WASHINGTON – The Health IT Policy Committee on Wednesday recommended that federal officials ease up the meaningful use requirements, allowing providers to defer some of them and still earn bonuses under the American Recovery and Reinvestment Act.

The recommendations included allowing qualified providers and hospitals to defer three criteria in the quality domain, one in the care coordination domain and one  in the population health domain.

The panel also approved recommendations to require that CPOE be done by the authorizing physician or under his or her authority. Recommendations also included that physicians record visit notes in their patient's electronic health records and information on ethnicity and race must be included in quality reports.

David Blumenthal, MD, chairman of the federal advisory HIT Policy Committee and the national coordinator for health information technology said meaningful use requirements are "not set in stone" and are likely to change in the next couple years.

The Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS) released the proposed rule on meaningful use in December that would set requirements for hospitals and physicians to qualify for Medicare and Medicaid bonuses. The agencies are accepting public comments on the proposed rule until March 15.

Blumenthal said the concept of setting goals for the use of healthcare information technology - rather than just the installation of technology - is a novel approach. "You have a very influential potential in HIT policy globally," he told the panel.

Paul Tang, chairman of the meaningful use workgroup said the proposed rule is a significant piece of legislation, especially in the absence of a health insurance reform bill from Congress. "It will be one of the biggest elements in transforming healthcare in our country," he said.

The group voted to recommend that providers be allowed to defer up to 20 percent of the proposed meaningful use requirements for up to a year and still receive incentives. The deferred objectives would not include those for privacy and security, and all providers would be required to report their clinical measures to their states and CMS.

Tang said the flexibility would be needed because "the all-or-nothing approach may not accommodate legitimate, unanticipated, local circumstances or constraints."

Jodi Daniel, ONC director of policy and research said ONC is working with the National Institute of Standards and Technology to release more specifics on standards soon.