The "all or nothing" approach to defining and achieving meaningful use is too ambitious and will only widen the "digital divide," according to the College of Healthcare Information Management Executives (CHIME), which held its annual meeting in Atlanta, GA, on Sunday.
Other "critical concerns" that CHIME expressed in comments on the Centers for Medicare and Medicaid Services' (CMS) EHR Incentive Program include the fact that it doesn't take into account providers' need for flexibility and does not reward incremental progress. CHIME wants CMS to give providers until 2017 to achieve EHR implementation. Their proposed incremental approach would deem a provider a meaningful user if it can achieve 25% of objectives by 2011, 50% by 2013, 75% by 2015, and "substantially all" by 2017.
According to the comments, it also wants CMS to delay quality reporting to 2012, writing that although automated quality reporting is critically important to the meaningful use of EHRs, no system in use today can automatically report the full set of proposed measures.
"Without an approach that rewards progress or provides sufficient time, organizations with limited resources will likely have little chance of qualifying for payments, thus widening the 'digital divide' in the country," the organization stated in its comments.
CHIME also comments on specific objectives and HIT functionality measures included in the proposed regulations. The organization seeks the elimination of administrative measures, such as EHRs producing metrics on automated claims submissions and insurance eligibility, and makes recommendations about CPOE, medication reconciliation, data submission to public health agencies, and HIT functionality data submissions.
"We wanted to make our position known on the proposed regulations," said Pamela McNutt, senior vice president and CIO of Methodist Health System in Dallas, who chairs the group's policy committee.
Responses to the CMS proposal are due March 15.