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July 21, 2010

Electronic Health Record "Meaningful Use" Requirements Issued

by Jonathan B. Stepanian, Esq.
Electronic Health Records

On July 13, the Department of Health and Human Services announced requirements practitioners must adopt to qualify for incentive payments encouraging the implementation of electronic health records (EHR).  Using certified EHRs in a meaningful way is critical to individual practitioners and hospitals not only because millions of dollars in incentive payments are available through Medicare and Medicaid but also because those presently available incentives will ultimately transition to penalties if practitioners delay implementation of electronic record-keeping.

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 established the monetary incentive program for the implementation of EHRs.  Congress enacted the HITECH Act in conjunction with the broader fiscal stimulus programs of the American Recovery and Reinvestment Act.  Under HITECH, Medicare and Medicaid incentive payments are available to “meaningful EHR users” beginning in January 2011.  The definition of “meaningful use” has been the subject of debate, which finally resolved with the issuance of two related final Rules on July 13.

The first rule, issued by the Centers for Medicare and Medicaid Services (CMS), establishes the requirements constituting “meaningful use” of EHRs under HITECH.  The rule contemplates a staged approach for the implementation of EHRs.  CMS summarizes this first stage in part as follows:

The Stage 1 criteria for meaningful use focus on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating that information for care coordination purposes, and initiating the reporting of clinical quality measures and public health information.

CMS will issue additional rules in the future expanding the “meaningful use” requirements in two subsequent stages.  Information about the current rule and requirements can be found at the CMS Electronic Health Record Incentive site.

The Office of the National Coordinator for Health Information Technology (ONC) issued a companion rule that establishes standards and criteria for the certification of EHR systems.  These standards and criteria have been issued to ensure that developers of EHR systems develop systems that are capable of meeting the regulatory requirements, including those requirements related to interoperability and security.  Although these requirements are aimed principally at developers of EHR products, practitioners and hospitals should be generally aware of those requirements so that the EHR system they adopt meets the requirements and has the abilities to be “meaningfully implemented.”


Jonathan B. Stepanian, Esq.

Jon is an attorney whose practice is specialized in litigation, complex medical professional liability defense, health care, and providing legal counsel on numerous issues associated with day-to-day hospital operations. He has successfully tried several cases to verdict as first-chair trial counsel before juries in both state and federal court. Jon has also represented clients in appellate litigation, mediation, and in connection with administrative agency investigations.

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