The American Academy of Family Physicians is calling for significant changes to “meaningful use” criteria that will be used to determine whether health care providers are eligible for federal subsidies for health IT usage, Modern Healthcare reports.

In a seven-page letter to acting CMS Administrator Charlene Frizzera, Ted Epperly, chair of AAFP’s board of directors, wrote that the group agrees with many of the criteria’s stated goals, but urged CMS to reconsider:

• Requirements to report computerized physician order entry measures that he maintains could force health workers to manually enter results from laboratories that do not have an interoperable interface;
• A requirement that a patients’ health information be shared with them within 48 hours; and
• Language that requires physicians to meet all of the proposed requirements to receive incentive payments.

In addition, Epperly asserts that the term “health information” is used throughout the proposed criteria but is never defined explicitly (Robeznieks, Modern Healthcare, 3/7).

Above Article Publish on http://www.ihealthbeat.org/articles/2010/3/8/aafp-asks-cms-for-significant-changes-to-meaningful-use-criteria.aspx

Practices that have been waiting for CMS to define the term “meaningful use” are finally in luck. But as is always the case when the feds are involved, don’t look for a quick one-sentence definition.

The American Recovery and Reinvestment Bill of 2009 (ARRA) offers annual bonuses to practices that show “meaningful use” of electronic health records, and in 2015, practices that aren’t showing meaningful use will face penalties.

On Dec. 29, CMS and the Office of the National Coordinator for Health Information Technology announced that the definition was finally available for public comment. “CMS’s proposed regulation would define and specify how to demonstrate ‘meaningful use’ of EHR technology, which is a prerequisite for receiving the Medicare incentive payments,” said Charlene Frizzera, CMS’s acting administrator, in a Dec. 30 statement.

25 measures: Stage 1 of the meaningful use criteria (which begins in 2011) includes 25 objectives/measures for eligible professionals (most Part B practices fall under this category) and 23 objectives/measures for eligible hospitals. To be considered a meaningful EHR user, you must meet all of the criteria set forth.

For example: The following includes just a sampling of what you’ll find in the list of 25 meaningful use criteria for stage one of the incentive program. To read the complete list, check out the proposal in the Federal Register.

• Use a computer physician order entry (CPOE)
• Implement drug-drug, drugallergy, drug-formulary checks
• Maintain an up-to-date problem list of current and active diagnoses based on ICD-9 or SNOMED CT
• Generate and transmit permissible prescriptions electronically
• Maintain an active medication list
• Maintain an active medication allergy list
• Record demographics (preferring language, insurance type, gender, race, ethnicity, and date of birth)
• Record and chart changes in vital signs
• Record smoking status for patients age 13 and older
• Incorporate clinical lab test results into EHR as structured data
• Generate lists of patients by specific conditions
• Report ambulatory quality measures to CMS
• Send reminders to patients for preventive follow-up care (per patient preference)
• Implement five clinical decision support rules relevant to specialty or high clinical priority
• Check insurance eligibility electronically from payers
• Submit claims electronically.

Keep in mind: You can not only qualify for a financial bonus if you use EHRs — but you could also boost your practice’s efficiency, CMS says. “Widespread adoption of electronic health records holds great promise for improving health care quality, efficiency, and patient safety,” said David Blumenthal, MD, national coordinator for health information technology, in a Dec. 30 statement.

CMS will accept public comments on the rule for 60 days, either electronically or by mail (CMS, Department of Health and Human Services, Attention: CMS-0033-P, P.O. Box 8013, Baltimore, MD 21244-8013). If you do submit comments, refer to ID CMS-0033-P.

Article publish on http://hitnews.inhealthcare.com/fact-finder/hitech-physicians-must-meet-25-criteria-to-achieve-meaningful-use/?dynamic_id=2086766482

The Centers for Medicare & Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) encourage public comment on two regulations issued today that lay a foundation for improving quality, efficiency and safety through meaningful use of certified electronic health record (EHR) technology. The regulations will help implement the EHR incentive programs enacted under the American Recovery and Reinvestment Act of 2009 (Recovery Act).

A proposed rule issued by CMS outlines proposed provisions governing the EHR incentive programs, including defining the central concept of “meaningful use” of EHR technology. An interim final regulation (IFR) issued by ONC sets initial standards, implementation specifications, and certification criteria for EHR technology. Both regulations are open to public comment.

“Widespread adoption of electronic health records holds great promise for improving health care quality, efficiency, and patient safety,” said, National Coordinator for Health Information Technology David Blumenthal, M.D., M.P.P. “The Recovery Act’s financial incentives demonstrate Congress’ and the Administration’s commitment to help providers adopt and make meaningful use of EHR technology so they can give better care and their patients’ experience of care will improve. Over time, we believe the EHR incentive program under Medicare and Medicaid will accelerate and facilitate health information technology adoption by more individual providers and organizations throughout the health care system.”

