July 14, 2011
ASA Update on Electronic Health Records and Meaningful Use
Over the past 18 months, ASA has intensively lobbied the Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator (ONC) to obtain modifications to the Electronic Health Records Incentive Program Stage 1 meaningful use requirements. In current form, the vast majority of ASA members will be eligible to participate but not able to successfully meet Stage 1 meaningful use requirements or receive Stage 1 incentive payments.
There is great inflexibility regarding the timeline for implementation in the law resulting in a daunting task for those writing the regulations. The Stage 1 meaningful use requirements focus on primary care and fail to address the practice intricacies of many medical specialties including anesthesiologists.
During a recent meeting with ASA, ONC acknowledged that Stage 1 meaningful use requirements will not be modified for any specialty including anesthesiologists; however, it did state that the needs of specialties may be addressed in the Stage 2 requirements. The fact that the ONC is going to address the needs of specialty societies is a direct testament to the persistent lobbying by ASA members and staff. ASA will continue to lobby to ensure the actual practice of anesthesiology is considered when Stage 2 meaningful use requirements are written. Given this new development, anesthesiologists deemed eligible under the EHR incentive program should work with their electronic health record (EHR) vendor and information technology department to assess whether Stage 1 or Stage 2 certification is feasible.
The Electronic Health Records (EHR) Incentive Program was created under the American Recovery and Reinvestment Act (ARRA). While a majority of anesthesiologists will be deemed “eligible professionals” and thus theoretically eligible to receive the incentive payments for the “meaningful use” of EHRs, most anesthesiologists cannot meet the Stage 1 meaningful use requirements. The full incentive payments for the Medicare incentive program is $44,000 per eligible professional over five years if they begin successfully attesting in 2011 or 2012, and $39,000 over three years if they wait to attest in 2013, when Stage 2 meaningful use requirements are expected to take effect. If an eligible professional does not begin meaningfully using a certified EHR, Medicare payment penalties are scheduled to begin in 2015.
Each ASA member should consider five questions regarding meaningful use:
1. Am I an eligible professional?
2. Am I using a certified (or certifiable) electronic health record?
3. Does my use of the electronic health record satisfy the Stage 1 meaningful use criteria?
4. How can I influence my facility and vendor to implement a certified electronic health record?
5. How can I advocate CMS and ONC to ensure future meaningful use criteria incorporate the anesthesiologist’s unique clinical process?