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Meaningful Use Provisions Challenged at Hill Hearing

Janice Simmons, for HealthLeaders Media, July 21, 2010

Are the new meaningful use guidelines enough to improve the standard for quality? Some Republican members of the House Ways and Means Health Subcommittee do not believe so and used Tuesday's hearing to challenge the meaningful use requirements. Much less is expected from the healthcare providers receiving subsidies under the new measures than what the Centers for Medicare & Medicaid Services had initially proposed.

Much less is expected from the healthcare providers receiving subsidies under the new measures than what the Centers for Medicare & Medicaid Services (CMS) had initially proposed, said Rep. Wally Herger (R-CA), the ranking Republican on the panel. Overall, the final regulations "represent a missed opportunity to improve patient care and reduce waste," Herger added.

Subcommittee Chair Pete Stark (D-CA), though, at the hearing opening disagreed—saying that "in my opinion, [the Department of Health and Human Services] took a responsible position in the final rule: The standards are aggressive, but [they] set realistic goals."

While the proposed rule initially called on eligible professionals to meet 25 requirements (23 for hospitals) in their use of electronic health records, only 15 core requirements are now mandatory for eligible providers and 14 are mandatory for hospitals—along a menu of 10 additional requirements, of which five needs to be met.

David Blumenthal, MD, the National Coordinator for Health Information Technology, told the panel that HHS will likely place greater demands on providers later on in the future.

The meaningful use standards from July 13 are first in a series of rules and will apply only to incentives payments before 2013, he said. Additional stages for rolling out electronic records will be released—and will have much more stricter requirements, he said.

"Our approach to meaningful use must be both ambitious and achievable. Like an escalator, [the Health Information Technology for Economic and Clinical Health Act] attempts to move the health system upward toward improved quality and effectiveness in healthcare," Blumenthal said. "But the speed of ascent must be calibrated to reflect both the capacities of providers who face a multitude of real-world challenges and the maturity of the technology itself."

The overall approach was to "make well-intended, capable physicians and hospitals able to get to the first step, get some help financially, get the encouragement of being able to use the record," he says. If the federal government went too low, "I think we would indeed be in danger of not getting value for money. If we went too high, we would be in danger of stifling the program right at the beginning."

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