Statement on Final Rule on "Meaningful Use" and Health Information Technology Funding
Matthew Fenwick - (312) 422-2820
Jennifer Armstrong Gay - (202) 626-2342
President and CEO
American Hospital Association
July 13, 2010
America’s hospitals are working to advance the quality of care they provide to patients and communities through greater adoption and use of electronic health records (EHRs). While many hospitals have been pioneers in harnessing information technology (IT) to improve patient care and quality, the challenge now is to extend its use and integrate it into the routine care processes in all hospitals, big and small, in both rural and urban areas.
In today’s final rule, Centers for Medicare & Medicaid Services (CMS) has made some important improvements. However, the American Hospital Association (AHA) remains concerned that the requirements may be out of reach for many of America’s hospitals. Given this rule’s complexity, we are fully reviewing it and consulting with our members in order to understand its implication for hospitals and patients.
From our initial review, we are pleased that CMS has provided some additional flexibility for hospitals in the criteria to become “meaningful users” of EHRs. CMS rightly recognized the special role that critical access hospitals play in their communities by providing needed access to Medicaid funding under this rule. CMS also removed some unnecessary administrative burdens that would have been time consuming and costly for hospitals, without improving patient care.
Unfortunately, CMS continues to place some barriers in the way of achieving widespread IT adoption by our nation’s hospitals and physicians. In particular, individual hospitals in multicampus settings are unfairly excluded from incentive payments. Hospitals within a health care system should each be eligible for incentives. Additionally, we are concerned this rule may adversely impact rural hospitals and the patients they serve and exacerbate the digital divide in health care. We also are concerned that the rule requires hospitals to immediately use Computerized Provider Order Entry (CPOE), which can be complicated, costly to implement and takes time to do right.
In combination with the certification process, which penalizes early adopters by requiring them to upgrade or replace already functional systems, these rules limit how quickly hospitals can adopt a certified EHR that can benefit patient care. We continue to be concerned that, given limited vendor capacity and workforce shortages, many hospitals will not have timely access to certified products, since no certified EHR systems are available today.
Every day, the women and men of America’s hospitals strive to improve the safety and quality of patient care. Implemented successfully, EHRs can limit errors, improve care and increase efficiency. But for hospitals to realize the promise of EHR systems, much planning and deliberation are needed up front. The promise and intent of Congress and the President was to provide needed funding to hospitals and physicians with the goal of spurring adoption of EHRs. Hospitals strongly share that goal, but today’s rule raises some serious concerns and needs to be further evaluated to determine its impact on hospitals and the communities they serve.
The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the improvement of health in their communities. The AHA is the national advocate for its members, which includes more than 5,000 member hospitals, health systems and other health care organizations, and 38,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends.
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