Providers who were prepared for the Electronic Health Record (EHR) Incentive Programs' meaningful use stage 1 might have a brief reprieve from implementing meaningful use stage 2 if the rules are finalized with a proposed delay -- but that doesn’t mean anyone has time to stop and smell the roses.
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The Health IT Policy Committee (HITPC) has sent its stage 2 recommendations to the Office of the National Coordinator for Health IT (ONC), spelling out in a letter a proposal to give some providers more time for the second phase. The letter also details the committee’s suggestions for meaningful use stage 2 criteria, which are expected to be finalized by June 2012.
The meaningful use stage 2 timeline has been contentious since even before stage 1 really got under way this year. Providers who participate in the EHR Incentive Programs have two years to complete each stage. For those who began demonstrating meaningful use in the first year of the program, 2011, the next step would be to start stage 2 in 2013.
However, the proposed meaningful use stage 2 criteria are still being hammered out. With the expected release date next year, both providers and vendors have argued that they will not have enough time to test and implement updated systems before the required 2013 start date.
Under the timeline developed by ONC and the Centers for Medicare & Medicaid Services (CMS), which oversees the EHR Incentive Programs, providers who wait until 2012 to first demonstrate meaningful use stage 1 will use 2014 as their first year of stage 2 implementation.
Acknowledging that time crunch in its recommendation letter, the Policy Committee suggests providers who met stage 1 in 2011 should be allowed to wait until 2014 to begin stage 2. This would not affect hospitals and doctors beginning stage 1 in 2012, who will still be expected to implement meaningful use stage 2 in 2014.
While the delay for meaningful use stage 2 might be a boost for some providers and hospitals, it won't change the adoption timeline for medical clinics.
"After careful consideration of the trade-offs between the urgency with which new functionality is needed and the ability to safely deliver and to effectively use the new functionality, the HITPC recommends that -- only for those who begin to attest to MU in 2011 -- an extra year be provided to phase in the stage 2 expectations," the committee wrote in its meaningful use stage 2 recommendations letter. "We understand that despite this relatively short delay for a limited number of participants, the meaningful use requirements for stage 2 need to be robust enough to maintain progress towards the information support needed for health reform."
National Coordinator Farzad Mostashari, M.D., has signaled he agrees with the Policy Committee’s recommendations. Nothing will be official, however, until a final rule is published next year.
Delay in meaningful use stage 2 won't alter EHR adoption strategies
Among the other recommendations, the policy committee supports making meaningful use criteria that had been optional under stage 1 required for stage 2. Providers who are preparing for next steps are already making that move, according to Christopher Tashjian, M.D., president of River Falls, Ellsworth and Spring Valley Medical Clinics in western Wisconsin.
Tashjian said the practice, which completed meaningful use attestation for stage 1 in April, is currently implementing the optional criteria it did not choose the first time around.
For example, using some of the incentive money it received, River Falls is currently installing color printers in each patient room so that giving patients a summary of their visits becomes part of the workflow, Tashjian said. "It works really nice when you can have a color print out of a child’s growth chart and hand it to the mother. When it's in the room, it doesn't break the flow."
While the delay for meaningful use stage 2 might be a boost for some providers and hospitals with bigger systems and more complex IT staff that need a longer ramp-up time, it won't change the adoption timeline for the medical clinics, Tashjian added.
River Falls uses Cerner Corp.'s cloud-based EHR system and has more flexibility for making updates. The key driver, though, is patient demand -- patients expect more effective care and see technology as a way to get there, Tashjian said.
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