Meanwhile, providers who don't participate, or who come up short, risk being declared meaningless and paying for it.
“This is their first investment in healthcare reform, and I think it will make a huge difference,” said Darlene Burgess, vice president of corporate government affairs for Detroit's Henry Ford Health System, in describing the federal spending spree. “We're quite happy.”
“A drop in the bucket” was how Burgess described the $3 million to $4 million subsidy large hospitals can earn through a $2 million “bonus,” plus more, depending on a formula involving Medicare patient share and the hospital's number of Medicare discharges. “But it's a drop in the bucket we welcome,” she said.
The starting gun was fired with CMS' release of the final rules on meaningful use of health IT. The rules explain not only how the largest reality game show of all time will be played, but also what contestants must do to claim their prizes.
In preliminary events, Donald Berwick was sworn in as the new CMS administrator in Boston on July 12, a day before the regulations were released. Berwick will referee the proceedings, enforcing newly released rules, including one that strengthens rarely enforced privacy laws and another that spells out how products that don't exist yet will be judged or “certified.”
“We are actually attempting, through these rules and our other programs, to comprehensively address the barriers that have been identified to the widespread adoption and use of electronic health systems for effective improvement in quality and efficiency,” David Blumenthal, national coordinator for health IT, said during a July 13 news conference.
To make matters more interesting, the meaningful-use obstacle course is still being assembled, even though several players already are running on the track unaware of where the first hurdle will be placed.
This is because, to qualify as a meaningful user, a physician must utilize a “certified” electronic health record, but—until last week—no one knew what the certification criteria would be. Those criteria were released July 13 in 228 pages of companion rules to the meaningful-use requirements and the final rules that were released June 18 on a temporary program that established a process for an organization to become an Office of the National Coordinator-authorized testing and certification body. At least one organization—the Certification Commission for Health Information Technology—had sought the ONC's blessing to become an authorized testing body.
Vendors can now start developing products to certification standards even if there is still no one to certify them.
The ONC has promised to move these applications through as quickly as possible, said Patricia Wise, vice president for healthcare information systems at the Healthcare Information and Management Systems Society. But she added that, even if an organization receives authorization on Aug. 1, it may not be ready to set up shop as an EHR-certification business on Aug. 2, as it will need to establish its testing process and then promote its services to the IT market.
Wise also noted that vendors may wait to see how many authorized testing and certification bodies emerge so they can gauge their options as far as setting their price and location.
“I think, consequently, it will be fall of 2010 before we start seeing certification of EHR technology,” Wise said.