Loud and getting clearer

Mary Stevens, editor, CMIO

The ONC’s Health IT Policy Committee will have its hands full sorting through the comments on the proposed Stage 2 criteria for meaningful use. A slew of comments from a spectrum of stakeholders were announced in the final days before the Feb. 25 deadline for comments. In the CMIO.net sampling this week, there were a variety of viewpoints and not much consensus once we got past the general accolades for the time and effort that federal agencies have spent in developing the proposals.

One frequently cited pain point was the current time table for Stage 2 implementation, which many groups, including the American Medical Group Association and the eHealth Initiative, believed was too rapid to foster success. But that view wasn’t shared by everyone, apparently. For example, a survey by the Certification Commission for Health IT (CCHIT) found that,  in general, respondents believed the proposed new Stage 2 objectives and measures could be accomplished by 2012,” said CCHIT Chair Karen Bell, MD, in a March 3 EHR Decisions blog.

The CCHIT survey also showed More than 50 percent of providers and 40 percent of vendors and others felt that syndromic surveillance was not ready to be a core measure in Stage 2, Bell wrote. In addition, few settings have implemented medication reconciliation as part of Stage 1 and respondents recommended making it a core measure in Stage 2, but keep the percentage of patients to which it applies until Stage 3, she stated.

When it comes to ensuring privacy, security and accuracy of patient data, Stage 2 could do more, according to some groups. For example, individuals should have the right to restrict certain services from disclosure, stated AHIMA. Likewise, segmentation of patient data “is essential to protect sensitive information, but also is absolutely critical for patient safety, so that erroneous health information can be kept from disclosure,” stated the group Patient Privacy Rights.

These are not the final words on Stage 2 measures, of course. Once the comments have been digested, the Stage 2 set will be proposed, disseminated and analyzed before it’s finalized. If Stage 1 was any indicator, the federal rulemakers may make significant changes to Stage 2 based on stakeholders' early comments. They likely won’t please everyone, but at least a range of interests have been heard. 

What measures or thresholds would you include in Stage 2? What would you leave out or leave alone? Let me know at mstevens@cmio.net.

Mary Sevens
Editor of CMIO