Meaningful Use, CEHRT & Appropriate Use

The federal government has invested more than $35 billion to spur the implementation and adoption of electronic health records (EHRs) across the nation. There’s no question, with nearly all hospitals and the large majority of physicians having adopted these systems, that wide-spread implementation has been a success. However, there is growing consensus that the Meaningful Use program needs to evolve to better support patient care. The check-the-box approach to health IT is severely limiting innovation, frustrating caregivers and increasing costs, and is not the right approach to solving interoperability challenges. There are varying sets of requirements for different provider settings and clinician types, making compliance exceptionally complicated. CMS has called for some sizeable changes to the program in the Inpatient Prospective Payment System (IPPS) proposed rule and if finalized will change the program substantially.

CMS is also implementing new “Appropriate Use” of imaging requirements, though they have been delayed several times. Although mandated under law, they are not expected to be required until 2019.

CHIME Top Recommendations to Policymakers

Meaningful Use
  • Synchronize the various sets of Meaningful Use requirements with the “Advancing Care Information” (ACI) performance category under the Merit-based Incentive-based Program (MIPS)
  • Immediately remove the all-or-nothing program construct of the Meaningful Use program
  • Permanently implement 90-day reporting periods for every program year as has been the case since 2014
  • Pause the program at Modified Stage 2 indefinitely while assessing how best to overhaul the program
  • Don’t require use of Version 2015 CEHRT until the majority of vendors are certified
  • Amend the HITECH statute to remove the directive to make the program more stringent over time
Appropriate Use
  • Delay Appropriate Use criteria until no sooner than 2019

CIO Cheat Sheets

Meaningful Use

Letters to the Administration

Congressional Letters & Testimony

Centers for Medicare & Medicaid Services (CMS)

Office of the National Coordinator (ONC)

Government Accountability Office

Office of the Inspector General