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Meaningful Use, EHR Standards Proposals Released by HHS

Janice Simmons, for HealthLeaders Media, December 31, 2009

The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Improvement Technology (ONC) on Wednesday released for public comment two anxiously awaited regulations providing both the details of "meaningful use" and the standards to improve the efficiency of health information technology used nationwide by hospitals and physicians.

"Both regulations are important in their own right, but they should be seen as part of a larger effort—a more comprehensive effort—to improve the health of the American people and the efficiency of its health system by equipping physicians, hospitals, and other health professionals with the best, most accurate, and most up-to-date information that they need and can use to help their patients, " said David Blumenthal, MD, national coordinator for health information technology, at a briefing late Wednesday.

The proposed rule defining meaningful use for the Medicare electronic health record (EHR) incentive programs proposes a definition that would apply to eligible professionals participating in the Medicare fee-for-service and the Medicare Advantage EHR incentive programs. A definition is provided as well that would apply to eligible hospitals and critical access hospitals.

The rule proposes a phased-in approach to implement the proposed requirements for demonstrating meaningful use. The meaningful use criteria proposed on Wednesday is the first of what will be three stages of meaningful use criteria to be used between now and 2013.

The initial set of criteria will focus on collecting data electronically, sharing this data with other healthcare providers and patients, and finally reporting the measures to the government, Blumenthal said. The second stage of criteria would be proposed by the end of 2011. This will focus on structured information exchange and continuous quality improvement. Stage 3, which will focus on decision support for "national high priority conditions" and population health, would come out in 2013.

CMS will provide a 60-day comment period on the proposed rule after the rule is published in the Federal Register in January.

The interim final regulation 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 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.

This regulation spells out the way industry can standardize the way in which EHR information is exchanged between organizations, and sets forth criteria required for an EHR technology to be certified.

The Department of Health and Human Services was required to adopt an initial set of standards for EHR technology by Dec. 31. This regulation will go into effect 30 days after publication, with an opportunity for public comment and refinement over the next 60 days. A final rule will be issued in 2010.


Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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