'Meaningful use' EHR rule now final

A much anticipated final rule on what constitutes the "meaningful use" of electronic health records - at least in an initial phase - saw a July 13 unveiling by the Health and Human Services Department.

The Health Information Technology for Economic and Clinical Health Act--passed into law as part of the American Recovery and Reinvestment Act of 2009--included incentive payments to health care providers to adopt EHRs, provided they make meaningful use of the technology. Medicare payments to individual providers will start to drop in 2015 unless providers demonstrate meaningful use. HHS now estimates that the incentive payments will total between $9.7 billion and $27.4 billion over a decade.

The proposed HHS rule on meaningful use had come under criticism and officials said they've incorporated public feedback in the final rule, which defines meaningful use through 2012. Later rules will specify additional measures healthcare providers must subsequently adopt.

Among the main changes in the final rule from the proposed rule is that providers will now be required to meet a "core set" of objectives--such as an electronic check of drug interactions and providing patients with electronic copies of their health information--and a "menu set" of procedures from which providers can defer the implementation of five objectives. Physicians must meet 15 of the core requirements--hospitals must attain 14 of them--and all providers must pick five of 10 possible objectives from the menu set.

The final rule also gives more credit for partial fulfillment of the objectives. For example, the original proposed rule would have required physicians to prescribe 75 percent of their prescriptions electronically, while the final rule is satisfied with just 40 percent.  

For more:
- download the final rule (.pdf)
- read an article by health IT coordinator Dr. David Blumenthal and Marilyn Tavenner, principal deputy CMS administrator, on the final rule
- take a look at this companion NEJM piece from Surgeon General Dr. Regina Benjamin
- read this HHS press release
- go to the CMS website on electronic health record incentive programs

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