Investments in health information technology (IT) will continue to be made in emergency departments, thanks to two new final rules that will take effect in early fall.

Two complementary rules—one from the Centers for Medicare and Medicaid Services (CMS) and one from the Office of the National Coordinator for Health IT—were published in the Federal Register on July 28.

ACEP advocated for the changes reflected in the final CMS rule, which are a win for emergency medicine, because the emergency department will continue to be an important place in hospitals for investing in health IT, especially as these programs progress.

The rules were called for under the American Recovery and Reinvestment Act of 2009, which established Medicare and Medicaid incentive programs for physicians and hospitals to adopt meaningfully used health IT and establish standards and guidelines around the use of that technology. The rules use the time-honored carrot-and-stick approach.

“Meaningful users” of health IT can be reimbursed for adopting a “certified” system under the incentive program, with the first incentive payments scheduled to begin in 2011. Penalties come into play in 2015 for noncompliant providers, however. These programs are expected to lay a foundation for improving quality, efficiency, and safety through meaningful use of certified technology.

the emergency department will continue to be an important place in hospitals for investing in health Information technology.

Dr. David Blumenthal, National Coordinator for Health IT, will be speaking at ACEP’s Scientific Assembly on Sept. 28, and will be engaging members in a listening session on these topics.

Particularly relevant to emergency physicians, the final CMS rule includes the emergency department in several areas where hospitals may meet their meaningful use requirements, and ED throughput measures have been finalized for the initial phase of reporting.

While emergency physicians are categorically excluded from receiving direct incentives, many areas remain where emergency physicians can influence how well hospitals meet requirements.

Reacting to the initial proposal, ACEP urged drafters to include computerized physician order entry (CPOE) that takes place in the emergency department in the hospital’s CPOE meaningful use requirements, and to encourage hospitals to deploy clinical care systems (such as EHRs, CPOE, etc.) in the ED that are specifically engineered to improve the emergency care process.

ACEP also strongly supported the inclusion of ED throughput measures in the proposed clinical quality measures for electronic submission by eligible hospitals for payment year 2011-2012. The hope is that the reporting of these measures will focus attention on boarding (the common practice of holding admitted patients in the ED).

Emergency physicians can expect impacts in many areas. See the box below for an outline of the core measures as they relate to emergency physicians.