The requirements for how healthcare providers would demonstrate meaningful use of health information technology have gotten a little clearer.

The HIT Policy Committee, led by national health IT coordinator David Blumenthal, adopted July 16 a list of health IT objectives and measures for 2011, 2013 and 2015. It also agreed to give providers more time to adopt electronic health records.

The committee’s meaningful use work group revised some of the health IT objectives for 2011 that were presented at its June meeting, separating out goals by hospital and physician, essentially by inpatient and outpatient environments.

Under the American Recovery and Reinvestment Act, providers will be eligible for increased Medicare and Medicaid payments beginning in 2011 if they demonstrate meaningful use of their health IT.

The committee’s recommendations allow providers who need more time to get started to accomplish the health IT objectives based on “adoption year” instead of specifically in either 2011 or 2012.

In effect, said Paul Tang, chair of the Palo Alto Medical Foundation and co-chair of the meaningful use work group, it lets providers push out to 2013 or 2014 the 2011 foundation criteria.

Providers who do that will be eligible for less incentive money, but will at least have the opportunity to participate in the program. But the first adoption year will be still be considered as 2011, no matter when the provider comes in to the program through 2014.

“We thought there was a kind of double jeopardy in that, if a provider couldn’t make the 2011 or 2012 criteria, and coming into 2013 the bar would be raised higher, it’s almost like you can’t get into the game at all” Tang said. “We’re trying to find a way for people to participate even if it’s a little bit delayed.”

CMS will need to consider the recommendation and its implications for the development of future regulations, Blumenthal said.

The goals for meaningful use are for providers to electronically capture data, report quality measures and use the data to track patients’ medical conditions. Providers must steadily meet more stringent goals with increasing health IT functions, and link them with outcome measures for quality and efficiency improvement in 2013 and 2015.

The work group added measures for 2011, such as providers reporting quality measures to CMS, checking insurance eligibility electronically and submitting claims electronically.

It revised some of the health IT objectives introduced in the June meeting, including implementing drug reaction checks and alerts, problem diagnoses lists based on standards, electronic prescribing and computerized physician order entry (CPOE) for all orders, though interfaces for CPOE are not necessary. Hospitals would have to generate 10 percent of their orders through CPOE.

The committee also endorsed the use of disease registries, which could be used for many purposes, but specifically as a way for specialists to report quality data and demonstrate meaningful use.

Blumenthal will publish an interim final rule by the end of December for the meaningful use of health IT. CMS will also issue a rule by December on provider incentives.

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