The Massachusetts Board of Registration in Medicine is working on proposed regulations to implement a small provision of Massachusetts Chapter 224 of the Acts of 2012 that has a disproportionately large impact. Section 108 of Chapter 224 requires the physicians “demonstrate proficiency in the use of computerized physician order entry, e-prescribing, electronic health records and other forms of health information technology.” At a minimum, Chapter 224 states that this proficiency requires a showing of “meaningful use” as defined in federal regulations. This one provision of Chapter 224 has caused a lot of concern because of the potential hardship imposed on physicians across the Commonwealth.
The electronic health record (EHR) proficiency requirement becomes effective for all new and renewal applicants after January 1, 2015. Under the proposed regulations, new applicants must show proficiency or qualify for an exemption, whereas a renewal applicant may also obtain a waiver.
Proficiency may be shown in 1 of 4 ways: (i) participation in a Stage 1 Meaningful Use program as an eligible health care professional, (ii) employment with, credentialed by or in a contractual agreement with an eligible hospital or critical access hospital in a certified program, (iii) participation in the Massachusetts Health Information Highway, or (iv) completion of a qualifying course.
There are five potential exemptions that an applicant can seek. It is necessary that the exemption be claimed each licensing cycle. The exemptions are: (i) the applicant will not engage in the practice of medicine, (ii) an applicant for an Administrative License, (iii) an applicant for a Volunteer License, (iv) an applicant on certain types of active duty, or (v) an applicant for an Emergency Restricted License.
Lastly, applicants renewing their license may seek a waiver, which only provides an extension of the time in which an applicant must either demonstrate proficiency or receive an exemption. Under the proposed regulations, an applicant may obtain a 90-day waiver, at the Board of Registrations discretion. This is not a permanent waiver, just a temporary one.
Currently, it is uncertain how many physicians in Massachusetts will be able to meet the EHR proficiency requirement. Accordingly, it will be important to track the Board’s proposed regulation and assess its impact. The initial draft seems to demonstrate some flexibility, but expect changes to occur as comments are received.