February 2010 is almost here, and implementation for the HITECH legislation is moving ahead on schedule. For those unaware, the HITECH Act is designed to promote the adoption of electronic health records (EHRs) by reimbursing physicians who purchase and use qualified EHR systems. Physicians with enough Medicare patients can receive up to $44,000, and physicians who see at least 30% Medicaid patients will qualify for $64,000. Meaningful Use is a set of standards physicians and EHR vendors must meet in order to qualify.

The Meaningful Use Interim Final Rule (IFR) and the Notice of Proposed Rulemaking (NPRM) is still within the public comment period, which lasts until March 15th. According to David Blumenthal, National Coordinator for Health Information Technology, the NPRM is “not a done deal.” The National Coordinator promises to entertain all comments “within the scope of the regulation.” The government won’t be able to add anything else to the rule, but may modify or remove existing aspects.

The Meaningful Use IFR will be much more difficult to change, according to Jodi Daniel, ONC’s director of the Office of Policy and Research. This is good because many EHR vendors are working to ensure their systems will meet the requirements. She said the office is still accepting comments, however, and expects some small changes.

Some groups view the meaningful use IFR requirements as “too high and too many.” Catholic Healthcare West, Intermountain Healthcare, and Kaiser Permanente have all adopted EHRs, but there are gaps between the systems’ features and meaningful use requirements. The groups are critical of the “all or nothing” approach taken by the legislation. In this case, the advantage lies with practices who do currently have an EHR system. They can purchase a system that will meet their needs and the meaningful use requirements right out of the box. Existing EHR users may face expensive upgrades.

Certification for meaningful use is also moving forward. CCHIT has discontinued their “preliminary” meaningful use certification and replaced it with an updated “meaningful use stage 1” comprehensive and modular certification. Although CCHIT has long been the most well-known certification agency, the National Institute of Standards and Technology (NIST) awarded consulting group Booz Allen Hamilton, Inc, a contract to develop a testing method and process for certifying EHRs. No one is sure which organization will actually issue certifications. According to Blumenthal, ONC will review the final legislation and see where CCHIT “fits in.” He states that CCHIT will “clearly have the option to participate in certification going forward,” but no one is sure exactly what that role will be.

Physicians need to get started with their EHR purchase post haste to qualify for the first year of reimbursements in 2011. Implementation of any EHR system usually takes a couple of months. In addition, many vendors are currently backlogged with installations. Contact your health IT consultant today to see how you can qualify.

The HITECH Stimulus Act is legislation designed to promote the adoption of Electronic Health Records (EHRs) among physicians. Passed near the beginning of 2009, the HITECH Act will reimburse qualified physicians who purchase and implement a certified EHR system. If a physician’s practice includes 30% Medicaid patients or more, they could qualify for up to $64,000. Medicare incentives could total up to $44,000, depending upon allowable charges.

“Meaningful Use” is a core concept of the HITECH Stimulus Act. Physicians must do more than simply seeing a certain amount of Medicaid or Medicare patients. “Meaningful Use” outlines a set of EHR features that physicians must use in their practice. On December 30th, 2009, The Centers for Medicare and Medicaid Services (CMS) along with the Office of the National Coordinator for Health Information Technology (ONC) published a final recommendation for the meaningful use definition.

Meaningful use is broken up into several stages. In Stage 1, physicians will have to use features like Computerized Physician Order Entry (CPOE), implement drug-to-drug, drug-to-allergy, and drug-to-forumlary checks, and maintain an updated problem list with ICD-9 or SNOMED, along with a whole host of other requirements. For the most part, the final recommendations look much the same as the initial recommendations from the ONC committee earlier in 2009. The final recommendations will take effect in approximately thirty days; the public is encouraged to comment for the next sixty days. CMS could decide to change the recommendations before final adoption, but most think any changes will be minor.

Deliberations over the meaningful use definitions created a great deal of uncertainty in the EHR market. Most physicians put their buying plans on hold, rather than taking the chance of purchasing an EHR that may not meet the requirements. While caution is understandable, physicians who wait too long may have trouble implementing an EHR in time to qualify for the 2011 reimbursements.

Purchasing an EHR is not like buying off-the-shelf software. With all the vendors, systems, and options, it normally takes several months to make a purchase decision. Once they sign papers, physicians may need to wait up to six months for installation to begin because of vendor backlogs. After installation, physicians and their staff still have to train, which can take weeks for more complicated systems.

Fortunately, the wait is over. CMS and ONC have published their final recommendations. EHR vendors are busy making sure their systems meet the meaningful use requirements. Likewise, physicians need to get busy with their EHR search. Physicians need to make a decision as soon as possible to qualify for 2011 and avoid increasing vendor backlogs. If you are interested in participating in the HITECH Stimulus, ask an EHR vendor to perform a needs analysis for your practice.