“These regulations are closely linked,” said Charlene Frizzera, CMS acting administrator. “CMS’s proposed regulation would define and specify how to demonstrate ‘meaningful use’ of EHR technology, which is a prerequisite for receiving the Medicare incentive payments. Our rule also outlines the proposed payment methodologies for the Medicare and Medicaid EHR incentive programs. ONC’s regulation sets forth the standards and specifications that will enhance the interoperability, functionality, utility and security of health information technology.”

CMS and ONC worked closely to develop the two rules and received input from hundreds of technical subject matters experts, health care providers, and other key stakeholders. Numerous public meetings to solicit public comment were held by three Federal advisory committees: the National Committee on Vital and Health Statistics (NCVHS), the Health IT Policy Committee (HITPC), and the Health IT Standards Committee (HITSC). HITSC presented its final recommendations to the National Coordinator in August 2009. These recommendations, along with all other input were considered to help inform the development of the regulations announced today.

The IFR issued by ONC describes the standards that must be met by certified EHR technology to exchange healthcare information among providers and between providers and patients. This initial set of standards begins to define a common language to ensure accurate and secure health information exchange across different EHR systems. The IFR describes standard formats for clinical summaries and prescriptions; standard terms to describe clinical problems, procedures, laboratory tests, medications and allergies; and standards for the secure transportation of this information using the Internet.

CMS provides a 60-day comment period on the proposed rule. “The definition and requirements for demonstrating meaningful use of EHR technology are proposals. CMS welcomes and will give serious consideration to comments that improve our proposal while achieving the goals Congress established for the EHR incentive programs,” Frizzera said.

The CMS proposed rule and fact sheets, may be viewed at http://www.cms.hhs.gov/Recovery/11_HealthIT.asp

ONC’s interim final rule may be viewed at http://healthit.hhs.gov/standardsandcertification. In early 2010 ONC intends to issue a notice of proposed rulemaking related to the certification of health information technology.

Above article publish on http://www.hhs.gov/news/press/2009pres/12/20091230a.html

Last week, CMS released proposed regulations defining the “meaningful use” of electronic health records, Reuters reports (Wutkowski/Heavey, Reuters, 12/31/09).

In addition, the Office of the National Coordinator for Health IT released an interim final rule describing the required certification standards for EHR technology (Simmons, HealthLeaders Media, 12/31/09).

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs will qualify for incentive payments through Medicaid and Medicare.

Officials will offer a 60-day public comment period after both regulations are published in the Federal Register on Jan. 13. The interim final rule on EHR certification is scheduled to take effect 30 days after publication (Goedert, Health Data Management, 12/30/09).

Phased Approach to Meaningful Use

CMS’ plan proposes phasing in meaningful use requirements over three stages between now and 2013.

The first stage of the meaningful use criteria emphasizes:

• Collecting electronic health data in coded formats;
• Implementing clinical decision support tools;
• Reporting clinical quality measures and public health data; and
• Using EHR data to track conditions and coordinate care (Monegain, Healthcare IT News, 12/30/09).

The criteria call for physicians to submit at least 80% of their orders electronically and for hospitals to submit at least 10% of orders electronically. The proposed rules also call for health care providers to use EHRs to check for potential drug interactions (Perrone, AP/San Francisco Chronicle, 12/30/09).

In addition, the rule requires health care providers to provide patients with electronic copies of their medical records within 48 hours of a request (Hensley, “Shots,” NPR, 12/31/09).

A list of Stage 1 criteria for physicians and a list of Stage 1 criteria for hospitals are available from Healthcare IT News (Healthcare IT News, 12/30/09).

The Stage 2 criteria are expected to focus on structured data exchange and continuous quality improvement. CMS is scheduled to release the second phase criteria by the end of 2011.

The Stage 3 criteria are expected to center on advanced decision support and population health. CMS is scheduled to publish the third phase criteria by the end of 2013.

Certification Criteria for EHRs

ONC’s interim final rule outlines the technical standards and features that EHR systems must include to receive certification for meaningful use.

The rule includes:

• Standard formats for clinical summaries and prescriptions;
• Standard terms to describe clinical problems, laboratory tests, medications and procedures; and
• Standards for secure transmission of online data.

The rule focuses solely on standards for certified EHRs. Later in 2010, ONC is scheduled to release additional guidance on the process for EHR certification.

Reduced Budget for Incentive Payments

When federal officials released the two new regulations, they also announced that the government might distribute less money than anticipated for the incentive payment program.

Initially, the Congressional Budget Office estimated that total federal incentive payouts could reach $34 billion (Mosquera, Government Health IT, 12/30/09).

However, officials last week said the outlays are likely to range from $14.1 billion to $27.3 billion.

They added that the government might pursue further budget revisions after evaluating the popularity of the incentive payment program (Schulte/Schwartz, Huffington Post Investigative Fund, 12/30/09).

