Now that the Centers for Medicare and Medicaid Services (CMS) has defined "meaningful use" of electronic health records (EHR), hospitalists know what's expected of them in order to grab a piece of the $20 billion set aside for doctors and hospitals that adopt new technologies.
CMS’ final rule (PDF) is less restrictive than the proposed rule put forth in January, but it still challenges HM groups and their respective institutions to meet new guidelines to make digital record-keeping routine. Stage-one rules, which take effect next year, require eligible physicians (EPs) and eligible hospitals to meet goals in 15 and 14 categories, respectively. Up to five goals can be deferred, according to CMS. The CMS timeline includes second and third stages, each of which will require goals that are even more advanced.
Some hospitalists feared the rules in stage one would be punitively strict, says Robert Lineberger MD FHM, medical information officer at Durham (N.C.) Regional Hospital, part of the Duke University Health System. “What it means is the government is serious about helping people instead of being as strict as it appeared they were going to be,” says Dr. Lineberger, who serves on SHM's IT Core Committee. “I think people are overall pretty pleased there was a relaxation.”
The road to full adoption of EHR is far from complete, and hospitals that have yet to put in place even the most basic electronic infrastructure might struggle to meet even the lowest thresholds.
And while specific standards for future stages have not been codified, “like everything else that goes on in the hospital, [HM] should be in the middle of that,” Dr. Lineberger says.