HIMSS: Blumenthal emphasizes need for input on CMS proposals

David Blumenthal at HIMSS10

ATLANTA–At a roundtable discussion at HIMSS, David Blumenthal, MD, National Coordinator for Health IT, took a range of questions from about three dozen AMDIS members and physician IT leaders and emphasized the need for CMIOs and healthcare professionals to submit their comments to CMS as well as their congressional representatives.
 
Much of what CMS is trying to do with regard to meaningful use funds and definitions of eligible providers is tied to legislation, said Blumenthal. For example, although providers have some flexibility with time frames for implementing electronic medical records (EMRs), the regulations regarding reimbursements are rigid, so providers cannot receive funding up front to help get them off the starting line on implementation.

When asked whether CMS has contingency plans for a wide-scale failure of healthcare facilities to deploy EMRs, Blumenthal said CMS is planning for some degree of noncompliance, but also said he believes EMRs will come online even without stimulus funding. Physicians have seen what electronic records offer, and they want to adopt them, he said. "I think we are at the beginning of a sigmoid adoption of EHRs. Never underestimate the power of peer pressure and group dynamics in changing the perception of people. Right now, physicians and hospitals are successfully adopting EMRs and the numbers show that 90 percent of physicians are satisfied with the EHRs they are using."

Following are some of the questions and his answers.

Q: Should our comments now be about HIT Policy Committee’s Feb. 17 recommendations, or about the original recommendations? Or both?

A: If you wish to influence the final regulations, you should comment on the original regulation. The policy committee has been a wonderful source of advice. Its advice to me and the secretary has been very influential. It is an advisory committee not a regulatory committee.

Q: Is there any way to get some funds out to providers for real-time support to get them off the starting line with EMR implementation?

A: The formula for payment is rigidly described, and we have no discretion for starting payments earlier. We have some flexibility in time frames for demonstrating compliance, but we don’t have discretion for getting funds out earlier.

Q: Can you speak about the criteria of certification of meaningful use? CCHIT is out there and and they’ve been certifying facilities, but not for meaningful use. Physicians really want to purchase a system that meets the criteria for meaningful use, but here we are in March, and we have only 10 months left now to begin having a program.

A: The rule on certification will be out very, very, very soon, like you could hold your breath, but we had to do that by regulation. [Note: The NPRM on certification was released two hours later.] To write a regulation for the federal government is not a fast process. We’ve gotten two regulations out in 10 months. In federal government terms, that’s warp speed. When this regulation comes out, it probably can be mobilized quickly. All of which does not change the fact that the time table is very fast.

Q: My group interpreted the standards as requiring a rate of 80% electronic medication reconciliation completion would be required. Is med rec only storage and documentation, or an integrated system?

A: If it’s not clear to you what the regulation says, you should comment on it. The intention is to give hospitals an incentive for CPOE.

Q: We have heard that innovation curves [for vendors] are being truncated because vendors are working on MU to have a compliant [EHR] system. Do you see this?

A: There may be some things vendors won't do because they are backfilling. But once they get back on development, the market will dictate what comes next [and thus what they want to buy].