February 24, 2012 — The Centers for Medicare and Medicaid Services (CMS) yesterday released its proposed rule regarding Stage 2 meaningful use (MU) of electronic medical records (EMRs). The Office of the National Coordinator for Health IT (ONC) is expected to publish the associated standards, implementation specifications and certification criteria in the next couple days. Both proposals will be published in the Federal Register on March 7 with 60-day public comment periods.
The Healthcare Information and Management System Society (HIMSS) said these are significant steps forward in transforming healthcare in the United States. In an unusual move, the NPRMs were discussed in general terms prior to actual public release during this week’s HIMSS 2012 annual conference. In the preview presentations, CMS and ONC staff indicated that several of ACR’s MU recommendations have been incorporated in some form into the NPRMs, including:
· A menu set (discretionary) measure focused on diagnostic image accessibility via certified EHR technology
· Massively increased flexibility in the definition of “certified EHR technology” so that eligible professionals (EPs) no longer have to implement technology certified for criteria that correspond with measures from which they have been excluded (with certain exceptions due to statutory requirements)
· Menu set measures to promote cancer registry and specialty society registry participation
· Exclusions from individual measures appear to be more flexible and useful
· More information specific to the future penalties, including a question posed by CMS regarding significant hardship exemptions for EPs in certain situations
· Clinical quality measures of relevance to radiology
· More flexibility/direction in the definition of an encounter
· Consolidation of the patient information provision related measures
For many years, HIMSS has championed the best use of information technology and management systems for the betterment of healthcare. Since the inception of the HITECH provisions of the American Recovery and Reinvestment Act of 2009 (ARRA), HIMSS has equipped stakeholders for increasingly sophisticated meaningful use of health information. To help providers and patients improve care delivery and health outcomes for all Americans, HIMSS members strongly encourage the federal government to continue promoting the adoption of EHRs through the Medicare and Medicaid EHR Incentive Program in support of the standards-based collection, analysis, and exchange of health data in a safe and secure environment.
The Medicare and Medicaid EHR Incentive Programs have already had an enormous impact on EHR adoption rates. Forty-three states have started their Medicaid EHR Incentive Programs; more than 190,000 EPs and eligible hospitals (EHs) have registered for the Medicare and/or Medicaid EHR incentive programs; and more than $3 billion has been paid in incentive payments to EPs, EHs, and critical access hospitals (CAHs) across the country.
New HIMSS Analytics data, reported in the “December 2011Summary of Meaningful Use Readiness,” indicates that seven segments of hospitals show increased capability to achieve Stage 1 of meaningful use. The hospitals in these seven categories typically demonstrate IT adoption that outpaces their peers, a segment that also includes hospitals at Stage 6 or Stage 7 on the HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM). HIMSS said tremendous progress has been made toward improved patient care and efficiencies offered by health IT, and HIMSS is excited to work with our members to move into this next phase of transforming healthcare.
The American College of Radiology (ACR) was also pleased to see many of its recommendations incorporated into the proposed rule.
“We are encouraged by early indications from the agencies that many of ACR's various 'asks' have apparently been included to a certain degree,” said Keith Dreyer, M.D., chair of the ACR IT and Informatics Committee-Government Relations Subcommittee. “We will review both proposed rules over the next several days and provide additional information, including an in-depth regulatory summary, as soon as possible,” he said.??Following the public comment period, the agencies will review the stakeholder feedback received and begin the process of developing the final rules. As always, the ACR IT and Informatics Committee invites interested members to provide input for potential inclusion in the future ACR comments.
“It is important to remember that these proposed rules have a very long way to go in the rulemaking process. Many things can, and will, change before the final rules are promulgated by CMS and ONC later this year,” said Dreyer.
The ACR will provide more information about the content of the NPRMs as soon as internal reviews and regulatory analyses are complete. ??The CMS notice of proposed rulemaking (NPRM) regarding Stage 2 MU can be found on the Office of the Federal Register’s Public Inspection Desk.
For more information: www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1