Healthcare chief information officers see stiff challenges ahead in meeting obligations outlined in the final rules for the Meaningful Use program, released late Tuesday afternoon by the Centers for Medicare and Medicaid Services.

While the modifications to Stages 1 and 2 will give providers a better chance of meeting those targets, the industry will be hard-pressed to meet the requirements of the final rule.

Several CIOs questioned why it took so long for CMS to release the modifications to Stages 1 and 2, given that the final release was not greatly changed from the proposed rule that it released in the spring.

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“The modification rule is essentially unchanged from the proposed rule, so there was no real reason to delay its release until after the final 90-day period of (calendar year) 2015 had begun,” said Randy McCleese, vice president of information services and CIO at St. Claire Regional Medical Center, Morehead, Ky.

Changes to Stages 1 and 2, which reduce the number and achievement levels of some objectives, give providers a better chance of meeting the targets, says Pam McNutt, senior vice president and CIO at Methodist Health System, Dallas.

“The relaxation of Stage 2 measures and objectives is greatly appreciated, as is the adoption of a 90-day reporting period,” she said. Previously, Stage 2 had required providers to report on Meaningful Use objectives for a 365-day period; a shorter reporting period lessens the burden on providers to gather and report data.

Adjustments in the requirement to electronically provide information to patients also will help the industry, said Charles Christian, vice president of technology and engagement for the Indiana Health Information Exchange, based in Indianapolis, and board chair of the College for Healthcare Information Management Executives.

“That’s much needed relief for the majority of hospitals struggling to establish an acceptable patient engagement program,” Christian added. “However, many of the hospital CIOs I’ve spoken with continue to struggle with the getting to the 5 percent threshold originally presented in Stage 2.” That’s the level for patient engagement now set for Stage 3 objectives.

McNutt believes the industry will still need future flexibility as the Meaningful Use program continues. “There is still more flexibility needed in Stage 3, but quite frankly, there is still to adjust it, just as (CMS) adjusted Stage 2,” she said. “I hope this is just setting the highest bar, but a bar that will be adjusted as we see where adoption of Stage 2 takes us over the next two years.”

“The delay in the rule-making on Stage 3 will give providers more time to learn from the changes made under the modifications rule and to create a Stage 3 regulation that best positions providers to be successful in new care process models,” Christian said.

Still, “The lift from Stage 2 to Stage 3 is huge,” McNutt said. “The vendors and providers have a mountain to climb to get the measures and objectives met, even by 2018.”

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