On Tuesday, the long-awaited Final Rule for Meaningful Use was unveiled. This new rule specifies what physicians must do in order to access Electronic Health Record (EHR) incentive bonuses through the Centers for Medicare and Medicaid Services (CMS).
At the same time, the Office of the National Coordinator for Health IT (ONC) also released the Final Rule concerning Standards and Certification, which spell out what EHR vendors must do in order to create products that can be HHS Certified. Using HHS Certified products is a requirement for clinicians who want to demonstrate “meaningful use of certified EHR technology” and access the incentive bonuses. As of now, there are no HHS Certified products, since the Authorized Certification and Testing Bodies (ACTBs) – the organizations who will conduct the Certification testing of EHRs – have yet to be designated. On July 1, the ONC released the final rule for selection of ACTBs and the first bolus of applications were sent out to interested parties on that date. It will take a month or two for that process to occur, and once ACTBs are designated then the ONC will list them on its web site.
But all the pieces are now in place. The only item still in preliminary form is the specific testing criteria elaborated by the National Institute of Standards and Technology (NIST), which will likely become finalized now that the Certification Final Rule is published.
What are the differences in Certification criteria in the Final Rule and what had previously been proposed in the Interim Final Rule (IFR)?
The biggest change is that no longer will Certified EHR products need to include billing or insurance-eligibility testing. This was in response to many in the EHR vendor industry who pointed out that billing (with insurance eligibility checking) is typically built as a separate, often stand-alone product – though tight integration with the clinical piece (the EHR) is still frequent. Billing has been a mature market, usage of electronic billing systems is high, and often such systems are outsourced by practices rather than contained in-house (or wherever the EHR is located).
Additional changes are fairly small and detailed, and modify what vendors need to demonstrate in order to become Certified. The overarching features remain in place – the main thrust is around interoperability of health information, and features required to allow physicians to demonstrate Meaningful Use criteria, as we summarized.
The work done by the ONC has been impressive. It has been the distillation of a prolonged process of input and review by a wide array of stakeholders. We look forward to building products that will help move American healthcare in the direction articulated by the ONC’s vision. The hard work of going through the Certification process with the upcoming ACTBs is what lies ahead of us next.
Robert Rowley, MD
Chief Medical Officer
Practice Fusion EMR
