CMS developing 'meaningful use' guidance to remove contradictions

It was inevitable, given the short timeline and the apparent seat-of-the-pants nature of the rulemaking process, but CMS is preparing a guidance document intended to clarify several details and fix some inconsistencies in the final Stage 1 rule for "meaningful use" of EMRs.

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At last week's meeting of the Health IT Policy Committee's workgroup on meaningful use, Tony Trenkle, director of the CMS Office of e-Health Standards and Services, said the guidance will provide more detail on the objectives and measures in the rule and "should help clarify issues and help the [committee] plan for recommendations for future stages," Government Health IT reports. The clarifications should be out "shortly," Trenkle promised.

Meanwhile, the workgroup is looking ahead to Stage 2 of meaningful use, 2013-14, which will have higher thresholds of compliance than Stage 1, while trying not to deter hospitals and physicians from adopting EMRs. "We want to pay particular attention to smaller practices and hospitals," workgroup chair Dr. Paul Tang said, according to Government Health IT. "We want to raise the tides but not sink the boats."

For the next stage, the workgroup likely will attempt to find a happy medium between the initial standards for 2011-12 and the more rigorous requirements for Stage 3, which is set to begin in 2015. For example, Stage 1 requires physicians to write 30 percent of their prescriptions electronically and federal officials ultimately would like to see a 90 percent e-prescribing rate, so expect the Stage 2 standard to be 60 percent.

The Health IT Policy Committee would like to take some of the reporting burden off of providers, so Stage 2 probably will call for EMRs to have more standard and coded data for easier extraction. ""We hope that they are capturing the information as part of patient care and not a separate activity," Tang said.

Expect the workgroup to have Stage 2 recommendations ready for public consumption by October, and to seek comments on its preliminary plan in December.

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For additional information:
- read this Government Health IT story