July 14, 2010, 12:29 PM — The federal government has, in many ways, lowered the bar for physicians and hospitals to receive reimbursement for implementing electronic medical records (EMRs), while also retaining the fundamental measures to maintain quality and safety, experts say.
The U.S. Centers for Medicare and Medicaid Services (CMS) released its final version of so-called meaningful use rules on Monday, which will be used by the government to qualify EMR implementations for billions of dollars in incentives.
Bill Connelly, an attorney with the Healthcare Division of the New York-based law firm of Manatt, Phelps & Phillips LLP, said the changes made by the CMS in quality measures were significant. The CMS dropped the measures from 90 to 44, and physicians only need report electronically on three.
For example, if a patient has diabetes, a physician or hospital is required to report that they are in fact taking blood pressure readings on that patient, or if a patient has had a heart attack, they must report that they have prescribed an aspirin regimen. Part of the reason for the dropping so many of the requirements in the first phase of meaningful use rules is that CMS itself has no way to receive reports electronically much of the time, Connelly said.
The new rules were finalized after a three-month public comment period during which more than 2,000 recommendations were received by the U.S. Department of Health and Human Services on its preliminary "notice of proposed rule making" effort. The final document is 864 pages long.
In the final rules, CMS does little to promote the electronic exchange of EMRs between hospitals and among states. "There wasn't much to promote health information exchange in the proposed rule, but they scaled it back even further in the final rule," Connelly said.
He added that state health information exchanges will likely be addressed in phase two and three of the rules. Phase two is expected as early as this fall. There has yet to be a date set for phase three of the rules.
Mark Segal, vice president of Government and Industry Affairs for GE Healthcare IT, said CMS basically took what were a set of "all or nothing" rules and accounted for the realities of implementing EMRs in a short time frame. For one, they lowered the percentage of EMRs that had to include patient demographic and vital sign information from 80% to 50%. "It's more attainable. It gives them more leeway," he said.