The American Hospital Association (AHA) submitted comments to CMS on the proposed definition of "meaningful use" of Electronic Health Records (EHR). The Health Information Technology for Economic Clinical Health (HITECH) Act contains an EHR Incentive Program. That program is designed to encourage eligible providers to make "meaningful use" of EHR technology. The proposed rule defines "meaningful EHR user" as an eligible professional or eligible hospital that, during the specified reporting period, demonstrates meaningful use of certified EHR technology in a form and manner consistent with the certain objectives and measures presented in the regulation. Some of the objectives include: EHR technology to improve the quality, safety, and efficiency of health care delivery and ensures adequate privacy and security protections for personal health information.
In its comments on the proposed rule, AHA believed that CMS's definition for "meaningful use" set too high of a standard and that very few eligible hospitals would be able to meet that standard. For instance, AHA expressed concern that CMS's method for determining eligibility would create a larger division between small and large hospitals in that there is already research suggesting that larger hospitals are better prepared to meet the meaningful use objectives.
AHA also recommended that CMS loosen its timeline for EHR implementation, including allowing hospitals to meet the meaningful use definition if they meet 25% of the objectives in 2011 or 2012.
In addition, AHA expressed concerns that the broad definition of hospital-based eligible professionals, defined as those who furnish at least 90% of their services in the impatient hospital, outpatient hospital, or emergency department setting, would limit the number of professionals that can participate in the program. AHA's included its alternative definition for hospital-based eligible professionals: a pathologies, anesthesiologist, emergency physician, hospitalist, intensivist, or neonatologist for whom at least 90% of his/her billed claim lines have a site of service of the inpatient, outpatient, or emergency department and for whom at least 90% of his/her claims do not contain an ambulatory care visit code (as set forth in the e-prescribing policy) and for whom the hospital funded more than 85% of the cost of the ERH.
The AHA outlined its concerns with CMS's proposed rule, but also emphasized hospitals' desire to move forward in the meaningful use of EHR to improve care, safety, and improved health. However, AHA emphasized that its proposed alternatives to some of the rules in the CMS provision still meet the goals of the HITECH Act, but also outlines an attainable path for American hospitals to successfully adopt EHR.
Please see the attachment to read the AHA's comment letter.
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