At this point, I’m guessing that most people have heard of meaningful use and many likely know about the 25 meaningful use criteria (15 core MU measures and 10 menu). I’m not sure how well communicated the exclusions that are available for most of the meaningful use criteria. Elizabeth Woodcock explains some of the details in her Modern Medicine article:
For the 13 of the 25 criteria that have exclusions, CMS designates narrow windows for physicians to report that the objective or measure does not apply to them because “They have no patients, or no or insufficient number of actions that would allow calculation of the meaningful use measure.” For example, a physician who has no patients age 65 or older or age 5 or younger would not have to meet the requirement to send an appropriate reminder to 20 percent or more of all patients in those age groups during the EHR reporting period.
Also of some comfort to dermatologists is that CMS lowered thresholds for many of the meaningful use measures. For example, the measurement for electronic prescribing will be for more than 40 percent of all permissible prescriptions written by the physician to be transmitted electronically using certified EHR technology. CMS backed off from its initial proposal setting the minimum e-prescribing threshold at 75 percent of all permissible prescriptions.
Some are still saying that specialists are still left out of the meaningful use and EMR stimulus programs. They rightfully note that meaningful use was and is focused on primary care and not specialists. In fact, ONC hasn’t been shy about generally making the same observation.
The question is whether exclusions like the one mentioned above does enough to encourage specialists to implement an EHR. I’m inclined to lean with many of the specialist medical societies that are saying that it doesn’t.
I’d make an even bolder prediction. Don’t be surprised to see specialists still leading in number of EMR implementations done despite not being stimulated to do so by the government.
John, very good observation. I think it’s pretty clear the EHR incentives are not desgined for the specialists. Just look at who the Regional Extension Centers are mandated to help. With that said, the lowering of measurements and the option to “exclude” certain measure definitely helps specialists and others like the Chiropractors. Hopefully, enough specialists will qualify to create even faster adoption for them.