Reading through the headlines, the press releases and checking in on today’s HIT Policy Committee meeting, it appears that the over-riding theme of comments regarding Meaningful Use (MU) rules (these were due by COB on 3/15) is to relax the rules, particularly regarding reimbursement and clarify other requirements of MU to ease the burden on providers seeking to comply.

This is not too surprising.

The policy to make incentive payments for EHR adoption and all or nothing deal (either you comply 100% to MU criteria to get reimbursement or nothing) is just plain silly.  Sure, flexibility will put a greater administrative burden on the Center for Medicare and Medicaid Services (CMS), but the risk of low adoption due to lack of flexibility is a real issue that CMS needs to address.

Another problem is that some of the reporting requirements are not terribly specific and will likely create an overhead reporting burden for providers.  In this case, the call is for more specificity to simplify and potentially even automate this process.

One area that Chilmark is seeing a wide range of comments is with regards to patient access to their medical records.  While there does not seem to be any major organization calling for a relaxation of this requirement, the MU rules are also not terribly specific on what access to one’s records actually means. Is it just a portal view, is it interactive, can one’s records be readily downloaded and transferred to another site (e.g., Google Health, HealthVault or other)?

Also, Stage One MU is pretty weak on the issue of providers delivering health content to a patient/citizen following a diagnosis.  This is such an easy thing to do, just don’t see why MU rules are not more forceful on this count. The tools/technologies/services are readily available, it is just a matter of making it happen. Speaking from personal experience, providing such health content after a diagnosis would go a long way towards a truly engaged and educated patient (and their support network) than what we have today.

The most thoughtful comments seen are those from the Markle Foundation.  Granted, Chilmark Research did play a small role and is a signatory, but really, they are quite good and are the result of Markle’s stellar outreach to the community (56 organizations were involved) in drafting these comments and suggested recommendations for MU rules.  Markle’s recommendations are a likely bellweather of what is to come in the final rules for unlike the multitudes of others who submitted comments, all with some sort of vested interest (AHA, AMA, HIMSS, etc.) Markle is neutral and the comments were developed by consensus from across the healthcare community.  To simplify your ability to review these comments, they have been uploaded to Scribd for easy viewing.

Early word is that the final rules for Stage One MU will be released late Spring.