Relaxing of Meaningful Use Final Rule

There’s a lot of interesting speculation going on right now around what HHS is going to do in regards to meaningful use. There’s no doubt that a lot of the feedback given to HHS on meaningful use surrounded the idea that it was too much and had too many objectives. The question remains, what will HHS do with this feedback?

A number of people have suggested that the meaningful use objectives will be relaxed. In this company is past healthcare IT czar, David Brailer. The interesting part of this chorus is that it includes a large number of providers that say it’s going to be relaxed. Then, they follow up that statement with something like, “If it’s not relaxed, then doctors won’t show meaningful use and will not worry about the EMR stimulus money.” Basically, it will become a failed government initiative if the meaningful use bar is too high.

Other people are suggesting that meaningful use is going to stay the same. Carol Flagg of HITECH Answers quotes the following from David Blumenthal as indication that meaningful use will not substantially change:

“Introducing change in health care is never easy. Historically, adopting our most fundamental medical technologies, from the stethoscope to the x-ray, were met with significant doubt and opposition. So it comes as no surprise that in the face of change as transformational as the adoption of health IT – even though it carries the promise of vastly improving the nation’s health care – some hospitals and providers push back….The question health care providers are facing today is whether we are pushing too hard, too fast to make this important change. I respectfully submit, no. In turn, I ask, ‘Can we make these changes expeditiously enough?… Every provider, every patient throughout our nation will benefit from the goals envisioned by the HITECH Act. Yes, this will be a challenge. While large hospital networks and smaller providers may be stretched to meet national health IT goals, it is not beyond their capacity for growth.”

Little by little I’m leaning this direction. I’m not sure exactly why, but I’m getting the feeling that HHS either can’t or won’t change the meaningful use criteria. It’s basically going to be similar to what we have now with maybe one or two items of note.

What do you think? What will happen with the MU final rule?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

13 Comments

  • I really thought there’d be some relaxation/flexibility until I saw that post by Dr. Blumenthal. It felt like a warning, a bellwether of things to come. The sad thing to me is that there has been so much good work done on HITECH, I’d hate to see it as yet another failed government initiative. If things remain unchanged, though, the future for HITECH doesn’t look too promising.

  • The IFR review and commentaries have basically diverged into two camps: [1] healthcare industry stakeholder groups arguing for relaxation of both the criteria and the timelines (although I would note RECs like mine are concerned that relaxation would make providers less likely to engage our services, given that they are neither mandatory nor fully subsidized), and [2] consumer/patient advocacy groups demanding the the Final Rule be set forth as currently written, that any dilution would be seen as just more expensive corporate welfare (mostly garnered by the larger, more financially secure entities), to the detriment of patient and taxpayer interests.

    To me, it’s problematic. I am less concerned with the specific MU criteria (including the quality reporting measures) than with the compressed Stage 1 timeline. We see a lot of skeptical pushback bemoaning the short time frame to get to MU attestation for the maximal incentive payment.

    Then there’s THIS emergent concern: http://www.thehealthcareblog.com/the_health_care_blog/2010/06/do-physicians-have-a-right-to-privacy.html

  • Those that have been really listenng to Blumenthal are getting ready to implement EHRs. The train has left the station. The only relaxing there will be is if they wait to release and let us relax over the 4th. And John it is going to be hard living with Carol now that she is actually a tag on your blog! What have you done…

  • Roberta,
    Yes, the train has left the station, but we haven’t gotten the final numbers of how many doctors are on the train yet or not.

    Sorry for the pain I’ve caused you with Carol. However, I figured if I tagged her maybe she’d take me to dinner next time you’re in Las Vegas;-)

  • But I am not so sure that matters to them. I think they are looking for quality not quantity. They (ONC) are not looking at it in the age old way as they have to spend all the money or they won’t get it next year. I agree that MD adoption won’t be great but the hospitals and the HIOs will be. Foundation will be sound and that will be the winning ticket. The MD will come along when the patients will seek out those who have it. And I don’t think that is so far away. Have you seen an Ellen Page commercial today? And FYI we are ALL about the fine dining in Vegas!

  • I’m not sure they really want to be doing what you call quality versus quantity. I think they’d love to go for quantity. I just wonder if the legislation will permit them to relax meaningful use or not. I might email some connections I have at ONC to see what they might say.

    I didn’t see an Ellen Page commercial today. And I know you like fine dining. That’s why I need Carol to pay…lol

  • Inducing a change in the system can be a tricky business. There would be some for whom the proposed timelines would be sufficient to adopt the change and there would be some for whom it would be a mammoth task. The Government needs to understand this and then come up with a solution for enforcing this change.

    In my opinion, it makes more sense to analyze the current state of care providers and study their current state of healthcare IT adoption. They can then be segregated into 3 levels of MU readiness and each level would have different goals, timelines and incentives.

    For example, a care provider (say ABC) has been identified with having a low degree of healthcare IT adoption. Therefore, ABC would be tagged under Level 1 of MU readiness and hence will have relaxed goals and timelines as compared to the providers tagged under Level 2 & 3. So now, ABC is not playing a lost game, and hence would be motivated to work towards MU compliance.

    Just an idea from my side, dont know if this has already been considered.

  • Abhimanyu,
    It’s an interesting idea to have levels. The problem is that you don’t want to penalize those that are further along. Basically, that would be penalizing those that are doing the thing that you want done.

  • John
    I am concerned about the measruing of Meaningful Use. What will be the standards for measuring a practice’s goal of the Meaningful Use Criteria. Also most of the EMR systems currently out there have a lot of features which may help achieve the Meaningful Use Criteria but the question I have is how many providers would be using all the features of an EMR system ?
    In my experience providers are performing the minimum tasks into the EMR system.

  • Alefia,
    At first I thought you were referring to what I call Practical Meaningful use details: https://www.healthcareittoday.com//2010/04/22/practical-meaningful-use-details/

    However, now I think you mean that many may not qualify because they have an EMR and use an EMR, but not fully. Actually, this is likely the reason for meaningful use. To get doctors to use the EMR more fully. No doubt even those who have used an EMR for years will have to make some changes to meet the meaningful use guidelines. Whether they will or not is yet to be seen.

  • John,
    Well, thats one way to look at it. But, we should also consider the greater incentives enjoyed by the early birds. 🙂

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