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The crippling effect of meaningful use stage 3 uncertainty

Many providers have changed business strategies to accommodate the meaningful use program. The lack of resolution about stage 3 has left some of their plans in limbo.

Providers that have already met the requirements of the first two stages of the meaningful use program have a new concern: What form will stage three take, if it happens at all? Delays and lack of support from Capitol Hill could have drastic impacts on hospitals' technology plans. There are doubts about funding availability for meaningful use stage 3 and questions surrounding the sustainability of the incentive program.

The previous delays of ICD-10 and extensions to the last two meaningful use stages leave healthcare executives concerned about the likelihood of meaningful use stage 3 happening at all. Simply put, the requirements of this potential final stage require a significant number of investments in human capital and technologies. The current stage 3 requirements call for more systems interoperability as well as patient engagement technologies and tools.

CIOs are aware of the sizable investment that will be needed as part of meeting the stage 3 requirements. While improved patient outcomes and population health management initiatives have begun in preparation for stage 3, the costs of these programs could prove crippling if the incentives do not come to fruition.

There are several core areas in which healthcare organizations will need to invest to ready for stage 3 requirements.

Install needed infrastructure upgrades

There are doubts about funding availability for meaningful use stage 3.

The requirement for primary care physicians and emergency physicians to store patients' imaging data within their EHRs will likely increase the demand for storage and computing power. There will also be a need to provide greater support for health-specific applications such as patient portals to meet various stage 3 criteria.

Enhance security practices

A much higher volume of data will be exchanged across a number of devices between patients and providers, spanning a number of types of networks. Hospital IT departments must be able to adapt to these changes and adopt tools and security services to ensure all data is secured regardless of its destination or source.

Invest in data sharing platforms

Submitting data through an HIE is and will continue to be the ideal means of exchanging information. Unfortunately, there are still significant challenges faced by many private HIEs to sustain their model. For some healthcare organizations, a local or regional HIE isn't even a viable option. These organizations are forced to consider adopting other means to exchange information with other hospitals. This would require additional funding to help meet the data exchange requirements included as part of meaningful use.

Enable enhanced patient interactions

As recommended by the Health IT Policy Committee Meaningful Use Workgroup, patients must be able to share health information with their providers electronically. Whether it is through medical devices offered by the health organization or patient-owned smartphones, IT will need to find a way to help support this initiative. Other investment areas will be some of the endpoints that must be offered to patients in order to capture their electronic data. Devices such as kiosks or tablets offer patients entry points for surveys, risks assessments and intake forms.

Enhance provider and patient communication

Web portals have been used as an avenue through which patients can safely communicate with their providers. Current recommendations state the messaging solution must offer the ability to further track responses given by the provider. In addition, hospitals will likely need to implement additional functionality around of the electronic health records.

Arrange for care coordination and collaboration

Meaningful use stage 3 has a clear goal, and it is improved patient outcomes. More efficient care collaboration and coordination are significant components of that goal. In order for those objectives to be met, providers must invest in platforms that allow them to share data, collaborate and report on patients' conditions.

Adopt advanced data analytics and reporting

Meaningful use was created, in part, to make good use of the growing volume of electronic health information being collected by healthcare organizations. One way to better analyze data could be to build a data warehouse where information from a number of health systems is collected, offering a central location from where massive quantities of data can be mined. This would offer organizations new insights into their patients and help drive improved outcomes and research. In addition, the current criteria call for reporting data to health registries as part of the Consolidated-Clinical Document Architecture standards.

Perform software upgrades

As part of the certification requirements, healthcare providers will need to purchase software upgrades. That means they have to put their money on the line prior to the reporting period, making the upgrades a must-have in order to be eligible for incentive payments. Upgrades, in effect, would be bets that stage 3 will happen.

Enable integration across systems

Stage 3 is designed to continue the push for more coordinated care and interoperability. An example of this is that EHRs will be required to process information from medication tracking systems. Providers can use this process to ensure the correct medication is administered. There are also additional requirements around imaging that would add imaging support within EHRs.

Investing in storage, interface engines, new software tools and medical devices that can integrate with EHRs are a few of the products that will require capital investment. In observing the lack of momentum in Washington, D.C., to push what has been accomplished thus far through the meaningful use program, many providers are getting concerned about whether their initial plans and investments for stage 3 should be put on hold -- at least until concrete requirements and timelines are released.

About the author:
Reda Chouffani is vice president of development at Biz Technology Solutions Inc., which provides software design, development and deployment services for the healthcare industry. Let us know what you think about the story; email
 editor@searchhealthit.com or contact @SearchHealthIT on Twitter.

Next Steps

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This was last published in September 2014

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