The government delivered on Wednesday the long-awaited definition of meaningful use of electronic health record technology, and it came wrapped in about 700 pages of proposed regulation.
The ability to exchange health data among providers, security of that data, standard formats for clinical summaries and prescriptions and standard terms to describe clinical problems, procedures and tests are part of the package.
A proposed rule issued by CMS outlines proposed provisions governing the EHR incentive programs, including defining the central concept of “meaningful use” of EHR technology. An interim final regulation (IFR) issued by ONC sets initial standards, implementation specifications, and certification criteria for EHR technology. Both regulations are open to public comment.
For providers, who have feared that "meaningful use" would be unreachable in 2010,CMS recommends phasing the criteria in three stages. "Such a phased approach encompasses reasonable criteria for meaningful use based on currently available technology capabilities and provider practice experience, and builds up to a more robust definition of meaningful use, based on anticipated technology and capabilities development," the proposed rule says.
The Stage 1 meaningful use criteria focuses on electronically capturing health information in a coded format, using that information to track key clinical conditions and communicating that information for care coordination purposes. It also calls for implementing clinical decision support tools to facilitate disease and medication management and reporting clinical quality measures and public health information.
CMS officials recommend Stage 2 criteria proposed by the end of 2011 and the Stage 3 definition proposed by the end of 2013. "Our goals for “Stage 3” meaningful use criteria represent overarching goals which, we believe, are attainable by the end of the EHR incentive programs," the proposed rule says.
CMS seeks comment
The IFR will go into effect 30 days after publication, with an opportunity for public comment and refinement over the next 60 days. A final rule will be issued in 2010. A proposed rule regarding the certification of EHRs is in the works and expected "soon," according to ONC officials, declining to speculate on how the meaningful use criteria might impact products certified by the Certification Commission for Health Information Technology.