WASHINGTON – Providers are airing their concerns about the newly proposed "meaningful use" requirements as they begin to wade through the 700 pages of documents that will help them gain bonuses under the American Recovery and Reinvestment Act of 2009.

The Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology released a list of 25 Stage 1 Meaningful Use criteria for eligible providers and a list of 23 Stage 1 Meaningful Use criteria for eligible hospitals on Dec 30. A final rule will be issued after the 60-day public comment period, which began on Jan. 13 when the proposed rule was published in the federal register.

The Medical Group Management Association said medical groups would confront significant challenges in trying to meet the program’s requirements due to its complexity. Others agreed,

“The regulation is complex,” said Marc Probst, CIO at Intermountain Healthcare in Salt Lake City. He says although he supports the overall concept of meaningful use as proposed by the Health IT Policy Committee, he “remains concerned about the pace of the change required by the meaningful use requirements.  At the pace defined I think there are many hospitals, clinics and physician practices that will not be capable of achieving meaningful use and may negatively incent some from even trying…” 

Probst is a member of the government’s Health IT Policy Committee, a federal advisory panel. He spoke as CIO of Intermountain, he said, not as a member of the panel.

“The time line feels too aggressive,” agreed Stephanie L. Reel, vice president for information services, Johns Hopkins Medicine and vice provost for information technologies, Johns Hopkins University. “October 2010 is just a few months away.”

“This incentive plan still seems to reward the ‘how’ and not the ‘what,’” added Reel. “That worries me. As a leader in an academic medical center, I want to create new knowledge, and support discovery.  I worry that a prescriptive solution, with incentives tied to process and tools, may stifle innovation.”

Bruce H. Taffel, MD, vice president, chief medical officer at SharedHealth in Chattanooga, Tenn., sees CMS’ plan as strategic. “It’s hard to know at this juncture how hospitals and eligible professionals will navigate the many different potential paths to qualifying for incentives or which path(s) are most efficient and effective, but CMS is smart for trying to evolve our healthcare system at a revolutionary pace,’ he said.

“I was very surprised about the quality measurement CMS is proposing related to meaningful use,” said Denni McColm, CIO, Citizens Memorial Hospital in Bolivar, Mo. “First, that they would even consider requiring quality measurement for meaningful use prior to CMS being able to accept quality measures from an EHR. And, second that they are proposing new quality measures and an alternate quality reporting system separate from Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) and PQRI.”

Representatives from the American Medical Association and the American Academy of Family Physicians said they are still reviewing the proposed requirements.