EHR Certification Guidance Offered for 'Ineligible' Providers

September 23, 2013

While the Medicare/Medicaid meaningful use incentive program has driven significant EHR adoption by health care providers, there remains a broad swath of care providers who are ineligible for Medicare and Medicaid EHR incentive payments.

These include certain mental and behavioral health professionals, as well as other professionals who practice in long-term and post-acute care settings. Yet, these “ineligible” providers routinely interact with hospitals and physician practices that are eligible for EHR incentive payments.

Recognizing that these providers are equally important to the care continuum, the Office of the National Coordinator (ONC) has drawn up a certification guidance aimed at technology developers serving these specialized providers.

The five-page guidance, issued Sept. 9, specifically focuses on interoperability. Here, ONC says it is seeking to open critical communication lines between eligible and ineligible health care providers in order to support broad health care goals, such as care coordination and reduced hospital readmissions.

In practice, that could mean improved health information exchange among not just traditional care settings but even clinical laboratories, public health agencies and more.

For example, one section of the 2014 Edition EHR certification criteria specifically supports interoperable summary care record exchange — a fundamental capability necessary to enable care coordination across different health care settings.

ONC officials say the guidance is meant to serve as a building block for federal agencies and stakeholders as they work with different communities to achieve interoperable electronic health information exchange. They note that health care providers eligible to receive incentive payments under the Medicare and Medicaid EHR incentive programs will, depending on the stage of meaningful use they seek to achieve, need to have EHR technology certified to these criteria. “We encourage EHR technology developers serving ineligible health care providers to also seek certification to these criteria.”

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