The federal government has been asked to relax the requirements for providers seeking to receive health information technology incentives that are part of the American Recovery and Reinvestment Act.
Looser IT subsidy rules?
Panel advises relaxing requirements to qualify
A health information technology advisory committee on Feb. 17 recommended that, among other things, HHS relax a “pass/fail” requirement for hospitals and office-based physicians to qualify for federal IT subsidy payments.
Separately, but also under the ARRA, Joy Pritts, a lawyer, privacy researcher and Georgetown University faculty member, was named the first chief privacy officer to HHS' Office of the National Coordinator for Health Information Technology.
The 12 meaningful-use recommendations adopted by the Health IT Policy Committee and forwarded to the ONC for possible adoption would tweak the proposed meaningful-use requirements released Dec. 30 (Jan. 4, p. 4). The law says in order to qualify for subsidies providers must not just buy an EHR, but also use it in a “meaningful manner.”
The public comment period on the CMS rule closes in mid-March.
Under the CMS rule, the government proposes three stages of increasingly more stringent meaningful-use requirements. In the first stage on which initial Medicare subsidy payments will be based in 2011, providers may qualify for subsidy payments while only partially achieving certain requirements. For example, to qualify for federal EHR subsidies, the CMS rule proposes that all office-based physicians use a computerized physician order-entry system, but an office-based provider only has to enter 80% of orders using CPOE under the first-stage criteria. Requirements that providers electronically keep patient medication and allergy lists are among other criteria that have an 80% compliance threshold in that stage.
But, under the current proposed CMS rule, to achieve meaningful use, providers must meet all of the two dozen or so requirements set out in the rule. A provider that falls even a bit short in just one required area will fail to qualify for any EHR subsidy. Paul Tang, co-chair of the policy committee's work group on meaningful use and chief medical information officer of the Palo Alto Medical Foundation said “an all or nothing approach may not accommodate legitimate, unanticipated, local circumstances or constraints.”
Flexibility would not be extended to all meaningful-use criteria under the committee's proposal. Privacy and security, for example, would still require 100% compliance.
Overseeing health IT privacy at HHS will be an academic with experience researching the subject. Pritts is an assistant research professor at Georgetown University's Health Policy Institute and the author of a 2007 research report in which she concluded that the U.S. lags in privacy practices regarding patient control over the release of medical information.
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