The long awaited "meaningful use" regulations are an important step in the process of weaving health information technology into the fabric of U.S. healthcare.
Policy makers hope that Health Information Technology ("HIT") will be the common thread that joining the two primary elements of healthcare reform: (1) outcomes measurement, and (2) financial risk-bearing delivery models. Policy makers have hit the regulatory trail hard, knowing that implementing the regs will be time consuming and costly. They figure to implement the HIT via two "sticks": incentive payments to the "eligible professionals" that use certified HIT, and a cut in Medicare reimbursement for those who don’t ("disincentives"). Of the two, given the cost of HIT infrastructure and the time involved implementing it, the disincentives are clearly most ominous.
The so called "meaningful use regs" were formulated on July 13, 2010. Incentive payments for eligible professionals who achieve "meaningful use" of certified EHR technology are scheduled to begin October, 2010-January, 2011. These final regs take into account over 2,000 comments and begin the process of actually using electronic records in healthcare settings.
According to the new regs, eligible providers (including physicians) are subject to 25 specific criteria, while hospitals are subject to 23. The final rule sets forth standard formats for clinical summaries and prescriptions; defines terms to describe clinical problems, procedures and lab tests, medications and allergies; and establishes security safeguards for exchange of electronic health information over the internet. In general, the final rule is designed to give professionals and hospitals greater flexibility in demonstrating meaningful use of certified EHR technology. The flexibility arises out of the rule’s three step process. The final rule establishes Stage One. A Stage Two update is scheduled for the end of 2011. Stage Three update is set for the end of 2013.
At this time, eligible professionals must meet a core group of 15 required objectives, including:
- Use of computerized provider entry for at least 30 percent of all unique patients with at least one medication in their medication list seen by their physician;
- Implementation of drug-drug and drug-allergy interaction checks;
- Recording and charting changes in vitals, BP and BMI for at least 50% of all unique patients between 2 and 20;
- Recording smoking status of 50% of all patients over 13; and
- Provision of clinical summaries to patients of each office visit within three business days of the visit for at least 50% of all office visits.
This is just the beginning of the HIT component of healthcare reform. It’s gonna be a long road!
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With over 20 years of healthcare law experience following his experience as legal counsel for the Florida Medical Association, Mr. Cohen is board certified by The Florida Bar as a specialist in healthcare law. With a strong background and expertise in transactional healthcare and corporate matters, particularly as they relate to physicians, Mr. Cohen’s practice immerses him in regulatory, contract, corporate, compliance and employment related matters. As Founder of The Florida Healthcare Law Firm, he has distinguished himself and his firm for providing exceptional legal services with the right pricing, responsiveness and ethics.
