Final "Meaningful Use" Rule Offers More Flexibility

Doctors spoke and policy makers listened. The final rule on "meaningful use" of EHRs includes provisions designed to provide more flexibility and multiple pathways for those charged with meeting the requirements.

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Healthcare professionals voiced their concerns, and rule makers listened.

At 10 a.m. EST, the Office of the National Coordinator for Health Information Technology (ONC) issued a final rule on the definition and requirements for demonstrating "meaningful use" of EHRs to qualify for incentive payments under the HITECH Act.

The final regulations include several medications designed to provide more flexibility and multiple pathways for those charged with meeting meaningful use requirements. The changes, said David Blumenthal, MD, the National Coordinator for Health IT, were made in response to the 2,000-plus comments that were received in regard to the proposed rule, which was issued in December of 2009.

In particular, it was “concerns about the pace and scope of implementation of meaningful use” that led rule makers to “adopt a two-track approach regarding the objectives that allow practices and hospitals to qualify for incentive payments in the first 2 years of the program,” wrote Blumenthal and Marilyn Tavenner, RN, in an article published today in the New England Journal of Medicine.

The final rule outlines the specific criteria that must be met to achieve stage 1 meaningful use, and the clinical quality measure reporting requirements needed to receive incentive payments in 2011 and 2012 (the 864-page document is available here through the Office of the Federal Register).

The most notable changes to the proposed rule include the following:

• The number of quality measures that has to be met has been reduced to 44 (physicians must meet six of those objectives, and hospitals must meet 15).

• The number of measures required to demonstrate that EHRs are being used in a meaningful way has been reduced to 15 for physicians and 14 for hospitals.

• The number of clinical decision support requirements has been reduced from five to one (for stage 1).

• The percentage of prescriptions that need to be sent electronically has decreased from 75 percent to 40 percent.

In addition, some of the meaningful use quality reporting measures are being deferred to stage 2.

“The rule was too inflexible,” said Blumenthal during the press conference.

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