Health information technology stakeholders are reacting to a proposed federal rule to ease compliance with meaningful use requirements during 2014 and extend Stage 2 by a year. At least on first read, folks like what they see.
Here is a sampling of comments:
John Moore, managing partner at Chilmark Research: CMS/ONC have been receiving a lot of push-back on Stage 2 MU requirements. As was expected, Stage 2 requirements were a significant step up from Stage 1 as Stage 1 was simply meant to get EHR tech adopted and deployed with fairly simple MU requirements. It doesn't make much sense to have significant barriers to adoption in the first round. Unfortunately, this allowed a lot of EHR vendors to also jump or at least stay in this market - HITECH basically created a false market. With Stage 2 we are now starting to see that many of these EHR vendors simply don't have the resources to upgrade their solutions in a timely manner for Stage 2 certification requirements. Many EHR vendors (almost all on the ambulatory side) may never get there. This is creating part of the problem we are now facing. On the provider side, we have a wide range of issues to deal with from ICD-10, delayed once again, to the move to value-based reimbursement models to population health. The industry is going through significant transformation and healthcare organizations can only do so much. Increasingly, MU is becoming tactical, not strategic, and organizations are subsequently prioritizing their initiatives accordingly.
Stanley Nachimson, principal, Nachimson Advisors and a 30-year HHS veteran: I believe that these changes reflect the difficulties of both vendors and providers to meet the 2014 requirements. Like ICD-10, it remains to be seen if a change in dates will enable the industry to meet the deadlines, or if there is a significant flaw in the MU program. I think that the comments from the industry on this proposed rule may give us a sense of that.
Rick Pollack, executive vice president, AHA: The AHA welcomes this proposed rule and the enhanced flexibility it would provide. Due to delays in certification of 2014 Edition EHRs and delivery of vendor products, very few hospitals have been able to meet the stringent meaningful use requirements using the 2014 Edition. Without the flexibility the proposed rule offers, many, if not most, hospitals would not meet meaningful use in FY2014 and would be a setback to the movement toward widespread adoption of these new technologies.
Tom Leary, HIMSS vice president of government relations: HIMSS is pleased that CMS and ONC have taken steps to address the challenges many providers were facing in implementing 2014 certified edition EHR technology, with the publication of the NPRM (notice of proposed rules). The agencies have proposed a new model for the remainder of 2014 that should go a long way toward relieving some of the time crunch eligible professionals and hospitals are experiencing, and help them continue the march toward meaningful use of EHRs and healthcare transformation. Some questions remain about the impact the revised timeline may have on meaningful users, especially eligible hospitals. We look forward to working with the agencies and our members to clarify the intended outcome for healthcare community stakeholders.
Russell P. Branzell, president and CEO of the College of Healthcare Information Management Executives: While the proposed changes are complex, CHIME believes the adjustments will ensure broad program participation and will enable providers to continue their meaningful use journey. If the government acts quickly to finalize the proposed rule, it will provide the flexibility needed for our members and their organizations to adequately optimize newly deployed technology and ensure success of the program. According to the proposed rule, eligible professionals, eligible hospitals and critical access hospitals will be allowed to use 2011 Edition Certified EHR Technology (CEHRT), 2014 Edition CEHRT or a combination of the two Editions to meet meaningful use requirements in 2014. Because providers are at various Stages and are scheduled to meet different Stage requirements in 2014, CMS and ONC also have proposed giving providers the option of meeting Stage 1 requirements or Stage 2 requirements. However, CHIME is concerned that the timing of these changes may not afford hospitals a chance to take advantage of the proposed flexibility. Given the late date of this announcement, it is imperative that CMS and ONC take tangible steps as quickly as possible to finalize this rule to ensure the maximum positive impact for EHs and CAHs, which are nearing their final reporting period, beginning July 1. CHIME will continue to evaluate the proposed rule to ensure full understanding of all its provisions, and if necessary, seek additional clarifications.
Robert Wah, M.D., CMO at Computer Sciences Corp. and president-elect of the AMA: In an interview with Health Data Management and speaking as a CSC official, Wah says the proposed rule is recognition by the government that providers for a variety of reasons are finding it difficult to achieve meaningful use. He believes the rule will be successful in getting more providers into the digital era. There continues to be talk in the industry of taking a review break between Stages 2 and 3 to verify if the meaningful use program is on the appropriate course to meet its objectives, Wah notes. There may now be more room for a review to be implemented because the new proposed rule clearly recognizes the challenges of the program.
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