WASHINGTON – Federal officials released the final rule on meaningful use July 13, a rule sets the criteria for physicians and hospitals to qualify for thousands of dollars in stimulus funding incentives for the adoption of electronic health records.

The 864-page final rule outlines the specific qualifications providers must meet beginning Oct. 1 if they want to collect the maximum incentives. Hospitals stand to gain $2 million a year, while office-based physicians whose patient mix includes at least 30 percent Medicaid beneficiaries are eligible for up to $63,750 over six years. Medicare physicians can earn a maximum closer to $44,000.

The final rule differs from the proposed rule issued last January by allowing providers more flexibility in choosing initially which measures to use for qualifications, says David Blumenthal, MD, national coordinator for health information technology.

The proposed rule required doctors to comply with 23 measures, and hospitals 25 measures. Taking into account more than 2,000 comments, the final rule requires doctors to meet a set of 15 core objectives during the first year – or Stage 1– of adoption. Hospitals are required to comply with 14 core objectives. In addition to the core objectives, both hospitals and doctors will have to choose five more objectives from a "menu" of 10, he said. The remaining objectives will be deferred to Stage 2 of adoption.

The final rule also reduced the number of electronic prescriptions a doctor is required to make from 75 percent to 40 percent.

Hospital executives were split on their reaction with the Federation of American Hospitals enthusiastically supporting the new rule, while the American Hospital Association said the added flexibility was not enough to make IT adoption achievable for most hospitals.

AHA President Rich Umbdenstock said individual hospitals in multi-campus settings are unfairly excluded from incentive payments, and the rule might adversely impact rural hospitals, exacerbating the digital divide.
William Jessee, president of the Medical Group Management Association, said: "While challenges remain, the final rule provides a better approach to the real-world issues faced by practices as they move toward meaningful use of EHRs.

Blumenthal said he is confident the use of electronic health records will become a core professional competency among physicians, who will eventually will be unable to imagine medical practice without them.

Justin Barnes, vice president of marketing, corporate and government affairs for Greenway Medical Technologies and chair emeritus of the EHR Association, said many doctors are beginning to grasp that healthcare IT is the "super-highway of the future."
Barnes, who has taught or spoken at more than 100 seminars and conferences on meaningful use, said he has had the opportunity to get a feel for providers' reactions to the HIT incentive program.
"More than half of them realize they need to be connected and part of it,” he said. “They can't be connected with paper.”

Meaningful use is a great catalyst, Barnes said, but it's not about just chasing down the meaningful use dollars. “I'm seeing half of the doctors out there doing this because it's the right thing to do for future of medicine. It's about higher quality patient care.”