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In Busy Week, House Considers Anesthesiologists' Concerns on Electronic Health Records

Tuesday, November 20, 2012

House Hearing on Meaningful Use

In a busy post-election lame duck session of Congress, the House Committee on Science, Space and Technology, Subcommittee on Technology and Innovation held a hearing to examine current government health information technology initiatives and "meaningful use."  Among the issues covered in the hearing titled, Is "Meaningful Use" Delivering Meaningful Results?: An Examination of Health Information Technology Standards and Interoperability were the concerns of anesthesiologists and other specialists regarding the Electronic Health Record (EHR) Incentive Program.

In the first question of the hearing, Chairman Quayle (R-AZ) stressed the need to ensure the meaningful use criteria are applicable to physicians covered by the hardship exemption (this includes anesthesiologists).  He asked Dr. Farzad Mostashari, the National Coordinator for Health Information Technology, if it is "appropriate to have the same core and menu requirements for different types of physicians?"

Of note, Dr. Mostashari replied that "this has been an issue we have been working with stakeholders and the policy committee for the past two years" and that they [Office of the National Coordinator] want interoperability and "yet allow for the differences in practice and what is relevant to different specialists."

Congressman Andy Harris (R-MD), M.D., an anesthesiologist, asked if the Administration would continue the hardship exemption for anesthesiologists until meaningful use parameters are worked out.

Dr. Mostahari responded, "Yes, as you know the particular issue for those three categories - anesthesiologists, pathologists and radiologists - was not only that they practice in some cases where they have less patient interaction, its also that the systems that they use are often times provided by the hospital where they practice rather than purchased by the providers themselves within their private practice.  The exemptions we asked about whether there should be more blanket exemptions for those categories and in Stage 2 we finalized that, it can be extended for up to five years, I think that given the current legislation I think that is the means that are available to us."

Previously, when referencing the hardship exemption in the Stage 2 Final Rule, CMS had stated that "physicians in these three specialties should not expect that this exception will continue indefinitely, nor should they expect that we will grant the exception for the full 5-year period permitted by statute."  The hardship exemption for anesthesiologists is determined annually.

Electronic Health Records Improvements Act

Additionally, Congresswoman Diane Black (R-TN) recently introduced the Electronic Health Records Improvements Act to improve the EHR Incentive Program.  This legislation, if enacted into law, would exempt anesthesiologists from some of the criteria required to demonstrate meaningful use including: 

  • exempting anesthesiologists from providing clinical summaries to patients
  • exempting anesthesiologists from being required to provide patients with an electronic copy of their health information
  • exempting  anesthesiologists and other eligible professionals from implementing drug to drug and drug to allergy interaction checks

The exemptions for anesthesiologists in this legislation, if enacted, would be an important step forward toward improving the EHR Incentive Program.

In August of 2012, CMS released the final rule for Stage 2 of the EHR Incentive Program.  As a direct result of ASA's advocacy efforts, the final rule created a temporary automatic hardship exemption from the penalties for anesthesiologists.

View a video of the hearing. (Chairman Quayle's questions begin at around 39 minutes and Congressman Harris' questions begin at about 1 hour and 9 minutes).
View more information about the hearing.
Review the ASA Frequently Asked Questions (FAQ) regarding EHR meaningful use.
View Congresswoman Black’s EHR legislation.

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