Above article publish on http://www.ihealthbeat.org/articles/2010/1/4/officials-announce-meaningful-use-ehr-certification-criteria.aspx

Article by Ryan

The HITECH Stimulus Act is legislation designed to promote the adoption of Electronic Health Records (EHRs) among physicians. Passed near the beginning of 2009, the HITECH Act will reimburse qualified physicians who purchase and implement a certified EHR system. If a physician’s practice includes 30% Medicaid patients or more, they could qualify for up to $64,000. Medicare incentives could total up to $44,000, depending upon allowable charges.

“Meaningful Use” is a core concept of the HITECH Stimulus Act. Physicians must do more than simply seeing a certain amount of Medicaid or Medicare patients. “Meaningful Use” outlines a set of EHR features that physicians must use in their practice. On December 30th, 2009, The Centers for Medicare and Medicaid Services (CMS) along with the Office of the National Coordinator for Health Information Technology (ONC) published a final recommendation for the meaningful use definition.

Meaningful use is broken up into several stages. In Stage 1, physicians will have to use features like Computerized Physician Order Entry (CPOE), implement drug-to-drug, drug-to-allergy, and drug-to-forumlary checks, and maintain an updated problem list with ICD-9 or SNOMED, along with a whole host of other requirements. For the most part, the final recommendations look much the same as the initial recommendations from the ONC committee earlier in 2009. The final recommendations will take effect in approximately thirty days; the public is encouraged to comment for the next sixty days. CMS could decide to change the recommendations before final adoption, but most think any changes will be minor.

Deliberations over the meaningful use definitions created a great deal of uncertainty in the EHR market. Most physicians put their buying plans on hold, rather than taking the chance of purchasing an EHR that may not meet the requirements. While caution is understandable, physicians who wait too long may have trouble implementing an EHR in time to qualify for the 2011 reimbursements.

Purchasing an EHR is not like buying off-the-shelf software. With all the vendors, systems, and options, it normally takes several months to make a purchase decision. Once they sign papers, physicians may need to wait up to six months for installation to begin because of vendor backlogs. After installation, physicians and their staff still have to train, which can take weeks for more complicated systems.

Fortunately, the wait is over. CMS and ONC have published their final recommendations. EHR vendors are busy making sure their systems meet the meaningful use requirements. Likewise, physicians need to get busy with their EHR search. Physicians need to make a decision as soon as possible to qualify for 2011 and avoid increasing vendor backlogs. If you are interested in participating in the HITECH Stimulus, ask an EHR vendor to perform a needs analysis for your practice.

Above article publish on http://www.ehrscope.com/blog/meaningful-use-%E2%80%93-interim-final-rule-published/

After federal officials publish an interim rule on the “meaningful use” of electronic health records, the Health IT Standards Committee will use public comments to shape a final version of the rule, according to John Halamka, vice chair of the committee, Government Health IT reports.

Halamka spoke last week during the panel’s final meeting of the year.

The Office of the National Coordinator for Health IT is scheduled to release interim certification standards on meaningful use by the end of the month. In addition, CMS is expected to publish guidance on the federal incentive payment programs.

During the standards panel meeting, Halamka said the committee strove to recommend meaningful use standards that would be amenable to health care organizations of different sizes and types.

The committee also pushed for data protection standards that align with the HIPAA privacy and security rule. The recommendations call for electronic health systems to authenticate identities, create an audit trail, encrypt and decrypt information and restrict access to authorized users.

When the committee returns to work in 2010, the group will continue its efforts to develop data standards, facilitate EHR adoption and reduce barriers to health IT, Halamka said (Mosquera, Government Health IT, 12/22).

Above article publish on http://www.ihealthbeat.org/articles/2009/12/23/public-comments-will-help-shape-meaningful-use-rule.aspx

By John Moore

The Centers for Medicare and Medicaid Services today awarded $16 million in matching funds among six states and the U.S. Virgin Islands to help them plan their systems and processes for the upcoming task of managing electronic health record incentive payments.

The American Recovery and Reinvestment Act’s HITECH provisions offer incentives of up to $63,750 over six years for Medicaid providers who can demonstrate meaningful use of EHR.

State Medicaid offices, not the federal CMS agency, will manage the incentive payments to Medicaid providers in their state.

The $16 million in funding announced today involves a separate ARRA funding stream, which provides a 90 percent federal match for state planning activities. The Medicaid incentive payments are expected to begin in 2011.

States receiving funds Wednesday include California ($2.48 million), Georgia ($3.17 million), Idaho ($142,000), Montana ($239,000), New York ($5.91 million), Texas ($3.86 million), and the U.S Virgin Islands ($232,000). Those states join Iowa, which received CMS planning funds last month.

To qualify for the matching funds, states must demonstrate, among other things, that it “uses the funds for purposes of administering the incentive payments including the tracking of meaningful use of certified EHR technology by Medicaid providers,” according to CMS’ September letter to state Medicaid directors.

Above article published on http://www.govhealthit.com/newsitem.aspx?tid=10&nid=72701