Government issues rules regarding electronic medical records

The federal government has issued 2 sets of regulations to lay the groundwork for physicians and hospitals to receive payments for implementing and using electronic medical records (EMRs). The first outlines provisions governing EMR incentives and details what constitutes "meaningful use" of the technology, which is a prerequisite for receiving incentive payments. The second regulation sets initial standards and certification criteria for using approved EMRs. Both rules, posted in the Federal Register on January 13, are open for public comment for 60 days.

The first, proposed by the Centers for Medicare and Medicaid Services (CMS), lists objectives that physicians and hospitals must meet to be deemed "meaningful" EMR users. These objectives are to be met in 3 stages: stage 1 begins in 2011, stage 2 in 2013, and stage 3 in 2015. For stage 1, CMS list 25 objectives for physicians and 23 objectives for hospitals. Each objective has an attached corresponding measure. For example, one physician objective requires doctors to submit at least 75% of all prescriptions electronically using certified EMR technology. Other stage 1 objectives include using computerized physician order entry, maintaining patient medication allergy lists, sending reminders for preventive/follow-up care, and recording patient demographics.

The second, interim final regulation issued by the Office of the National Coordinator for Health Information Technology describes standard formats for clinical summaries and prescriptions, standard clinical terminology, and standards for secure Internet transmission of information.