Hospitals Seek Simpler EHR Rules

The American Hospital Association is urging the Health and Human Services Department to simplify and clarify rules for electronic health record incentives and certification, among other regulations.

In a June 30 letter to HHS Secretary Kathleen Sebelius, Rick Pollack, AHA executive vice president, argued that rules managing the Medicare and Medicaid incentive program "are overly complex and confusing, leaving many hospitals concerned about their ability to meet the programs' demands."

In a January association survey, 53 percent of hospitals "cited lack of clarity in regulatory requirements as a barrier to achieving meaningful use in a timely manner." A nearly equal percentage cited complexity as a barrier, the letter said.

The certification requirements issued by HHS' Office of the National Coordinator for Health IT "are an example of regulatory complexity that acts as a barrier for hospitals trying to use certified technology - the opposite of the intended goal -- causing hospitals to buy technology that they will not be using," the letter said.

The association also is "concerned about the increasingly haphazard way that regulatory policies are being issued, especially with respect to the use of sub-regulatory guidance (including Frequently Asked Questions), the frequently understated compliance costs contained in regulatory analysis, old-fashioned approaches to reporting and recordkeeping, and uncoordinated regulatory policies."

The letter suggested that:

• The need to regulate behavior and the underlying objective of a regulation must be clear, unambiguous and well documented.
• Regulation should facilitate channels of communication between regulators and providers, and accountability of providers to their patients and communities.
• Regulation should be cost effective.
• Regulations should establish a safe haven for innovation and encourage the pursuit of excellence through best practices.
• Regulations should be applied prospectively and their implementation appropriately staged.