The final rules on "meaningful use" of EMRs have been out for about a week and a half now. While the early responses were overwhelmingly positive, some criticisms have started to surface now that more people have had the chance to slog through the 864 pages of bureaucrat-speak.
"Overall, I think the rule is fair," Dr. Ferdinand Velasco, chief medical information officer at Texas Health Resources, Arlington, Texas, says in an interview with CMIO magazine."If I had to give it a grade I'd give it a B-minus. I'd give the CMS folks in collaboration with ONC an A for effort."
Velasco admits being caught off guard by the decision to include the emergency department in all of the hospital quality measures. While he says it's reasonable to expect CPOE in the ED, Velasco was surprised to see the ED included in the measures for problem lists, medication lists and drug allergies. "It was an eye-opener because a lot of people weren't requesting or expecting that," Velasco says. "That's going to be a twist."
For its part, the College of Healthcare Information Management Executives is glad to see CMS allow hospitals some flexibility in meeting the Stage 1 criteria and reduce some of the thresholds for compliance. "Reducing reporting requirements in the early years of the incentive program aligns industry responsibility with current capabilities of commercially available EHR systems and CMS' own ability to receive quality data electronically," the organization of healthcare CIOs says in a press release.
However, CHIME is expressing concern that the objectives still represent "an aggressive target for the majority of the nation's hospitals" and says that many hospitals will struggle to meet tougher the guidelines expected in the second and third stages of the EMR subsidy program.
Meanwhile, the American Medical Association, after waiting a week to weigh in on the regulations, is expressing particular concern about the ability of small and solo practices to qualify for federal incentive payments.