The next few weeks offer an important opportunity for CIOs to digest the implications of meaningful use, as defined in CMS/ONC’s interim final regulation (IFR), and prepare comments that may ultimately shape its final form, according to panelists on a recently held CHIME members-only Webinar.
Among the most troubling items in the IFR are:
- Ineligible for incentives are hospital-based physicians who practice 90 percent of the time at a site of service that is in a hospital inpatient, outpatient or emergency room area — CMS estimates this excludes 30 percent of physicians (such as pathologists, radiologists, hospitalists or ED physicians). This would also include a hospital-owned site with a hospital-owned EHR, even if it’s not on the hospital campus. Teaching and primary care clinics are ineligible as well.
- There will be only one payment for multiple-campus hospitals that share a Medicare provider number.
- Many objectives will require manual collection of activities for which there are not automated processes (with 10 of the 35 hospital metrics being completely new).
- Security/privacy implications of requiring hospitals to issue electronic copies of records aren’t well understood.
Presenting on the Webinar was Pamela McNutt, Sr. VP & CIO, Methodist Health System (Chair, CHIME Policy Steering Committee) and David Muntz, Sr. VP & CIO, Baylor Health Care System (Chair, CHIME Advocacy Leadership Team).
McNutt urged physicians and hospitals to move quickly. “In the first payment year, doctors can get up to $21,250 — that’s as close to free money as we’re going to see here,” noting that out years see more stringent criteria combined with lower payments.
Muntz voiced concern that details on certification have yet to be released, though some information is expected by the end of January. He said large hospital organizations — which often have dozens of applications constituting their HIS — may face difficulty getting their overall environment certified.
Muntz also said he was unsure if vendors would have sufficient resources to support all their clients in the coming months. Thus, he advised CIOs to have contingency plans if vendors are unable to get certified in time for the incentive disbursements.
Written comments on the IFR are due March. 15.