AMDIS: Health execs initially pleased with meaningful use rules

OJAI, Calif.—A first look at the 864-page final rule for Meaningful Use and EHR Certification shows that policymakers “listened and responded” to some physicians’ concerns, said speakers Pat Wise, RN, vice president of healthcare information systems at HIMSS, and Michael Zaroukian, MD, PhD, CMIO and associate professor of medicine at Michigan State University, during a presentation at the annual AMDIS Physician-Computer Connection Symposium Wednesday.

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Video: Pat Wise, RN, responds to the Meaningful Use and EHR Certification final rule at AMDIS.
Although both Wise and Zaroukian cautioned that their presentation was a preliminary assessment of the new regulations, they said the final rule included some changes from the preliminary proposal that will make the process relatively easier to achieve.

However, it’s still a major challenge: “In order to attain meaningful use of all technologies, we certainly [have] a long way to go," said Wise. In addition, “meaningful use doesn’t stand in isolation,” she said, with HIPAA privacy and security compliance and ICD-10 implementation also on the horizon.

“Stage 1 is now a moving target,” Wise said, with criteria that will likely differ for facilities that seek to become meaningful users starting in 2013. If an organization elects to postpone meaningful use compliance, Stage 1 criteria have not yet been articulated, she said.

“It’s good to see the bar changing in direction … from seemingly impossible to achievable,” said Zaroukian.

There are now 10 fewer mandatory measures for eligible providers and hospitals in 2011-12, he said. “We pushed for a core set and another set that were optional, and they listened to that,” said Zaroukian. “From the remaining 10 that are now optional, you can pick five, and a passing score is meeting 20 out of 25.”

In addition, many measurements now have simplified denominators, often based on unique patients, not visits, which will simplify reporting, and the required percentages of compliance are lower than originally proposed, he said.

Also, hospitals will qualify as meaningful users under Medicaid if they qualify under Medicare.

The final computerized physician order entry (CPOE) requirements include some important changes from the original proposal: For example, in Stage 1, CPOE is required for medications only, orders can be entered by licensed healthcare provider in addition to physicians. The rate of compliance required is 40 percent.

“Structured data still matters, but new percentages reflect reality," he said.

Preceding the presentation, several questions were asked:
Q: When you’re making the case for meaningful use in the C-suite, who should be on your team?

A: Include the group of physicians who are engaged, and tell leadership, ‘CMS just gave us some breathing room, more leash to work with. Let’s use that, change our priorities and refocus to see what needs to be sequenced when.’

Q: The business of reporting clinical quality measures to CMS and the state is still troublesome. If there are 90 eligible professionals measures and 45 for hospitals, is there any more clarity in terms of what this means?

A: There’s some relaxation in this -- see the table on page 272, table six of the final rules. We’ll probably see the clinical reporting requirement hit home in 2013.  

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