UPDATED: The U.S. Department of Health and Human Services (HHS) the Centers for Medicare and Medicaid Services (CMS) has published a final rule for the Stage 3 requirements for the meaningful use of certified EHRs for Medicare and Medicaid incentive payments and the Office of National Coordinator (ONC) for Health Information Technology has published a final rule for the certification of electronic health records (EHRs) for 2015.
According to a CMS fact sheet, more than 70 percent of eligible physicians and other clinicians, and more than 95 percent of eligible hospitals have successfully used EHRs and received Medicare or Medicaid incentive payments from the federal government. The Stage 3 requirements will not become effective until January 1, 2018, making the Stage 3 requirements optional for providers in 2017. To give providers more flexibility and time to continue towards full EHR functionality, the final rule also allows any continuous 90-day reporting period for all providers in 2015, and extends the 90-day reporting period to new providers in 2016 and 2017, and to anyone choosing to adopt the Stage 3 measures a year early in 2017.
The Stage 3 final regulation also seeks additional public comment about the EHR Incentive Programs going forward, in particular with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which established the Merit-based Incentive Payment System and consolidates certain aspects of a number of quality measurement and federal incentive programs into one more efficient framework. CMS already had issued a request for information to inform its rulemaking to implement MACRA.
The ONC 2015 EHR certification final rule is renamed 2015 Health IT Certification requirements, and include:
- Improving interoperability by adopting new and updated vocabulary and content standards for the structured recording and exchange of health information, including a Common Clinical Data Set composed primarily of data expressed using adopted standards; and rigorously testing an identified content exchange standard (Consolidated Clinical Document Architecture (C-CDA));
- Facilitating the accessibility and exchange of data by including enhanced data export, transitions of care, and application programming interface (API) capabilities in the 2015 Edition Base EHR definition;
- Establishing a framework that makes the Health IT Certification Program open and accessible to more types of health IT, including health IT that supports a variety of care and practice settings, various HHS programs, and public and private interests;
- Supporting the CMS Medicare and Medicaid EHR Incentive Programs through the adoption of a set of certification criteria that align with provisions in the EHR Incentive Programs requirements;
- Addressing health disparities by providing certification to standards for more granular capture of race and ethnicity; for the collection of sexual orientation, gender identity, social, psychological, and behavioral data;
- Supporting the exchange of sensitive health information through the Data Segmentation for Privacy criteria;
- Ensuring all health IT presented for certification possess the relevant privacy and security capabilities;
- Improving patient safety by applying enhanced user-centered design principles to health IT, enhancing patient matching, requiring relevant patient information to be exchanged (e.g., Unique Device Identifiers), improving the surveillance of certified health IT, and making more information about certified products publicly available and accessible;
- Increasing the reliability and transparency of certified health IT through surveillance and disclosure requirements; and
- Providing health IT developers with more flexibility, opportunities, and time for the innovative, usability-focused development and certification of health IT.
The ONC also has published a fact sheet summarizing the final rule.