Work group members went line by line through a multipage spreadsheet. They often discussed in excruciating detail recommendations for more-stringent criteria that hospitals, physicians and other "eligible providers" may eventually have to meet to achieve meaningful EHR use and qualify for future government EHR subsidies.
The current advisory committee structure was established last year by the Office of the National Coordinator for Health Information Technology at HHS. The meaningful use work group is one of 15 work groups under the Health IT Policy Committee and its counterpart Health IT Standards Committee, both of which were created under the American Recovery and Reinvestment Act of 2009.
ONC head David Blumenthal says the committees have met about 200 times since then and that many miles remain before the estimated $27 billion in federal stimulus money for health IT incentives is spent. The initial "payment year" for hospitals under the program begins next Friday, Oct. 1, and for physicians on Jan. 1, 2011.
The meaningful-use work group will make recommendations to the Health IT Policy Committee, which has the power to ignore, amend or ratify them, then forward those recommendations to the ONC. It has final authority to similarly reject, change or accept them, and incorporate them into formal federal rulemaking.
More than a few of Wednesday's discussions ended with work group members agreeing that they needed more information or more discussion before making a final recommendation on specific rules. The spreadsheet on which changes in Stage 2 and Stage 3 recommendations were recorded has not been posted on the work group's page on the ONC website.