Blumenthal floats idea of multiple paths to 'meaningful use'

National health IT coordinator Dr. David Blumenthal seemingly wants some flexibility built into future requirements for "meaningful use" of health IT. But providers shouldn't be cheering just yet, since the Health IT Policy Committee--and perhaps the American Recovery and Reinvestment Act itself--might stand in the way.

Speaking at this month's meeting of the HIT Policy Committee, an HHS advisory panel, Blumenthal mused about distinguishing between "vanilla meaningful users" and others that might be able to demonstrate significantly better-than-average outcomes, reports. According to Blumenthal, some in the latter group "might say, 'If I've accomplished performance outcomes which are three standard deviations better than other institutions, related to 10 outcomes criteria using health information technology, maybe I should be exempt from the task of checking boxes, because I'm there; I've risen above the criteria you put in the regulation."

He also suggested that the Policy Committee might think about creating separate paths to meaningful use for various classes of providers when crafting the rules for Stages 2 and 3 of the federal EMR incentive program. "I'm just posing this as something to think about," said Blumenthal, who noted that he hadn't run the idea past legal counsel yet. "Offering more flexibility with greater monitoring might be a chore, but could also be, if constructed correctly, not more complicated."

At least two committee members expressed concerns that such an approach truly would be a chore. "I like the idea, but would we have to go through the same process for this that we are going through for the set of criteria we're struggling with for Stage 2 meaningful use measures?" asked Dr. Neal Calman, president and CEO of the Institute for Family Health. "Are we saying we have the capability to determine three alternative sets of criteria for 2013?"

Software entrepreneur Paul Egerman also wondered whether creating separate tracks might place an economic burden on organizations without a lot of money. "It's important that there is no economic aspect to these classes, that poorer institutions can participate in the same way," Egerman said.

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