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CMS, ONC Announce Health IT Rules

Today, the Centers for Medicare & Medicaid Services (CMS) announced its final version of “meaningful use” requirements for electronic health records (EHRs).  The new regulations responded to congressional criticism of draft regulations and abandoned an “all-or-nothing approach” in favor of greater flexibility for care providers.

The final regulations were written at the end of a six-month comment period that began when a draft version of the rule was published in January.  Also, the the Office of the National Coordinator (ONC) announced its final guidelines for EHR certification and testing via live webcast earlier today.

In April, a group of 27 senators signed a letter to then-acting CMS Administrator Charlene Frizzera, writing that they were “concerned that the CMS’ proposed rule regarding Medicare and Medicaid incentives for meaningful use of EHR technology is too restrictive.”

The group of senators included Orrin Hatch (R-UT), Amy Klobuchar (D-MN), Barbara Boxer (D-CA), and Lamar Alexander, (R-TN), who also expressed concern that the draft guidelines went “against the intent of Congress to reward those hospitals that already have taken important steps toward implementing EHR systems” by proposing an “all-or-nothing approach in which hospitals would be required to adopt all 23 separate EHR objectives.”

Another letter, authored by 37 Senate Democrats, had similar criticism for Kathleen Sebelius, Secretary of Health and Human Services.  The letter read, “while we believe that the general implementation framework outlined in the proposed rule should be preserved, starting with a phased, flexible approach to meaningful use would be a constructive change.”

The new regulations pared the list of 23 separate EHR meaningful use objectives to 15 core requirements for physicians and 14 for hospitals.  Core requirements include processes like writing prescriptions electronically, providing patients with an electronic copy of their health information if they ask for it and maintaining an active medication list for all patients to prevent harmful drug interactions.

Care providers will have to choose ten goals from a “menu set” that they will have to meet by the second stage of nationwide EHR implementation, according to David Blumenthal, national Health IT coordinator.

“We want objectives to be ambitious but achievable,” said Dr. Blumenthal at an HHS briefing earlier today.  “The first thing we’ve done is add flexibility of choice, allowing different providers with different situations to take different pathways to meaningful use.”

Dr. Blumenthal also announced ONC’s final version of EHR certification regulations at the briefing, ending jurisdictional questions about which government agency would author reliability and privacy rules for the new technology.

Janet Dillione, CEO of Nuance Healthcare Solutions, said that the criteria released by CMS reflect that “a key part – an absolutely fundamental part – of Meaningful Use is physician adoption of IT; how they use IT, and how effectively they use it,” adding “now that the final regulations are available to us, the journey moves forward to implementation.”

Since both the federal assistance requirements for EHR adoption and the federal regulations for EHR certification have been finalized, health IT vendors can finally get down to business and design software that will meet the needs of care providers as well as the requirements of the federal government.

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