With the administration ratcheting up their efforts to promote health reform, industry leaders and government technocrats are scrambling to keep pace with the finer points required as part of the Recovery Act.
Along with an aggressive timetable for electronic health records (EHRs) implementation, President Obama and his team at the Health Information Technology Policy and Standards Committees have been issuing proposed rules and draft guidance centered around one very important phrase: Meaningful use.
Health information technology, and the $19 billion set aside in the stimulus funding for IT, is front and center with the definition because healthcare providers must demonstrate meaningful use of EHRs to qualify for Medicare and Medicaid incentive payments starting in 2011 under the economic stimulus law.
Last Friday, Perot Systems’ Chief Medical Officer, Harry Greenspun, and Executive Vice President of the Healthcare Group, Tim Quigley spoke at an online webinar to talk about the latest actions surrounding “Meaningful Use” and what it means for the industry.
Mr. Quigley opened the hour-long session by giving attendees an overview of where current health reform legislation stands on Capitol Hill, and where potential pitfalls still remain.
“When major legislation is being worked on, neither chamber wants to get too far away from the other,” Mr. Quigley said. The House Ways and Means,and House Education and Labor Committees have passed a bill and so has the Senate Health, Education, Labor and Pension Committee. But the Finance Committee still has not finalized a bill.
There are “still very hard positions being held,” Mr. Quigley said of some members of Congress. And one of the big fights is over insurance. Employer-mandated and individual mandates to have insurance is an idea being tested in negotiations, but its proving difficult. “As we know from our work in Massachusetts, this is one of the key issues,” Mr. Quigley said. Perot Systems helped set up the IT framework and call center solutions for the Health Connector Authority, after the Commonwealth passed its landmark health reform bill.
Away from the political dealings in Congress, administration officials from the Department of Health and Human Services department and the National Coordinator for Health Information Technology, among many other organizations, have been busy setting the logistical groundwork first envisioned in the Recovery Act.
Among the more than two dozen requirements used in the proposed definition of meaningful use, two issues have received significant attention, Mr. Greenspun said. EHR adoption timelines and certification requirements outlined in previous definitions have been questioned by industry and hospital trade organizations, but Mr. Greenspun thinks the new definition better clarifies implementation requirements.
Under the new requirements, if a hospital implements EHRs in 2012 or 2013, they will be responsible for attaining the standards of 2011 criteria. Furthermore, hospitals have a little more leeway under the new terms, mandating that only 10% of orders be entered through an authorized process of electronic, or computerized, physician order entry (CPOE).
The new requirements, “avoid the situation of a moving target where the longer [hospitals] waited the harder it would be to achieve [meaningful use certification],” he said.
Another improvement cited by the Perot executives was that it was clear suggestions made during the comment period for meaningful use were taken into consideration. “The agenda of patients has increased,” Mr. Quigley said. “Eventually all patients will have access to PHRs, populated with real-time data.” But some worry at a cost to patient privacy. “Privacy is a high-profile issue,” he said.
“A lot of work being done w/ privacy, but people are concerned,” Greenspun agreed.
There’s a lot riding on how “meaningful use” ultimately is defined. Over a dozen work groups set up by are putting together guidance based on what is currently known about meaningful use, but, there’s still “a lot of open questions that probably won’t be resolved until the rule making in December,” Mr. Greenspun said. “As we get closer to the end of the year, it will become increasingly important.”
The informational session closed with a reminder that the window of full reimbursement closes in 42 months.
“Now’s a good time to sit down and have that long meeting with the CFO to talk ballpark costs. Its better to get started early than late,” Mr. Quigley said. “It’s a change management program, not an IT implementation. It will affect everyone in the organization.”