As promised, the Centers for Medicare & Medicaid Services (CMS) delivered their proposed rule defining meaningful use of certified electronic health record (EHR) technology.  As provisioned in the American Recovery and Reinvestment Act of 2009 (Recovery Act) incentive payments will be available to eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) who can demonstrate meaningful use of EHR technology.

 On December 30, 2009, CMS released their 556 page proposed rule on the requirements for the EHR incentive program (RIN 0938-AP78 and CMS-0033-P).  The major component of this rule is the definition of meaningful use.  CMS is proposing a multiple stage rollout for meaningful use.  Stage 1 is the focus of the current proposed rule.  Stage 1 criteria will be in effect for reporting year 2011.  CMS anticipates that Stage 2 will be implemented for reporting year 2013, and Stage 3 will be implemented for reporting year 2015.

 The proposed Stage 1 criteria for meaningful use focus on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating that information for care coordination purposes, and initiating the reporting of clinical quality measures and public health information.  The proposed criteria for meaningful use are based on a series of specific objectives, each of which is tied to a proposed measure that all EPs and hospitals must meet in order to demonstrate that they are meaningful users of certified EHR technology.

 For Stage 1, CMS proposes 25 objectives for EPs and 23 objectives for eligible hospitals that must be met to be deemed a meaningful EHR user.  For a detailed listing of the EPs and hospital criteria, please visit our website: www.ddfky.com/HITECH-Act.html.

 In a separate but related proposed rule, the Office of the National Coordinator for Healthcare Information Technology (ONC) released the proposed set of standards, implementation specifications, and certification criteria for EHRs.  Preliminary review of this proposed rule indicates that the standards are primarily based on existing standards and technology.  The intent is to make the goals more achievable in the desired timeframe.  Subsequent rules are expected to follow, with greater detail and steps toward better interoperability.

 Both of these proposed rules will have a 60-day comment period.  The respective agencies will review all comments and make final changes as quickly as possible.  I encourage all interested parties to review the rules and share your comments and concerns with the respective government agency.

 Jason D. Miller

Director of  Technology Consulting

jmiller@ddfky.com