TMA, the American Medical Association, and dozens of other physician organizations told federal officials they generally support the federal government's attempt to define "meaningful use" of electronic health records (EHRs), but they have some reservations.
President Obama's economic stimulus package authorizes the Centers for Medicare & Medicaid Services (CMS) to provide financial incentives for eligible physicians who "meaningfully use" EHRs. The payments begin in 2011 for eligible Medicare physicians; physicians who have not demonstrated that they are meaningful users of an EHR system by 2015 will face reductions in their Medicare payments, which start at 1 percent.
The groups said in a letter to David Blumenthal, MD, national coordinator for health information technology with the Department of Health and Human Services, that they are concerned that the government's timeline "is too aggressive, given that we continue to lack the necessary infrastructure, standards and systems." They added that they have "significant concerns" about the government's proposed rules covering appropriate access to, exchange, and reporting of health care data; costs associated with disseminating the information; privacy measures, including ineligibility for incentives due to alleged Health Insurance Portability and Accountability Act (HIPAA) violations; and patient compliance with specified measures.
The letter says among the challenges physicians face in achieving meaningful use are the lack of certifiable EHRs for certain specialties and the 12 to 18 months it takes a practice to move from initial adoption to robust use of an EHR system. In addition, physicians must comply with migrating to the HIPAA 5010 transactions and ICD-10 code sets at the same time they try to meaningfully use EHRs.
The groups sent Dr. Blumenthal recommendations [ PDF ] for defining the meaningful use of EHRs. They include guiding principles for achieving widespread adoption of EHRs and other health information technology (HIT) and ensuring patient access to quality and timely care. They also establish a pathway toward meaningful use, including a set of program specifications for meeting the 2011 incentive payment timeframe and beyond .
"Our proposal is aimed at ensuring that the 'bar' is not set too high or too low; one that is reasonable and ensures that all eligible physicians in all size practices and specialties are able to take advantage of the incentives specified in ARRA [American Recovery and Reinvestment Act]," the letter says.
TMA encourages physicians to proceed with caution and tap into the association's resources to make wise decisions regarding EHR selection and implementation. For more information, go to the new TMA Regional Extension Center Resource Center.
Action , July 1, 2009