The American Hospital Association is not pleased with final regulations on the meaningful use of health IT.
AHA officials said they are still reviewing the 864-page regulations, released Tuesday, and are pleased with the added flexibility and removal of some of the "unnecessary administrative burdens."
But that's where the positive comments end.
Overall, AHA leaders said they remain concerned that the requirements may be out of reach for many hospitals. "Unfortunately, CMS continues to place some barriers in the way of achieving widespread IT adoption," they said in a statement.
According to an AHA statement:
- Individual hospitals in multi-campus settings are unfairly excluded from incentive payments. Hospitals within a healthcare system should each be eligible for incentives.
- The rule may adversely impact rural hospitals and exacerbate the digital divide in healthcare.
- The rule requires hospitals to immediately use Computerized Provider Order Entry (CPOE), "which can be complicated, costly to implement and takes time to do right."
- The rule, in combination with the certification process, "penalizes early adopters" by requiring them to upgrade or replace already functional systems.
- The rule limits how quickly hospitals can adopt a certified EHR that can benefit patient care.
"Given limited vendor capacity and workforce shortages, many hospitals will not have timely access to certified products, since no certified EHR systems are available today," the AHA said.
Other groups were more approving of the final rule.
William F. Jessee, president and CEO of the Medical Group Management Association, said the MGMA is pleased the federal government acknowledged many of the group's serious concerns regarding the proposed rule.
"While challenges remain, the final rule provides a better approach to the 'real-world' issues faced by practices as they move toward 'meaningful use' of EHRs," he said. "Improvements sought by MGMA contained in the final rule include a reduction in the originally unrealistic threshholds related to e-prescribing, administrative transactions and computerized physician order entry, among others."
Jessee said the MGMA will "work closely" with the Centers for Medicare and Medicaid Services to incorporate additional changes.
“It’s definitely time to begin a coordinated effort to implement electronic health records by providers nationwide,” said College of Healthcare Information Management Executives (CHIME) President and CEO Richard Correll.
“We have been supportive of the federal government’s actions to encourage widespread implementation of EHRs, and we are increasing our educational programming in support of our members’ efforts to succeed in this new era of IT adoption,” Correll added.
The Markle Foundation, the Center for American Progress and the Engelberg Center for Health Care Reform at Brookings issued a joint statement backing health IT adoption incentives.
"The requirements must be ambitious enough to make the investments worthwhile, but not so onerous that they discourage large numbers of doctors and hospitals from participating," the three organizations said in a joint statement.
Carol Diamond, MD, managing director of the Markle Foundation, said the added flexibility should encourage provider participation.
The Healthcare Information and Management Systems Society (HIMSS) is expected to have a comment sometime Wednesday, with an in-depth analysis forthcoming, HIMSS leaders said.
Stephen Lieber, HIMSS' president and CEO, said HIMSS members "appreciate and understand the cultural and technical challenges that healthcare providers face in meeting the requirements for meaningful use," and "HIMSS will be a leader in the transformation."
