Administration announces looser requirements to get bonuses for using electronic health records

Last month we reported many hospitals said the initial rules proposed by the Obama administration for stimulus money to encourage adopting electronic medical records were too strict, especially for rural hospitals. Those pleas appear to have been heard; the Department of Health and Human Services announced a scaled back final version of the eligibility rules yesterday. The program could provide doctors and hospitals "as much as $27 billion over the next 10 years to buy equipment to computerize patients’ medical records," reports Robert Pear of The New York Times.

The initial rules would have required doctors and hospitals to meet at least 23 criteria. The new proposal would have doctors meet 15 specified requirements, plus five chosen from a list of 10 objectives. Hospitals would have to meet 14 requirements, plus five chosen from a list of 10 goals. "A doctor can receive up to $44,000 under Medicare and $63,750 under Medicaid, while a hospital can receive millions of dollars, depending on its size," for meeting the criteria, Pear writes. "To meet the new standards, doctors will have to transmit 40 percent of prescriptions electronically." The original proposal called for 75 percent.

Dr. Donald M. Berwick, who was sworn in Monday as administrator of the Centers for Medicare and Medicaid Services, told Pear that electronic health records would lead to "better, smoother care, more reliable care." Dr. David Blumenthal, the national coordinator for health information technology admitted the administration was "delaying some of the more ambitious requirements," but characterized the new standards as "ambitious but achievable" and said they would put doctors "on an escalator" toward full adoption of electronic records. (Read more)

The announcement was still met with some trepidation in the rural health community. "Some of our [larger urban] hospitals are in really good shape," Dr. W. Stephen Love, president and chief executive of the Dallas-Fort Worth Hospital Council, told Dave Michaels of The Dallas Morning News, but noted for "some of the smaller hospitals and rural hospitals in North Texas, it's going to be expensive and it's also going to be very time-consuming." (Read more)