The Office of the National Coordinator for Health IT has been out and about promoting the fact that specialists can meet requirements for the “meaningful use” incentive payment program as provided by the HITECH Act by taking advantage of exceptions in the final rule.
At a recent meeting of the American Academy of Ophthalmologists, David Blumenthal, MD, national coordinator of health information technology for the Department of Health and Human Services (HHS), pointed to exceptions to the meaningful use final rule that can enable specialists to qualify for incentive funds.
These exceptions were put in place because some meaningful use objectives are not applicable to every provider’s practice. As a result, when choosing which of the “menu item” objectives to focus on, those that are not applicable to that specialty are counted as meeting meaningful use requirements. For example, dentists do not perform immunizations. Therefore, under the exceptions rule, a dentist who is an eligible provider would be recorded as meeting the meaningful use of the menu item “Immunization Data to Registries.”
Some other exceptions include ones that apply to using computerized physician order entry systems and e-prescribing tools for ordering medications. Physicians write fewer than 100 prescriptions during the 90-day reporting period are excluded from those two rules. Another exception applies to the rule that physicians must supply patients with electronic copies of their health records. An exception applies if no patients ask for the records.
Still, some specialists would like to see separate requirements for them as part of the Medicare and Medicaid EMR incentive program. Many groups have weighed in on the topic including the American Academy of Orthopaedic Surgeons which published a position statement after the preliminary rules were released that supported the use of EMRs for improving the quality of patient care, safety and outcomes. But the statement also added, “Orthopaedic surgeons will have great difficulty in meeting the current 25 meaningful use standards.”
To date, the ONC has not issued a formal statement for specialists aiming to meet the standards. However, Blumenthal has spoken publicly a number of times stating that specialists could claim exceptions to rules that do not apply to them and that claiming exceptions is acceptable to meeting the requirements to qualify for EMR stimulus money.
The EHR stimulus programs were established to implement a national strategy for using health IT (HIT) to drive quality improvement and delivery of more efficient and patient-centered healthcare. The common definition of meaningful use for both Medicare and Medicaid means that a wide variety of providers will be focusing their reporting efforts on required data points to receive the incentive payments.