CMS has released the final rule that creates new Criteria for meeting the standards under Stage II of funding for those using an Electronic Health Record and are hoping to qualify for additional compensation in this stage. It should be noted that the Office of the National Coordinator for Health IT also issued a companion Final Rule that establishes certification criteria, standards and implementation specifications.
The final CMS rule contains 19 measures for hospitals and 20 measures for physicians. New core objectives have been added:
- One requires that physicians use secure electronic messaging to communicate with patients about health information;
- The other requires that hospitals track medications using the technologies that complement an electronic medication administrative record.
Additionally, the final rule changes the definition of hospital-based physicians, creating an application process for physicians to demonstrate that they are eligible to receive incentive payments directly.
Stage II meaningful use requirements will begin in 2014. These final rules have been published in the Federal Register on September 4th.
So many physicians are so overwhelmed by patients that the burn out rate is very high among active practitioners according to a recent article in the NY Times. So the question is “Is it worthwhile to spend the money and time to have an Electronic Medical Record just to reap the meager rewards being offered by the Federal Government. The answer should be that if an Electronic Medical Record adds value to a practice and to patient care, it should be considered. Many practices are discouraged by the amount of administrative time, the investment in infrastructure and training of staff to use the Electronic Medical Record.
There are many practices surviving without it. However in the near future a measurement of outcomes will be the basis for reimbursement. One might think that that idea is well in the future but it is not. Some Commercial payer and other health plans are giving consideration to such programs. But even if that were not a consideration, Practices should be thinking about how many patients they have on their panel; how many have chronic diseases and which ones. How is follow up being conducted to assure these patients are doing well. Of course the only way to measure and track that information is by keeping electronically. Is that a good reason to have an Electronic Medical Record? It is certainly a consideration but foremost is the consideration; does this help me manage my patients better.
In many articles written by physicians in family Practice and medical practice management the consensus seems to be that it takes more time and thus doesn’t add value. But when, for instance, you have a patient with a chronic disease, it might be important to trend the results of past studies to see where the patient has been and how well new meds are helping. The real value of the Electronic Medical Record specifications is that it has to be a tool very much like a diagnostic one. It has to help if it means spending more time doing the data entry. So the incentive cannot be just the possibility of a very little increase in reimbursement but rather a substantial increase in the efficiency of patient management and the ability to communicate information about the patient population you serve.
These are the issues that should be considered along with size of practice, the kind of discipline, the number of offices and the connection to the Hospitals system to obtain results from studies done in that settingone in that setting
Name: Cathy Idema
Address: 2194 Country Golf Drive, Wellington, FL 33414
Meaningful Use Rule has been finalized