Final Rules on Meaningful Use & Standards

This compendium summarizes resources and analysis related to the final rules for Health Information Technology - Meaningful Use and Standards.

AMA's American Medical News reports that "the final 'meaningful use' rule for electronic medical record adoption gives physicians and hospitals some flexibility in meeting certain objectives to qualify for billions in federal incentives."

Robin Raiford's quick summaries of 1) the objectives and measures and 2) a list of the standards.

Mu Quick

Standards Quick

The rules were announced in this press briefing:


David Blumenthal summarizes the objectives from The "Meaningful Use" Regulation for Electronic Health Records (NEJM):

John Halamka presents an overview of the Meaningful Use rules:
Meaningful Use

Keith Boone provides a Meaningful Use Standards Summary at Healthcare Standards.  John Halamka published an Analysis of the Final Standards Rule and FAQ's at Life as a Healthcare CIO.

House Ways and Means Subcommittee on Health reviews HITECH/Meaningful Use:

House Ways and Means Committee Hearing on HITECH 7_20

Blumenthal's testimony before the House Ways and Means Subcommittee on Health:  Efforts to Promote the Adoption and Meaningful Use of Health Information Technology:
2010Jul20 Blumenthal Testimony

Tony Trenkle's testimony before the House Ways and Means Subcommittee on Health:  Efforts to Promote the Adoption and Meaningful Use of Health Information Technology:
2010Jul20 Trenkle Testimony

Tony Trenkle's summary of the changes in the final rule was presented to the HIT Policy Committee on July 21 (see pages 16 - 33):

HIT Policy Committee - 2010-07-21


The bookmarked meaningful use final rule is available at http://mycourses.med.harvard.edu/ec_res/nt/401D45C0-6F53-44EE-9BC5-87454E612FCD/MUfinal.pdf.

The meaningful use rule implements the provisions of the American Recovery and Reinvestment Act of 2009 that provide incentive payments to eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) participating in Medicare and Medicaid programs that adopt and successfully demonstrate meaningful use of certified electronic health record (EHR) technology. This final rule specifies—the initial criteria EPs, eligible hospitals, and CAHs must meet in order to qualify for an incentive payment; calculation of the incentive payment amounts; payment adjustments under Medicare for covered professional services and inpatient hospital services provided by EPs, eligible hospitals and CAHs failing to demonstrate meaningful use of certified EHR technology; and other program participation requirements. Also, the Office of the National Coordinator for Health Information Technology (ONC) will be issuing a closely related final rule that specifies the Secretary’s adoption of an initial set of standards, implementation, specifications, and certification criteria for electronic health records. ONC has also issued a separate final rule on the establishment of certification programs for health information technology.

Electronic Health Record Incentive Program Final Rule 2010-17207

The Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology final rule (bookmarked) is available at http://mycourses.med.harvard.edu/ec_res/nt/8A3EA09D-B491-45FB-8D24-F3523F28E0A0/STANDARDSfinal.pdf.  

The standards rule completes the adoption of an initial set of standards, implementation specifications, and certification criteria, and to more closely align such standards, implementation specifications, and certification criteria with final meaningful use Stage 1 objectives and measures. Adopted certification criteria establish the required capabilities and specify the related standards and implementation specifications that certified electronic health record (EHR) technology will need to include to, at a minimum, support the achievement of meaningful use Stage 1 by eligible professionals, eligible hospitals, and/or critical access hospitals under the Medicare and Medicaid EHR Incentive Programs. Complete EHRs and EHR Modules will be tested and certified according to adopted certification criteria to ensure that they have properly implemented adopted standards and implementation specifications and otherwise comply with the adopted certification criteria.

Standards, Implementation Specifications and Certification Critera for EHR Technology Final Rule 2010-17210


NIST has documented the updated testing procedures at http://xw2k.nist.gov/healthcare/use_testing/finalized_requirements.html.  "NIST has completed its revisions of the draft test procedures to adjust to the Final Rule. These test procedures have been provided to ONC for the National Coordinator's approval for use under the temporary certification program by ONC-ATCBs. The test procedures will retain the "Approval (Pending)" status until formally approved by the National Coordinator."

Does HITECH / Meaningful Use need a Plan B? Vince Kuraitis and David Kibbe weigh in.