Stakeholders have mixed reviews on proposed meaningful use requirements

Physicians and privacy advocates aren't pleased with the newly proposed "meaningful use" requirements with which providers will likely have to comply to 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 proposed the rules on Dec. 30, and will take comments for 60 days before issuing a final rule.

The Medical Group Management Association said the requirements "are overly complex" and that medical groups will confront significant challenges trying to meet them.

“The Medicare and Medicaid incentive programs must be designed to facilitate the rapid deployment of health information technology,” said MGMA President and CEO William F. Jessee, MD. “Overly burdensome requirements and needlessly complex administration will only discourage physician participation in the program and the implementation of (electronic health records)."

Jessee encouraged the administration to simplify the meaningful use criteria and qualifying procedures.

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According to the MGMA, the rules will create "significant barriers" for physicians trying to achieve meaningful use of EHR data, including:

  • Unreasonable threshholds for some meaningful use criteria, including computerized prescription order entry, electronic claim submission and electronic insurance eligibility verification;
  • Potentially difficult meaningful use attestation after the first year; and
  • A requirement that physician offices provide patients and others with electronic copies of medical records.

"We were pleased to see that the CMS and ONC rules include some flexibility, especially in the areas of escalating stages of meaningful userequirements, straightforward first year attestation and reasonable 90-day reporting windows," Jessee said. “However, we firmly believe that the government should make additional changes to achieve widespread adoption by professionals in all types of clinical settings."

Privacy advocates are also displeased with the rule. Deborah C. Peel, MD, founder and chairwoman of Patient Privacy Rights, said the rule "does not contain the single most important criteria American patients and consumers demand to trust electronic health systems: control over personal health information." 

Comments submitted by the bipartisan Coalition for Patient Privacy, representing millions of Americans, were not  considered, Peel said.

The rule "guarantees that the stimulus billions will be wasted to purchase obsolete, unethical EHR 'clunkers' instead of EHRs with privacy-enhancing technologies that put patients in control of their sensitive health records, from prescriptions to DNA," Peel said.

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fredbuhr say: Dr. Peel is Right!

Because the proposed rule doesn't specify that consumers and patients should have control over their personal health information, billions of stimulus dollars will be wasted to purchase obsolete, unethical "clunkers" and worse. My experiences, as a former in-house data administration consultant with the Wisconsin Department of Health Services (DHS) and current member of the U.S. Health Information Technology Standards Panel (HITSP), confirm her observations and expectations of wasted money for the future.

Wisconsin is slated to receive $9.44 million from ONC this year to plan for health information exchanges (HIEs). Wisconsin then expects, over the next few years, to receive $80 or so million for HIE implementation projects. A request for information (RFI) for a Long Term Care Infrastructure HIE project that would integrate all legacy long term care systems, vital records and Wisconsin's data warehouse was released in August 2009. DHS has indicated that it will likely release a request for proposal (RFP) for the infrastructure project in 2010.

By Wisconsin acquiescing to the egregious privacy invasive practices of the Bureau of Aging and Disability Services (BADR) that permit mental health diagnoses to be entered and displayed on the electronic record summary screen of its Social Assistance Management System (SAMS), the fear that individuals have concerning potential breaches of privacy in their electronic healthcare records is not only well founded but already borne out in Wisconsin. No audit records appear to be kept as to who accesses the summary screens that hold individuals' most sensitive information.

Dr, Peel is right!

susiemas say: Explanation for groups who don't fit HIT criteria measures

This is a question I have asked countless number of times, with no response - How does an independent pathology group doing only anatomic pathology qualify for stimulus money when the criteria measures are not applicable? We of course realize that to maintain our clients it is necessary to provide EHR/EMR technologies (costing us big bucks) so the clients can produce a complete EMR, but yet while they claim a portion of the stimulus with our help, we don't qualify for anything. Can someone provide an explanation please, direction or instruction??

Thank you