- By far the biggest relaxation was to divide the original 25 measures (23 for hospitals) into two groups – 15 mandatory measures and 10 optional measures of which only 5 need to be fulfilled, per provider choice. This is in effect a 20% reduction of the Meaningful Use burden.
- They added back a requirement for hospitals to record advanced directives. It is listed in the optional group, which means that some hospitals could choose not to implement it, but one must be grateful for having it back on the list.
- In the ONC certification rule, Immunizations have been removed, along with procedures, from the minimum requirements for data elements to be shared with patients and other providers. For Pediatricians and all parents of young children, particularly this time of year, this is not welcome news. Hopefully vendors will go above the minimum here, since it is rather trivial to provide immunization histories to any interested party.
- The two Administrative requirements of submitting claims electronically and verifying eligibility with payers have been removed. On the surface this makes sense when talking about the use of EHRs. However, the vast majority of providers, hospitals and private practices, already meet both criteria since Medicare and Medicaid require electronic submission of claims, not to mention the potential cost savings from automating such process.
- For most measures, the minimum percentage for compliance has been dropped to about 50% or less. This gives the impression of further concessions, however it is rather meaningless. If you are going to manage medications in the EHR, you will do that for all patients, not just a select 30%. Not to mention that if you use electronic prescribing for some allowed prescriptions and not for others, you will end up with a reconciliation nightmare when electronic renewal requests start flowing in from pharmacies for all your paper scripts. Anyway, placing the bar lower is a friendly gesture from CMS
- Many previously required standards for terminology and data exchange have been relaxed in the ONC document, particularly for labs and medications. While completely irrelevant to physician users, this is a huge win for vendors whose efforts to retool their EHRs are now postponed by a couple of years.
All in all, the new Meaningful Use is a bit more flexible than the old version and what was bound to become a typically painful bureaucratic attestation for physicians, is now a rather straightforward process. Other than that, you still have to buy a certified EHR, install it and meaningfully use it by October 1st 2011. If you’re considering hopping on the bandwagon, call your Regional Extension Center and see if you can get some free services to get the ball rolling. Meaningful Use has been officially declared the Law of the HIT Land and there is no turning back now.
Margalit Gur-Arie blogs frequently at her website, On Healthcare Technology. She was COO at GenesysMD (Purkinje), an HIT company focusing on web based EHR/PMS and billing services for physicians. Prior to GenesysMD, Margalit was Director of Product Management at Essence/Purkinje and HIT Consultant for SSM Healthcare, a large non-profit hospital organization.