What is Driving EHR Certification?

Let’s be clear.  Certification is being driven by the Centers for Medicare and Medicaid Services, also known as CMS, with the intention of converting the entire country to Electronic Health Records.

If you do not understand the acronyms, and you are not keeping up with the moving targets, you will likely make a decision based on misinformation.  With the plethora of information on the web it is no simple task to parse details in a way that is relevant for you and your practice.  It is my hope that this article will help clear up some of the confusion that is circling the profession and to help you be more intentional about the adoption of an electronic record for your clinic or practice.

In 2009, under the American Recovery and Reinvestment Act, ARRA, (Cash for Clunkers and the bail out of companies too big to fail), the Obama Administration committed 831 billion dollars to prop up the United States infrastructure and to jump start the economy.

Of this 831 billion dollars, 36 billion was allocated to the medical community as an incentive to adopt electronic medical records.

Who is eligible for these incentive payments?

Eligible professionals under the Medicare EHR Incentive Program include: Eligible professionals under the Medicaid EHR Incentive Program include:
Doctor of medicine or osteopathy Physicians (primarily doctors of medicine and doctors of osteopathy)
Doctor of dental surgery or dental medicine Nurse practitioner
Doctor of podiatry Certified nurse-midwife
Doctor of optometry Dentist
Chiropractor Physician assistant who furnishes services in a Federally Qualified Health Center of Rural Health Clinic that is led by a physician assistant.
Below is the chronology of events for the adoption of Electronic Health Records as they unfolded at the Federal level.

American Recovery and Reinvestment Act (2009)

Health and Human Services 
(Kathleen Sebelius oversees HITECH and the allocation of incentive payments.)

(Health Information Technology for Economic and Clinical Health)

HITECH defines how to use an electronic record meaningfully.
It is being rolled out in three stages for Meaningful Use.
The country is currently working toward full implementation of Meaningful Use Stage 2.  If your credentials are not listed above and if you treat less than 30% Medicaid patients as part of your entire case load, you are not eligible for reimbursement.

If you are eligible to be reimbursed for the adoption of an electronic record, you must be using a Certified system and show that you are using it “meaningfully,” and complying with HITECH Stages of Meaningful Use.  For all providers being reimbursed by CMS, whether they hold credentials that are reimbursable or not, they will be penalized 1% in CMS payments for treatment, if they are not using a certified EHR by January 01, 2015.  Fines will go up as time moves on.  Certification is therefore, for CMS providers whose credentials are listed above.

(Is under the Office for Civil Rights OCR)

Because HITECH is the defining arm for the electronic transmission of Protected Health Information (PHI), HHS and OCR have to work together to make sure the standards defined under HITECH are in lockstep with HIPAA Standards.  HIPAA standards continue to evolve as technology takes front and center stage in the field of healthcare.

It is Empathic’s opinion that the Meaningful Use standards under HITECH, and the push for Interoperability, and Electronic Records are eventually going to have a profound impact on increased patient wellness and clinician vitality, lower healthcare costs, increased treatment effectiveness and productivity and that the creation of a unified national health record will be one of the most important giant leaps into the future this country could take as it regards healthcare reform.  A good electronic record should be your clinical and business infrastructure.  It is an investment in your practice, and yourself, and it should save you time and energy.  As painful as it is right now, we all need to take our medicine and get on board.

It is important that as a consumer, you adopt an electronic record out of knowledge and intentionality, not out of fear or impulse.  Be diligent.  Find an online record that works for you and not the other way around.  Your Electronic Health Record will be with you a long time.  Find one that speaks your language and gets the job done right.  Find a company you trust will be there for you.  Look for a partnership.  Under HIPAA, we are now all Business Associates with all of the privileges and responsibilities that go along with that.  Choose your Business Associates, well.

Notice of Proposed Rulemaking to Implement HITECH Act Modifications

Health and Human Services issued a notice of proposed rule making to modify the HIPAA Privacy, Security, and Enforcement Rules.

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, is designed to promote the widespread adoption and standardization of health information technology, and requires HHS to modify the HIPAA Privacy, Security, and Enforcement Rules to strengthen the privacy and security protections for health information and to improve the workability and effectiveness of the HIPAA Rules.

The proposed modifications to the HIPAA Rules include provisions extending the applicability of certain of the Privacy and Security Rules’ requirements to the business associates of covered entities, establishing new limitations on the use and disclosure of protected health information for marketing and fundraising purposes, prohibiting the sale of protected health information, and expanding individuals’ rights to access their information and to obtain restrictions on certain disclosures of protected health information to health plans.  In addition, the proposed rule adopts provisions designed to strengthen and expand HIPAA’s enforcement provisions.
U.S. Department of Health and Human Services