CMS must sustain Meaningful Use momentum


It started as a trickle of providers signing on to become meaningful users of electronic health records, but by the end of the year it was more like a torrent: More than 176,000 eligible professionals and hospitals registered for the Medicare and Medicaid EHR incentive programs in 2011 and federal and state governments paid out more than $2.5 billion in incentive payments, reps from the Centers for Medicare & Medicaid Services reported at a meeting of the Office of the National Coordinator's HIT Policy Committee this week.

Perhaps more important is the impact of EHR use on quality of care. CMS reported that 93 percent of the eligible hospitals and 90 percent of eligible professionals attesting to Meaningful Use under the Medicare program had met the recording objectives, 95 percent of the hospitals and 91 percent of the professionals had incorporated lab results, and 95 percent of the hospitals met the advance directive measurements.

CMS employees were almost giddy--staffer Robert Anthony said someone should bring in balloons.

But can the program sustain those dramatic numbers?

CMS certainly hopes so. "Meaningful Use is going to continue to be a cornerstone of a lot of our activities," reported National Coordinator for Health IT Farzad Mostashari, chair of the Committee.

But U.S. Department of Health & Human Services officials can't claim that 2012 will be a cakewalk. Anthony admitted that 2011 was so successful because the attesters were early adopters--providers who already were meeting many of the Meaningful Use criteria when they were established.

The real test will be how many providers with newer EHRs register for the incentive program and successfully attest to Meaningful Use.

"We're working very closely with the market and providers to say what kind of training, education and technical assistance do you need," Robert Tagalicod, head of CMS' Office of E-Standards and Services, said.

Committee members also know full well that the agency needs to keep attestation and payments moving in 2012 to ramp up for the second stage of Meaningful Use. Mostashari said interoperability and exchanges could be a more complex challenge than Meaningful Use, calling the progress made toward the next generation of quality measurement "frustrating." Providers should take the responsibility not only for measuring quality, but also for improving it, he said.

Then there are the related speed bumps on the road to EHR adoption, such as patient safety issues, malpractice litigation and the potential for fraud. Whether these will slow down traffic or cause full fledged roadblocks in 2012 is anyone's guess.

So HHS deserves to celebrate its success thus far. But it has its work cut out for it going forward. At least the agency appears to know that. - Marla

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