Blumenthal on New Meaningful Use Requirements: ‘We added some choice’

The confusion over “meaningful use” has finally come to an end after the Department of Health and Human Services released yesterday the conclusive set of requirements for healthcare providers to follow in order to receive federal funding for the implementation of electronic health services.

The revisions demand far less from providers wanting to apply for certification than the requirements found in original meaningful use definition. The stimulus package passed last year authorized incentive payments through Medicare and Medicaid to clinicians and hospitals when they use EHRs securely to achieve specified improvements in care delivery. But in order to qualify as meaningful users of EHRs, providers needed to follow the demanding guidelines that were set in place for certification.

After months of many physicians and hospitals expressing their confusion, the proposed new rules were sent in last Monday for review to the Office of Management and Budget.

Now that the rules have been reviewed and released, providers will more easily be able to apply EHR use to these guidelines to receive funding through the American Recovery and Reinvestment Act.

“We heard it was too inflexible; that it was an all-or-nothing set of objectives. So we added some choice,“ said National Health IT Coordinator Dr. David Blumenthal at the press conference on Tuesday. “We want the objectives of meaningful use to be both ambitious but achievable. So we added some choice.“

In order to make meaningful use more achievable, the Centers for Medicare and Medicaid Services added some flexibility to the rules. The CMS got rid of the rule requiring physicians to meet a set of 25 criteria and hospitals a set of 23 criteria to be eligible to receive funding for electronic health-records systems.

With the revisions, hospitals must meet 19 criteria and physicians 20 under a formula that includes 15 mandatory quality measures for doctors and 14 for hospitals with a choice of five others from a set of 10 rules that are part of a “menu“. Some of the items on the menu include capacities to perform drug-formulary checks, incorporate clinical laboratory results into EHRs, provide reminders to patients for needed care, identify and provide patient-specific health education resources and employ EHRs to support the patient's transitions between care settings or personnel, according to Blumenthal.

“We looked at the comments to figure out what was fair. We also reduced the clinical-decision support requirement from five rules to one,” he said. “There are a whole host of similar changes.“

“Moving from legacy paper systems to modern information technology is a big change; it's really a new culture, and you don't get there in one step,“ said Administrator of the Centers for Medicare and Medicaid Services Dr. Donald Berwick at the conference. “Today's final rule represents really, really good progress to get us toward the answers we need. It will be better for patients and for the people who care for them, and it's going to be less costly,“ he added.

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