Final Rules and Meaningful Use Announced

HHS Secretary Kathleen Sebelius brought out the top brass yesterday to announce the long awaited final rules for the EHR adoption initiative and transformation of health care systems to the 21st century. The newly sworn in head of CMS, Dr. Berwick, the ONC Dr. Blumenthal, and the Surgeon General, Dr. Regina Benjamin all gave personal accounts of their experiences with electronic health records and their commitments to the initiative. Berwick says the benefits of electronic health care systems are win-win. Blumenthal says he is optimistic and vows they will be successful. They both say they have never met anyone that has gone back to paper records after using electronic ones.

The CMS rules define meaningful use, the objectives to qualify as a meaningful user, and the incentive programs that will pay meaningful users. The ONC rules outline the adopted standards that systems will use to become certified. The 25 proposed objectives for EPs have been reorganized into 15 core objectives and 10 menu objectives for meaningful use. There are still the 5 priority outcome categories. EPs will be required to meet all of the core objectives and then chose from the menu objectives to qualify for stage 1 incentive money. The rules do not cover any details on stages 2 or 3 but comment on objectives that are not selected in stage 1 will be added to and required in stage 2. Some of the measures have also been decreased in response to public comments that insisted the proposed measures could not be met resulting in low adoption.

The table is set, now who will come to dinner? The objectives and measures have been relaxed for stage 1 meaningful use in a strategy of more participation. And since we have already heard that once you are an electronic user you won’t go back, it looks like we have a real bait and hook here. The reviews have started to come in but it will be another couple of weeks before everyone reads the thousand pages. For more on the rules, read Blumenthal’s “The ‘Meaningful Use’ Regulation for Electronic Health Records” in The New England Journal of Medicine and John Halamka’s “Meaningful Use and the Standards are Finalized” in his blog.