Many unsatisfied with 'meaningful use' proposal, but that's no excuse to wait

Wouldn't you know, HHS officials published the proposed standards for "meaningful use" of health IT while we were taking a publication break last week. Fortunately, we were able to get in on the press teleconference and cover the announcement late last Wednesday. Better late on Dec. 30 than on New Year's Eve, I suppose?

So now that the rules are out, at least in proposed form, there should be no more dawdling. It's time for everybody to get to work on complying with the standards so providers can capture some of the billions in stimulus dollars for health IT, right?

Not so fast. The 556-page CMS document on meaningful use is a proposed regulation. The companion piece from the Office of the National Coordinator for Health Information Technology--136 pages on data standards, implementation and EHR certification--is considered an interim final rule. Both are subject to a 60-day public comment period. HHS then will review the comments and produce final rules sometime this spring.

Judging by my very full inbox this morning, this won't be an easy process.

"ONC, respecting the need for natural market forces to work has, in some cases, refrained from establishing single standards, even in places where the Office acknowledges that a single standard should be established. Such restraint will have ramifications for healthcare, as will the necessary establishment of initial provider performance requirements that will ultimately drive quality improvements. We have much work to do within healthcare regarding simple adoption, well before we can achieve meaningful use of the IT. This foundational work--while required--will likely result in provider uncertainty about which IT products to adopt, costs through adoption of ever-maturing IT over time, higher costs associated with a need to support multiple standards, and somewhat delayed improvements in patient outcomes and costs," says HIMSS President and CEO H. Stephen Lieber.

"America's hospitals have serious concerns that the new health information technology rules severely limit hospitals' ability to access federal financing for health information technology that is used to improve patient care," offers Rick Pollack, executive vice president of the American Hospital Association. "America's hospitals believe the proposed definition of 'meaningful use' is a worthy goal, but it should be a destination point, not a starting point. Today, many hospitals are using clinical systems that reduce medication errors, track quality and outcome measures, and collect basic patient health information using computer technology. The intent behind the stimulus funds was to recognize the important efforts hospitals and physicians have undertaken to improve care and to stimulate greater use of health information technology and EHRs. However, the rules...create a stringent definition of 'meaningful use' that doesn't recognize these important efforts and would unfairly penalize many hospitals."

These are just two national associations. Wait until ONC and CMS hear from individual vendors and health systems. This will be a busy next few months within those agencies.

That said, we now have at least a general idea of what meaningful use will entail. Providers can't afford to wait if they want to earn incentives that start in October 2010 for hospitals and January 2011 for physician practices. No more excuses. - Neil

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