The federal government's EHR incentive program stands to be a major boost to physician group practice adoption. But the government needs to proceed carefully when designing adoption requirements in future iterations of the program, an expert at the Medical Group Management Association says. Robert Tennant, MGMA's senior policy advisor, walked participants at the group's annual conference through the recently enacted meaningful use requirements. "It was a simple law that morphed into a complicated and complex program," he said.

The government's first proposed set of rules to receive the incentive money was unworkable, and would have backfired, he said. And while Tennant applauded the Office of the National Coordinator for listening to industry feedback and simplifying the requirements of Stage 1 incentives, he cautioned against setting future requirements too high. The program will invoke additional rounds of expanded criteria during the next few years. And MGMA-which lobbied against the initial draft of meaningful use requirements with what Tennant described as the longest comments letter ever sent by the association-is pressing to keep things realistic, he noted. For one thing, EHR software vendors will need ample lead time to build in any increased functionality into their systems. Beyond that, the government needs to consider the success of the first round of criteria, he added.

Tennant urged group practices that are tentative about EHR adoption to consider embracing electronic prescribing as a first step. The technology is not nearly as complicated to implement, and CMS currently has an incentive program for practices prescribing electronically. The e-prescribing incentive program cannot be combined with meaningful use (which includes an e-prescribing component), Tennant pointed out. But implementing electronic prescribing-which can reduce medical errors and lower overhead for group practices--is a good first step toward understanding the changes in workflows necessitated by health I.T., he said.

--Gary Baldwin


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