As health care professionals digest the meaningful use final rule that governs how they will adopt information technology, officials are moving ahead with several programs to monitor and support that adoption.
Industry stakeholders welcomed the final rule, saying it clarified what's required of providers while helping to ensure that criteria for meaningful use Stage 1 requirements are easier to reach. Meanwhile, the Office of the National Coordinator for Health IT (ONC) has begun to develop systems for data collection, adoption modeling, performance measurement and support for meaningful use. The goal, according to officials who explained the program yesterday, is to track providers, find patterns in IT adoption and monitor how well the meaningful use initiative is working.
Paul Egerman, a member of the federal Health IT Policy Committee and chairman and CEO of eScription, a brand of Nuance Communications Inc., said the final rule removes proposed administrative and billing requirements -- a big relief for the industry. "People should feel really good how this whole thing turned out," he said, speaking to fellow members of the committee's Certification/Adoption Workgroup.
The workgroup, which had recommended that the Centers for Medicare & Medicaid Services (CMS) simplify those administrative requirements, met Wednesday. During the meeting, two ONC officials explained how the office will track and monitor the meaningful use program.
One of the main areas the ONC would like to monitor is the impact of implementation on workflow, said Melinda Buntin, director of ONC's office of economic analysis and modeling. Many of the comments for the meaningful use proposed rule focused on health care providers' concerns about loss of productivity and workflow interruptions because of IT. ONC wants to conduct more research and develop a comprehensive look into those concerns, she said.
"We have not found anything other than small case studies," Buntin said. "And we don't know how that [workflow] might be changing."
The ONC is also developing a dashboard as a way to measure the performance of the meaningful use program, Buntin said. The dashboard will help ensure that the office is meeting its requirements under the Health Information Technology for Economic and Clinical Health (HITECH) Act, while a public component of the monitoring system could show health care professionals and others where they stand with health IT adoption. "There are a number of things we have to report to Congress," she said.
In general, I think they made reasonable cuts.
Mark Segal, vice president of government and industry affairs, GE Healthcare IT
CMS released the 864-page meaningful use final rule Tuesday to an eager health IT audience, which has been waiting since winter to find out how the government would finally define the "meaningful use" of electronic health record (EHR) technology. At stake is some $23 billion in HITECH Act financial incentives for providers who use EHR systems and other types of health IT approved by policymakers.
Providers who want to be eligible for those incentives will have to adopt a set of 15 core meaningful use measures, in addition to choosing another five from a menu of measures. That approach builds in flexibility for hospitals and doctors -- one of the most contentious arguments the industry had made when the meaningful use proposed rule was released in January. Under the proposed rule, providers would have been required to implement everything at once, an all-or-nothing concept that had professionals bristling.
The reductions in the final rule make sense, according to Mark Segal, vice president of government and industry affairs for General Electric Co. Healthcare IT. The core requirements still include patient engagement measures, quality reporting and clinical information exchange -- all key components of electronic health care, he said. "In general, I think they made reasonable cuts."
Segal, who also is the past vice chair of the Healthcare Information Management and Systems Society (HIMSS) Electronic Health Record Association, or EHRA, pointed especially to the number of quality measures hospitals and doctors will be required to report on through the meaningful use rule. In the proposed rule, most of those measures lacked the technical specifications that would allow the data to be collected electronically. The quality measures in the final rule all allow professionals to use EHR systems to collect and send quality information, he said.
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