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HIMSS outlines meaningful use recommendations in town hall meeting

Giving providers partial credit for reaching meaningful use ranks among the Health Information and Management Systems Society’s recommended changes to federal meaningful use rules.

When it comes to meaningful use, the Health Information and Management Systems Society (HIMSS) generally endorses the federal government’s approach to implementing health IT but sees several areas for improvement.

During a town hall meeting at the HIMSS10 annual conference, the organization outlined its recommendations for changing the criteria for meaningful use outlined in late December by the Office of the National Coordinator for Health Information Technology Policy (ONC), and attempted to address the concerns of its members.

The most notable HIMSS recommendation was one that would let providers and hospitals receive federal reimbursement under the American Recovery and Reinvestment Act of 2009 (ARRA) after meeting many -- but not all -- of the meaningful use requirements.

Patricia Wise, vice president of health information systems at HIMSS, said this amounted to “partial credit.” HIMSS was flexible on the number of criteria needed for reimbursement, she said -- during the town hall meeting she suggested one-half or two-thirds -- and would want providers receiving partial credit to meet all remaining meaningful use criteria the following year.

Other specific recommendations on meaningful use, as well as the interim final rule (IFR) on standards and certification for electronic health record (EHR) technology, include the following:

• Use of The Joint Commission’s definition of managing data, especially as it pertains to the use of a computerized provider order entry systems

• Support for several patient data summary standards, including Continuity of Care Record (CCR) and Continuity of Care Document (CCD) for Stage 1 of meaningful use, but support for only one standard in Stage 2

• Support for counting hospital-based providers among those eligible for ARRA incentives

• Reassurance that providers will need to pull data on quality measures from a certified EHR system, not a data warehouse, as “that would be an administrative nightmare,” according to Tom Leary, senior director of federal affairs at HIMSS

In addition, HIMSS indicated that it intended to ask the ONC for clarification or additional information on the following meaningful use criteria and ARRA regulations:

• The electronic version of a personal health record, which, as one attendee pointed out, could be anything from a thumb drive to a CD to a PHR file

This is the first year when you go home from HIMSS and you don’t relax. You get right back to it.

Tom Leary, senior director of federal affairs, HIMSS

• The interoperability requirements, testing and certification of both complete and modular EHR systems

• The definition of a data breach, which, as another attendee said, could occur if Clinic A sends the wrong file to Hospital B, only Hospital B does not know it is the wrong file and opens it anyway

• The error rate threshold for a data breach, because, as a third attendee said, mixing up two patients named John Smith is less egregious than misplacing a hard drive

Both the meaningful use proposed rule and the IFR appeared in the Federal Register on Jan. 13, and the public comment period for both remains open until March 15. Meanwhile, the EHR certification program proposed rule announced at HIMSS10 will be open to public comment once it too, is published in the Federal Register.

“This is the first year when you go home from HIMSS and you don’t relax,” Leary said. “You get right back to it.”

Let us know what you think about the story; email Brian Eastwood, Site Editor.

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