EHR Regulations Could Be Changed

A proposed federal rule nips and tucks previously issued regulations governing the testing, certification and use of electronic health-record systems.

The proposed rule, issued jointly by the CMS and the Office of the National Coordinator for Health Information Technology, tweaks several of the meaningful-use criteria that healthcare providers must meet to qualify for payment under the federal EHR incentive program.

For example, it adds an alternative meaningful-use criterion for the electronic transmission of structured lab results from hospitals to ambulatory-care providers who ordered the lab test.

Under the new alternative criterion, hospitals must send structured electronic clinical lab results to the ordering ambulatory-care provider for more than 20% of total lab orders received from ambulatory providers, regardless of whether the orders were received electronically or by phone, fax or other communications method.

The original meaningful-use criterion for lab orders requires hospitals to electronically send structured lab data only in response to 20% of the lab orders that it also receives electronically. The alternative was added, according to the government, because some hospitals might find themselves sending significant percentages of results electronically but receiving very few orders electronically. If a handful of responses to the few electronic orders received were not sent via computer, the hospitals could find themselves failing to meet the 20% threshold.

Another of the changes is to be made to the ONC's 2014 EHR certification criteria, adopted in September 2012.

Specifically, the proposed change will update what's called the data element catalogue, which identifies all of the data needed to calculate the clinical quality measures included among the federal EHR incentive payment program's meaningful-use requirements. Providers must demonstrate their meaningful use of certified EHR systems to qualify for incentive payments.

A new version of the data element catalogue, or DEC, was needed to match the right data elements with the final electronic specifications for the 2014 edition's clinical quality measures, according to the government. The DEC update was created with the help of the National Library of Medicine.

The proposed final rule also adopts an updated version of a messaging standard for electronically reporting clinical quality measures to the CMS. Testing and certification of electronic health-record system technology using the new measures is expected to begin in January, according to the government.

The proposed final rule is slated for official publication in the Federal Register on Friday, at which point a 30-day public comment period will open.

Written by Joseph Conn for

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