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General Category => New! => : oneround January 05, 2010, 07:29:20 PM

: How to Get $20 Billion for Using Electronic Medical Records
: oneround January 05, 2010, 07:29:20 PM
How to Get $20 Billion for Using Electronic Medical Records

December 30, 2009

By Jacob Goldstein


The stimulus bill that Congress passed back in February said docs and hospitals that make “meaningful use” of electronic medical records would get big bonus payments from Medicare and Medicaid. The bill laid out a few basics about meaningful use — reporting quality measures, sharing information electronically — but didn’t get into much detail.
The feds released plenty of details late today, in  this 556-page proposed rule that lays out what doctors (a.k.a. “eligible professionals”) and hospitals will have to do to qualify for the money.

On the off chance that you don’t have the time or interest to read 556 pages, we suggest you skip to Table 2 on p. 103, which lists the criteria docs and hospitals will have to meet in the first phase of the roll-out.

The stuff there is largely what the people we talked to were expecting. Among the requirements: File prescriptions and submit insurance claims electronically; give patients electronic access to their health information; use computerized systems to enter at least some of doctors’ and nurses’ orders; track patients’ medications electronically; and record vital signs and lab test results electronically.

Sharing electronic information between different medical practices and hospitals isn’t something that happens very often; the meaningful use guidelines seem to recognize this. When the program kicks in, in fiscal year 2011, doctors and hospitals only need to say that they “performed at least one test” of their system’s ability to “electronically exchange key clinical information.”

Mike Valentine, EVP of the health records company Cerner, told the Health Blog that “they’re setting a much lower bar for interoperability and sharing” information, and a somewhat higher bar for the way docs and hospitals use electronic systems internally.

The stimulus bill specified that incentive payments — which can top more than $40,000 for a single doctor over several years and could total more than $20 billion nationwide (see  p. 449) — would be tied to meaningful use of certified systems. Now that there’s some clarification on meaningful use, one key question remains about certification: Just who is going to do it?

The feds did release  this proposed rule today regarding certification criteria. But Scott Decker, president of the EMR shop NextGen, pointed out to us that it’s still not clear what body will be doing the certifying.

There is an existing certification group, but the feds haven’t said for sure whether that group will be the key for getting a stimulus-ready system. “The lack of a certification body at this stage is a problem,” Decker said.

The proposed rules are, like the Health Blog, open for public comment. Final rules are expected next year.