WASHINGTON A Health and Human Services Department advisory committee is moving to make it easier for physicians to meet federal requirements for adopting electronic health records.
The Health IT Policy Committee has recommended that providers who adopt EHRs after 2011 or 2012the first years that federal stimulus money for adoption will be availablehave to meet only 2011/2012 requirements for "meaningful use" of EHRs in their first year of adoption. They will then need to meet additional requirements each year in order to continue getting the money, although they will receive less than they would have if they had adopted EHRs earlier.
"A rising tide floats all boats, but if you're not in the water, it just doesn't help," said Dr. Paul Tang, cochair of the committee's meaningful use working group. "So we're just trying to find a way to get people to deal with it, even if it's a little bit late."
Under the Recovery Act, $19 billion in stimulus money has been set aside to encourage adoption of health information technology, including EHRs. The money includes up to $44,000 in financial incentives for each physician who purchases a certified EHR system and who makes "meaningful use" of it.
To put the law into effect, the government has to define "meaningful use" and set standards for system certification and health information exchange. The HIT Policy Committee, chaired by Dr. David Blumenthal, national coordinator for health information technology at HHS, will make recommendations; the actual regulations will be written by staff members at the Centers for Medicare and Medicaid Services (CMS).
At a recent HIT Policy Committee meeting, committee member Gayle Harrell, former Florida state legislator, expressed concern that some of the meaningful use requirements were aimed more at primary care physicians and would not be appropriate for specialists. Dr. Tang agreed that the working group would try to make sure that specialists' needs were addressed when the recommendations were finalized, and noted that not all measures would apply to all specialties. The committee agreed to accept the meaningful use working group's recommendations.
Ms. Harrell also raised the question of whether specialists would now be liable for information presented in the EHR that falls outside of their purview. "Would an ophthalmologist have to verify whether or not I had a mammogram?" she asked.
Dr. Blumenthal said he didn't think the liability issue was within the committee's scope. "I think we have to stay focused on what we think appropriate good care should be, and we can't sort" the system out here.
The standards and certification subcommittee also presented the following five recommendations to the committee:
▸ Focus certification on meaningful use.
▸ Leverage the certification process to improve progress on security, privacy, and interoperability.
▸ Improve the objectivity and transparency of the certification process.
▸ Expand certification to include a range of software sources, such as open-source and self-developed systems.
▸ Develop a short-term transition plan for certification.
Dr. Neil Calman, a family physician and CEO of the Institute for Family Health in New York, said he was concerned that the last recommendation would send the wrong message to providers who were already certified by the Certification Commission for Health Information Technology (CCHIT), currently the government's only approved certifying body. "It basically makes it sound like CCHIT is temporary," he said.
But working group cochair Paul Egerman said that was not the message the group meant to convey. "I would be very surprised if … CCHIT wasn't equally involved with this [process] going forward. Basically, they're the ones that know how to do it," he said.
The committee agreed to adopt the working group's main recommendations but to let working group members rework some of the specifics.