February 2010 is almost here, and implementation for the HITECH legislation is moving ahead on schedule. For those unaware, the HITECH Act is designed to promote the adoption of electronic health records (EHRs) by reimbursing physicians who purchase and use qualified EHR systems. Physicians with enough Medicare patients can receive up to $44,000, and physicians who see at least 30% Medicaid patients will qualify for $64,000. Meaningful Use is a set of standards physicians and EHR vendors must meet in order to qualify.
The Meaningful Use Interim Final Rule (IFR) and the Notice of Proposed Rulemaking (NPRM) is still within the public comment period, which lasts until March 15th. According to David Blumenthal, National Coordinator for Health Information Technology, the NPRM is “not a done deal.” The National Coordinator promises to entertain all comments “within the scope of the regulation.” The government won’t be able to add anything else to the rule, but may modify or remove existing aspects.
The Meaningful Use IFR will be much more difficult to change, according to Jodi Daniel, ONC’s director of the Office of Policy and Research. This is good because many EHR vendors are working to ensure their systems will meet the requirements. She said the office is still accepting comments, however, and expects some small changes.
Some groups view the meaningful use IFR requirements as “too high and too many.” Catholic Healthcare West, Intermountain Healthcare, and Kaiser Permanente have all adopted EHRs, but there are gaps between the systems’ features and meaningful use requirements. The groups are critical of the “all or nothing” approach taken by the legislation. In this case, the advantage lies with practices who do currently have an EHR system. They can purchase a system that will meet their needs and the meaningful use requirements right out of the box. Existing EHR users may face expensive upgrades.
Certification for meaningful use is also moving forward. CCHIT has discontinued their “preliminary” meaningful use certification and replaced it with an updated “meaningful use stage 1” comprehensive and modular certification. Although CCHIT has long been the most well-known certification agency, the National Institute of Standards and Technology (NIST) awarded consulting group Booz Allen Hamilton, Inc, a contract to develop a testing method and process for certifying EHRs. No one is sure which organization will actually issue certifications. According to Blumenthal, ONC will review the final legislation and see where CCHIT “fits in.” He states that CCHIT will “clearly have the option to participate in certification going forward,” but no one is sure exactly what that role will be.
Physicians need to get started with their EHR purchase post haste to qualify for the first year of reimbursements in 2011. Implementation of any EHR system usually takes a couple of months. In addition, many vendors are currently backlogged with installations. Contact your health IT consultant today to see how you can qualify.