choice and a little flexibility enough to open the flood gates for implementation?

Maybe not entirely, but it may encourage some procrastinators to get there more quickly.

Practices that have already made the commitment to implement an EHR are likely to feel a little less pressure now that the goals are more realistic, said Erica Drazen, managing partner at consultant group CSC and lead of their Emerging Practices Group. “But, these requirements are going to come back in later stages, so it’s not like you’ve gotten a pass.”

Drazen said that physicians who figured they’d invest in an EHR to take advantage of the incentive funds in 2013, for example, may decide to implement quicker. That way, they can take meet these less stringent requirements for Stage 1 in 2011 and 2012, knowing that CMS may (and probably will) make even the Stage 1 requirements tougher by 2013. “This says, ‘Get going now,’” Drazen said.

Of course, if you implement now, there’s more incentive funding available, she noted. Seventy-percent of the funding will be available in the first two years. Drazen also said some practices will likely exceed some of the new metrics, such as the requirement that 30 percent of patients have at least one medication order entered using CPOE. Why have a third of your patients on an electronic system and the rest on paper?

The relaxed rules do seem to be giving many physicians a sense of relief. Dr. Lawrence Garber, an internal medicine physician and medical director for informatics (where he helps implement EHRs) at Fallon Clinic in Worcester, Mass., said this in a statement: “While continuing to keep the bar high, it doesn’t require breaking any world records. … I’m confident that most physicians using systems from the leading EHR vendors will be able to satisfy these 2011/2012 requirements and achieve the goal of improving the care that we give to our patients."

A further example of the rule’s flexibility is that CMS maintained the ability for providers to report for a continuous 90-day period to qualify for the payments, said Justin Barnes, chairman emeritus of the Electronic Health Record Assoc. and VP of marketing, corporate development and government affairs at Greenway Medical Technologies.

“This provision alone will greatly benefit the process, and in the rulings today the establishment of an EHR implementation surveillance program is promised which will merge certification best practices, and, I predict, show that quality and certifiable EHRs are currently equipped to provide Stage One and beyond meaningful use capture,” he said in a statement.

The MGMA also applauded the final rule for providing a “better approach” to the issues practices face. MGMA sought to reduce some of the thresholds in e-prescribing and administrative transactions, among others, and the final rule included those changes, according to MGMA’s statement.

The AMA and the American Health Information Management Association both issued statements that they were reviewing and analyzing the final rules. From AMA board member Steven J. Stack, M.D.’s statement yesterday: “The AMA will carefully review the rule to see if the requirements have been reduced to allow more flexibility than the proposed rule, as AMA urged.” Meanwhile, the House Ways and Means Health Subcommittee will be holding a hearing next week to examine the new guidelines.

What do you think about the final rule – does it prompt you to implement an EHR more quickly?