Off and Running

The release this week by HHS of final rules for the meaningful use of electronic health records is akin to the pop of a starting gun at the outset of a five-year marathon. Well down the road, at the finish line, is the promise of a transformed health care sector that leverages information technology in ways that others sectors--banking, e-commerce, entertainment--embraced years ago.

Getting there no doubt will be a slog, particularly for IT vendors whose products must meet certification requirements, reports Healthcare IT News.

The final rules start the race on a flatter, more forgiving surface than the steeper grade laid out in proposed rules released earlier this year. In addition to reducing the number of standards that adopters must meet in the first two years of implementation, HHS also relaxed "the rates at which providers will have to use particular functions to be considered meaningful users," according to a HHS release published yesterday by the New England Journal of Medicine.

The final rule, for example, requires eligible providers to use computerized physician order entry (CPOE) to order at least one drug for 30 percent of patients. The interim rule required the use of CPOE for 80 percent of all orders, including lab tests, referrals, etc.

"We want to get CPOE started, but we don't want to force a person too fast," David Blumenthal, the national coordinator for health information technology at HHS, said Wednesday in an interview with InformationWeek.

The final rues also simplify electronic reporting of data on the quality of care, but Erica Drazen, a managing director at CSC, an IT consultancy, says the bar remains high for vendors.

"It's not so much the reporting that's the challenge, it's getting the data to report," Drazen told Healthcare IT News. "I think some people have underestimated what is required."

Those challenges could encourage some vendors of electronic medical records "to leave the market, as they realize they're unable to meet the minimal requirements" for certification, said Jacob Reider, chief medical informatics officer at Allscripts.

Vendors who stay in the race but fail to quickly attain certification for their products will further impede progress toward widespread implementation of health information technology, said Denni McColm, CIO at Citizens Memorial Hospital in Bolivar, Mo. It is "not the meaningful use requirements as much as vendors in the market being able to be certified in the time frame," predicted McColm. "If we hospitals and physicians are required to implement major upgrades as a result of the certification versions - that may be certified best case scenario by fall - that will be scary."