The clock starts ticking today on a two-month window in which the public can comment on the Health & Human Service Department's "meaningful use" proposal, a set of rules outlining how providers can qualify for incentives for using electronic health records.
The Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT officially published their rules in the Federal Register Jan. 13.
The package comes in two parts: an ONC interim final rule (IFR) covering standards and certification of EHRs and a notice of proposed rulemaking (NPRM) from the Centers for Medicare and Medicaid Services defining the "meaningful use" of health IT.
According to CMS's meaningful use NPRM, the public has 60 days, or until March 15, in which to comment on the regulation after it is published in the Federal Register. Subsequent revisions will be made, with the final rule expected in spring of 2010.
The ONC interim final rule will become effective 30 days after it is published in the Federal Register, or Feb. 12. However, the public may comment on its possible refinement over the next 60 days, after which ONC will issue the final rule.
The rules describe how physicians and hospitals can qualify for tens of thousands of dollars in financial incentives for meeting three stages of progressively more demanding sets of measures when using health IT in their practices.
The initial set of criteria would concentrate on collecting data electronically, sharing information with other providers and patients, and reporting quality measures to the government.
The standards rule focuses only on standards that comprise a certified EHR. The actual process by which those systems will be certified will be the subject of an additional notice of proposed rulemaking ONC will announce later in 2010.
Since the announcement of the rules Dec. 30, health IT experts have offered a range of opinions about them. Writing in his blog this week, Dr. John Halamka, co-chairman of the Health IT Standards Panel, which advises ONC, said he had received hundreds of emails about the rules. Many find CMS's proposed rule "intimidating," he wrote Jan. 11
"Taking a typical community hospital from their current state to the degree of functionality required in the NPRM [proposed rule] is a challenge," said Halamka, who is also chief information officer of Boston's Beth Israel Deaconess Medical Center.
In summarizing the comments he received, Halamka said providers need specific guidance to meet the aggressive interoperability timelines in the rules. "This leaves a choice " either the standards need more detail, especially in the transmission area, or the NPRM goals need to be reduced in scope/extended in time," Halamka said in his blog.
