Final Meaningful Use Rule Includes Choice, Relaxed Requirements

CMS has relaxed the requirements and given providers some choice in how they achieve meaningful use of EHRs. The highly-anticipated final rule released today, which outlines the criteria for receiving federal incentive funding, includes several changes from the initial proposal.

“We very much want well intended providers to be able to become meaningful users,” David Blumental, MD, the national coordinator for health IT at the Department of Health and Human Services, said at a news conference, adding they wanted the rules to be “ambitious but achievable.”

“We’ve added some choice,” he said. CMS received more than 2,000 comments to the initial proposal, and many organizations, including MGMA and the AMA, criticized the rule as being too inflexible and overly aggressive.

Originally for Stage 1 of the program, physicians had to meet all of the 25 criteria. The final rule divides these elements into two groups: a set of 15 core objectives for providers, and an additional five activities, which providers can choose from a menu of 10. The rest of those activities can be achieved in the second stage.

The core objectives include basics like entry of patient data and demographics, active medications and allergies, and problem lists. Other core functions address safety and efficiency of care, such as clinical decision support tools. The second group of requirements include the capacity to perform drug-formulary checks, incorporate lab results, identify health education resources, and provide patient reminders.

Some meaningful use metrics were also relaxed in the final rule. For example, providers would have to electronically prescribe 40 percent of their prescriptions to achieve meaningful use, down from the proposed 75 percent. CMS also deferred some administrative transactions to Stage 2, and reduced the number of required quality measures. An explanation of the rule was published in the New England Journal of Medicine.

The rule “will push our entire health system forward” while giving healthcare providers flexibility to adopt electronic health records, HHS Secretary Kathleen Sebelius, said at the news which was broadcast online. “The transformation won’t happen overnight but the announcement we are making today set s us on a path toward a 21st century health system.”

Blumenthal also noted that these meaningful use criteria are just one part of an overall program to encourage adoption of EHRs. The criteria address the financial barriers to adoption, he said, “but there are also important logistical and technical barriers.” Regional extension centers and state grants are also aiming to ease the burden of adoption, he said.

What do you think about the final rule? We welcome your thoughts in the comments below.