With government incentives for the use of electronic health records (EHR) set to begin next year, physicians of all backgrounds have largely accepted the significant role that digital technology will play in the future of medicine. While some practicing physicians do not plan to integrate EHR into practice, many established and young physicians are investigating options to qualify for incentives and maximize the benefit of technology. Questions still remain about the recently released “meaningful use” final rule, but equally important in dermatology are growing concerns regarding certification bodies and the effect of the certification process on how EHR systems are designed.

An Uncertain Future
The 846 page final rule on meaningful use appears to have relaxed criteria somewhat, however, certain core requirements still have limited value in dermatology and other specialties. While the core measures are designed to provide a basic template for all EHR systems, it highlights the difficulty of defining “meaningful use” in broad strokes.

Matters related to certification and meaningful use are expected to take shape in the next few months, but the current lack of definition and continued concern from physicians in specialties such as dermatology raise economic questions about the future of EHR. Some of the larger specialties may have a bevy of EHR to choose from, but smaller specialties will likely have far fewer systems customized to their practices. In an ideal scenario, companies would be able to develop systems that comply with national quality measures while offering features tailored to a physician's own specialty. However, once certification criteria and clinical quality measures are more clearly defined, EHR companies will likely have to consider the economic viability of a dermatology-specific EHR.

While questions pertaining to the economic sustainability of EHR systems within various medical specialties cannot be answered definitively until regulations are more concrete, they bear consideration now due to the dwindling time remaining to qualify for government incentives.

Unfortunately, it will be difficult to determine which systems will provide the most benefit for dermatologists until resolutions are reached regarding certification bodies and we have more time to digest the final rule on meaningful use. EHR companies should then have enough direction to construct systems that comply with government standards and present them to discerning physicians, who will ultimately decide which systems are best for their practice and specialty.

Passing the Test
At this month's AAD Summer Meeting in Chicago, several companies are exhibiting their systems (Clinix Medical Information Services, doc2MD, Encite, Inc., MELA Sciences, Micro4, Inc., NexTech). In addition, a symposium will be held on EHR and dermatology. Next month's column will examine a number of dermatology- specific EHR systems, providing brief analysis of newer systems and those that may potentially be beneficial to dermatologists.

Dr. Kaufmann has no relevant disclosures.

New Criteria for “Meaningful Use”: Questions Remain
CMS's new requirements for meaningful use divide the 25 performance measures into dual tracks: the rigorous track of 15 required performance measures and the 10 remaining measures of which physicians need only satisfy five. Physicians now must transmit more than 40 percent of their scripts electronically (vs. 75 percent originally) and have three days to provide patients with electronic copies of health information upon request (vs. 48 hours). The threshold for recording demographic information has dropped to more than 50 percent (from at least 80 percent). For more information, visit http://www.cms.gov.