Panel asks HHS to be flexible with electronic health records rules

An advisory committee to the Health and Human Services Department recommended on Wednesday that clinicians and hospitals be given some flexibility in meeting standards this year for deploying electronic health records.

Health care providers must demonstrate their digital medical records for patients have so-called meaningful use if they want to receive incentives that can total as much as $40,000. But a panel of the Health Information Technology Policy Committee, which advises HHS on e-health records, recommended doctors and hospitals be granted some leeway in meeting the proposed standards.

In a letter to Dr. David Blumenthal, the national coordinator for health information technology at HHS, the chairmen of the panel, named the meaningful use workgroup, wrote, "It is important to achieve some flexibility in the 'all-or-nothing approach' to earning meaningful use incentives."

The workgroup is chaired by Paul Tang, chief medical information officer at the Palo Alto Medical Foundation at Stanford University, and George Hripcsak, chairman of the Department of Biomedical Informatics at Columbia University.

They suggested that clinicians and hospitals be allowed to defer up to six of the 25 meaningful use standards that HHS defined this year. This includes any three out of four proposed standards for using electronic health records to improve quality, safety and efficiency of care. If HHS adopts the recommendations, then health care providers will have to meet only one of these standards:

--Record demographic information as structured data;

--Report quality of care measures to the Centers for Medicare and Medicaid Services;

--Use a computerized patient order entry system;

--Generate and transmit prescriptions electronically.

Tang and Hripcsak also suggested the department not require clinicians to provide discharged patients with an electronic copy of physician-issued health care instructions and to test the ability of their systems to exchange information electronically with networks at other institutions. Clinicians also would be able to defer the need to show that the use of electronic health record systems improved the health of their patients such as using their systems to track diabetics and their care.

Under the flexible approach, HHS would recognize health care providers that have made progress toward the meaningful use of electronic health records while at the same time providing flexibility in meeting that goal, Tang and Hripcsak said.

Incentive payments to doctors and hospitals will be made through nonprofit regional extension centers, HHS Secretary Kathleen Sebelius said last week. Acumen Solutions in Vienna, Va., said on Wednesday the department has awarded it a contract to manage the incentive payment process.

Marty Young, managing director for Acumen's public sector division, said the company will use customer relationship management software from Salesforce.com to help extension centers manage their relationship with health care providers, including outreach and computerized dashboards that detail systems clinicians and hospitals use. Young said he expected to support about 2,000 end users at the extension centers. He declined to disclose the contract's value.