On Tuesday, July 13, 2010, the U.S. Department of Health and Human Services (HHS) released the greatly anticipated final regulations for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program and the Initial Set of Standards, Implementation Specifications, and Certification Criteria for EHR Technology.
HHS Secretary Kathleen Sebelius stated the regulations move Americans toward a 21stcentury health care system with patients and doctors regaining control. Dr. Donald Berwick, new Administrator of the Centers for Medicare and Medicaid Services (CMS), stated that EHRs are the future of health care and it will bring tremendous benefits to ensure patient safety, reduce costs and improve access. Dr. Richard Blumenthal, Director of the Office of the National Coordinator for Health Information Technology (ONC), explained that in his practice as a primary care physician he saw how the use of EHRs prevented tragic errors in providing prescription drugs and duplicating x-rays. He noted while they may be small victories, but if spread across the health care system, it would greatly bend the cost curve down.
In an HHS press release, the following key changes in the final rules were noted:
- Greater flexibility for eligible professionals (EPs) and hospitals in meeting and reporting certain objectives for demonstrating meaningful use;
- An objective of providing condition-specific patient education resources for both EPs and eligible hospitals and the objective of recording advance directives for eligible hospitals;
- A definition of a hospital-based EP is one who performs substantially all of his or her services in an inpatient hospital setting or emergency room only; and
- Critical Access Hospitals (CAHs) are within the definition of acute care hospital for the purpose of incentive program eligibility under Medicaid.
Dr. Blumenthal also noted that overall achievement levels were reduced, for example, EPs will only have to electronically prescribe 40 percent of medications, down from 75 percent in the proposed rule.
