The final meaningful use criteria for EHRs released in July by CMS and the Office of the National Coordinator for Health IT (ONC) scaled back the original interim final rule. The newer version with less stringent requirements gives cardiologists more of a chance to secure federal dollars for incentive payments to offset the cost of health IT adoption. But will current EMR technologies make the meaningful use cut?
Qualifying for money
Under the Health IT for Economic and Clinical Health (HITECH) Act, eligible healthcare professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR/EMR technologies to achieve specified objectives. As eligible professionals, cardiology practitioners stand poised to take advantage of up to $63,750 in the Medicaid EHR Incentive Program and up to $44,000 in the Medicare EHR Incentive Program.
To demonstrate meaningful use, the EHR reporting period is any continuous 90-day period within the calendar year. Thereafter, the EHR reporting period is the entire calendar year. Under the Medicaid program, there also is an incentive for the adoption, implementation or upgrade of certified EHR technology, which does not have a reporting period.
The meaningful use criteria are attainable in organizations across the U.S., says Brian D. Patty, MD, vice president and CMIO at HealthEast Care System, which includes three short-term, acute-care hospitals, one long-term, acute-care hospital and 14 primary care clinics based in St. Paul, Minn. “Certainly, if you’re shooting for 2011 or 2012, you should be well on your way to an EMR implementation. Even an organization that started its implementation when the initial rule came out a year and a half ago could easily hit it in the 2013 timeframe, and still qualify for the majority of the funding.”
Although for HealthEast most of the criteria are within easy reach, such as CPOE, Patty says that the healthcare system will have to adjust its timeline on certain initiatives including interoperability capabilities with surrounding organizations and the ability to capture and report data to CMS. It has scheduled a major EMR system upgrade to McKesson 10.3 from the 10.1 platform to enable reporting to CMS by October 2011.
For others, the incentive payment does not justify the accelerated means of adoption. “We would like to qualify for as much of the incentive funding as possible; however, we don’t want to completely tailor our implementation to the incentive schedule, because we need to ensure our EMR implementation is comprehensive, robust and fits the organization,” says Alan Katz, MD, director of cardiac imaging and informatics (CII) at St. Francis Hospital in Roslyn, N.Y. CII signed a contract in August to install an Epic EMR across six hospitals to handle the inpatient and outpatient functionalities. “We’re not going to capture every last dollar at the expense of having a less-than-ideal installation,” Katz adds.
One concern that Katz and others have is whether ONC-authorized testing certified bodies (ONC-ATCBs) will be able to produce enough certified EHR products in time for eligible providers and hospitals to meet Stage 1 meaningful use criteria. At the end of August, the Certification Commission for Health IT and the Drummond Group became the first ONC-ATCBs. While more organizations will become ONC-ATCBs, the question remains if these certified entities can review and certify all the available systems in time for facilities to make a wise purchase. At this point, investing in an uncertified system could result in zero incentive funding.
Opinions differ among stakeholders as to whether or not the implementation of an EMR system will cause organizational stress or burden. “Whether an organization meets Stage 1 of meaningful use will depend on the adjustment to workflow and the vendor,” says Vance Chunn, CEO of Cardiology Associates in Mobile, Ala. “For our practice, meaningful use of EHR technology should be achievable because we’ll have the infrastructure in place.”
Cardiology Associates, a private practice with 28 cardiologists across five full-time and five outreach locations, expects to fully implement an EMR system from