ONC: 2011 Criteria to be Basic

The federal government intends to implement a basic level of initial 2011 criteria for meaningful use of electronic health records systems to determine who will receive Medicare and Medicaid incentives under the American Recovery and Reinvestment Act. The meaningful use criteria then will get tougher in 2013 and 2015.

That's the word from David Hunt, M.D., chief medical officer in the Office of the National Coordinator for Health Information Technology. Hunt spoke Sept. 17 at Health Data Management's Health IT Stimulus Summit in Boston, giving hints at what a proposed rule in December on meaningful use criteria will look like.

Because the start of the incentive program in 2011 will be here "in the blink of an eye," the government's meaningful use definition must focus on goals that hospitals  and physicians  "can achieve quickly and reasonably," Hunt stressed. Thus, the Centers for Medicare and Medicaid Services primarily will be seeking evidence in 2011 that providers have purchased and are using EHRs, he said.

"You have to be able to send data and CMS has to be able to receive it," Hunt said. "The big thing for 2011 is that you actually acquire this equipment and start using it."

Asked if his comments meant that extensive meaningful use criteria for 2011 that the HIT Policy Committee has recommended to CMS will not be adopted, Hunt responded that federal officials are taking in a "tremendous amount" of information from many sources. "Obviously, when you start a journey, you always see how much you can possibly do."

But while explaining three major periods of phasing in meaningful use criteria for EHRs, Hunt labeled 2011 as a period of "structure," 2013 a period of "process" and 2015 a period of "outcomes."

Criteria in 2013 will focus on process measures to demonstrate providers have started to meaningfully use EHRs, Hunt noted. Goals and objectives for 2015 criteria will be heavily outcomes-oriented. "This is where we start to see results," he said, pointing to eventual efforts to measure the actual impact EHRs have on the quality of care.

CMS will collect public comment for 60 days after publishing proposed rules in December governing meaningful use incentives and certification of EHRs for meeting meaningful use criteria. Hunt urged industry stakeholders to submit comments and not assume that proposed rules show what the government wants to do and intends to do.

"Every single comment is reviewed and has a disposition," he asserted. "I have seen regulations put on hold in short order because senior officials didn't like what they were reading in the comments. They are seen at the highest levels."

Hunt also indicated a government assumption, based on recent statements and positioning by the Certification Commission for Health Information Technology, that the organization will be one of the entities that will certify EHRs as meeting meaningful use criteria. "CCHIT will be one of those entities; we have expectations that there will be other entities."

--Joseph Goedert

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