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Computerworld - The U.S. Department of Health and Human Services today issued the final guidelines that will determine how doctors, hospitals and other medical care facilities can qualify for reimbursements by rolling out electronic medical records (EMR) over the next four years.

Dr. David Blumenthal, national coordinator for health information technology, said the final "meaningful use" rules offer greater flexibility to physicians and hospitals than the initial guidelines first proposed earlier this year.

The new rules were finalized after a three-month public comment period during which more than 2,000 recommendations were received by HHS on its preliminary "notice of proposed rule making" effort. The final document is 864 pages long.

"We heard... it was too inflexible; that it was an all-or-nothing set of objectives. So we added some choice," Blumenthal said during a news conference today. "We want the objectives of meaningful use to be both ambitious but achievable."

For example, under the earlier proposed rules, physicians would have been required to write 75% of their prescriptions electronically. The final Phase 1 rule requires only that 40% of prescriptions be written electronically.

Last year, the American Recovery and Reinvestment Act set aside $36 billion to help hospitals and doctors purchase equipment to computerize patient medical records. But even the most sophisticated hospitals in the U.S. are still struggling to qualify for the payments, a recent study indicated.

HHS Secretary Kathleen Sebelius admitted during today's news conference that only 20% of physicians and 10% of hospitals now use even the most basic EMR systems -- which are also know as electronic health record (EHR) systems. "Our goal has never been to just use technology for the sake of technology -- to transfer everything on paper to a computer and call it quits," she said. "We're promoting electronic health records so that they can be used to deliver better care and give consumers more control over their own health care."

The Centers for Medicare and Medicaid Services (CMS), the federal agency tasked with writing the meaningful use rules, estimates that 66.4% to 92.6% of hospitals and between 21% and 53% of private physicians practices will have implemented EMRs by 2015.

Clinicians in private practices that deploy the technology and prove that their efforts are effective enough to meet the government's "meaningful use" standards can receive up to $44,000 per doctor in reimbursement funds through Medicare and $63,750 under Medicaid beginning next year. Hospitals could receive millions under the same program.

A 275-bed facility, for example, would be eligible for about $6 million to defray IT costs associated with deploying EMR technology. HHS estimates that as much as $27 billion could be spent on incentive payments.