Health and Human Services (HHS) advisory group in United States gave recommendation to the government to abandon its “all or nothing” approach to its plan for offering doctors and hospitals financial incentives next year for getting electronic health record systems up and running.
In a meeting of HHS Health IT Policy Committee, members recommended the government to relax some of its 2011 requirements for “meaningful use” of health IT in order to give providers more flexibility in qualifying for the plan in their first year of eligibility.
The Committee recommended providers be able to defer up to five proposed measures of meaningful use from 2011 to 2013. Six measures – including showing the ability to perform e-prescribing and providing patients an electronic copy of their heath records — would remain fixed first year requirements.
Under the committee’s Feb. 17 proposal, providers would still have to meet 80 percent of the original meaningful use measures. The shift would establish a common set of health IT functions among providers qualifying in the first year of eligibility while providing them options for ramping up for the new technology.
“We believe it is important to exhibit some flexibility in the ‘all or nothing’ approach to earning meaningful use incentives, while preserving a floor of important mandatory functional use requirements,” said Paul Tang, the vice chairman of the committee and chief medical information officer of the Palo Alto Medical Foundation. “It is difficult to predict which objectives and measures will be most difficult to achieve for a provider in the local environment,” he said.
Altogether, healthcare providers must perform 25 different measures of meaningful use, including showing computerized physician order entry (CPOE,based on proposed rules published last month by the Centers for Medicare and Medicaid Servcies).
The measures are grouped by healthcare priorities, including quality and safety; patient engagement; care coordination, public health and privacy and security.The mandatory measures are taken from each of the priority areas and the providers cannot eliminate all measures from any one of the priority areas. The approach recognizes providers who make significant progress and is designed so “it would not obviate the people moving in the direction of all five of those categories,” he said.
In addition to relaxing the qualification process, the committee recommended 11 other changes to the meaningful use rule. Those include requiring that CPOE be done by authorizing physicians instead of by someone working on their behalf; requiring that physicians enter progress notes about patient visits in their EHRs; and requiring that variables such as ethnicity and race be identified in quality reports.
The committee also endorsed a workgroup proposal that strengthened and clarified how to conduct a risk assessment of provider health information files, the sole measure to demonstrate privacy and security under meaningful use.
Providers who have been fined for a significant HIPAA violation will not qualify for meaningful use incentives that year, the panel noted.
The committee wants more details on how to calculate measures that require knowing the percentage of electronic usage versus manual usage.