The Health IT Policy Committee's meaningful use workgroup held its second listening session on May 27 to get feedback from stakeholders on their recommendations for Stage 3 of the electronic health records incentive program. What vendors told the workgroup was that more focus and prioritization is needed for Stage 3.
Leigh Burchell, vice chair of the HIMSS Electronic Health Records Association, argued that Stage 3 must be designed in such a way as to avoid and also reverse many of the unintended consequences created during Stage 2. As everyone knows, CMS and ONC announced a significant relaxation of the 2014 participation obligations on May 20 and explicitly acknowledged that the Stage 2 timelines were simply too short given the extensive scope of the requirements, said Burchell. Indeed, the thinking underlying this proposal aligns well with what we have learned from Stage 1 and Stage 2, and is a primary reason weve begun urging a more focused and prioritized approach to Stage 3 of the incentive program.
Burchell told the workgroup that the EHRA, a trade association representing EHR companies, applauds the recent work of the HIT Policy Committee in scaling down recommendations on criteria for Stage 3, which include 19 objectives for providers to comply with compared with 26 in an earlier version. However, she said the organization still believes the scope of Stage 3 recommendations is too broad and further narrowing needs to be done by CMS and ONC in writing the proposed rules.
The emphasis, in evaluating what to keep from the recommendations, should be on greater and more effective use of the far-reaching and robust Stage 2 requirements and associated EHR capabilities, as well as any needed enhancements for interoperability, care coordination, and more effective and less costly quality measurement, said Burchell. A highly focused approach will enable vendors to meet other customer needs and reduce the degree to which extensive, prescriptive meaningful use requirements squeeze out development requested by our customers, impose costs and implementation uncertainty on providers, slow certification and implementation, and interfere with usability.
Jon Zimmerman, vice president and general manager for clinical business solutions at GE Healthcare IT, joined Burchell in calling for a more focused and prioritized approach to Stage 3 and associated certification. Consistent with recent recommendations by the Certification and Adoption Workgroup, the emphasis for Stage 3 should be on greater and more effective use of Stage 2 requirements and associated EHR capabilities, and of course the needed interoperability enhancements, said Zimmerman. Add as few new certification requirements as possible and look for opportunities to eliminate existing requirements. Any new or revised items should focus primarily on interoperability and rely on mature standards.
He also echoed EHRAs call for CMS and ONC to allow at least 18 months before the start of Stage 3 and to establish a 90-day or calendar-quarter reporting period for the first year of Stage 3, as was done for Stage 2.
The lone voice of dissent on the vendor panel at the workgroups listening session was Dan Haley, vice president of government and regulatory affairs for athenahealth Inc.
Stop reducing standards. Stop extending timelines. Stop subsidizing technologies that do not meet the most basic standards of the program under which those subsidies are funded, urged Haley. Demand more of vendors and many more of them will deliver 21st century functionality. Keep reducing and delaying and those same vendors will be more than happy to continue to sell annual licenses for non-interoperable static software that frustrates care providers, drives up systemic costs and fails to improve care.
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