Associations weigh in on MU timeline change

The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT’s (ONC's) major announcement of a one-year extension for Meaningful Use (MU) Stage 2 got industry stakeholders talking. While there is added flexibility down the road, there remains no immediate relief as Stage 2 rolls out—leaving many in the field to question, is it enough?

HIMSS

In its official comments, the Healthcare Information and Management Systems Society (HIMSS) said it is “gratified” that CMS and ONC extended MU Stage 2 by one year—but that its call to action to extend year 1 of the MU Stage 2 attestation period still need to be addressed.

“Given the challenges some providers, hospitals and vendors are experiencing upgrading to the 2014 certification, we call on the government to address the timeline and allow at least 18 months in which eligible hospitals and eligible providers can attest to Meaningful Use requirements for one quarter,” the society wrote in a statement.

Data from the more than 5,400 hospitals in the HIMSS Analytics database indicate real challenges for eligible hospitals and tethered ambulatory care facilities in MU Stage 2 preparation, according to the release. These data show up to 72 percent of eligible hospitals and 44 percent of tethered ambulatory facilities have purchased the necessary software to attest to the 2014 Certification requirements.  

“We continue to monitor the important issue of upgrades to the correct certified version, but are still concerned that many may still be waiting for the necessary upgrade to the certified version,” according to HIMSS’ statement.

“We will continue to engage our stakeholders, chapters, events and resources to ensure the effective adoption and implementation of electronic health records for improved patient care.”

AMDIS
William F. Bria, MD, president, Association of Medical Directors of Information Systems (AMDIS), told Clinical Innovation + Technology that in regard to CMS and ONC’s MU timeline change announcement, responses from members on the association’s listserv range from “that’s interesting” to “that’s not going to make a lot of difference.”

“It’s not a bad thing to do. I would scrutinize any statement saying that’s the case. But the idea that it solves everything, that is problematic, too,” Bria commented.

Of immediate pressing concern, he said, is that organizations are facing problems with vendors as they scramble to come up with the technology for Stage 2.

“The challenge is not simple, it’s multidimensional,” he said. Adoption of MU is particularly tricky because communities and healthcare organizations are not uniform.

The reality is there are a number of permutations of technology implementation that must be navigated, and this is challenging an era of decreasing reimbursement. “Every aspect of commercial systems need to meet the needs of all the customers and clinicians in a community, and some aspects require configuration changes that outstrip the resources within the health system,” he said.

He said in Stage 2, the health community now must show a connection to the community and do value work. “It’s a big deal.” Getting there “isn’t a simple equation of saying that it’s all set.” It will require an understanding of accountability of all components, including physicians, the hospital community, healthcare IT, CMIOs, CIOs, communities, vendors and government regulators, he said.

“We need a healthy dose of common sense during this transition of healthcare. It affects the lives of real human beings in many ways. We need to be intelligent about it. If there is not clear communication and avoidance making these issues turn into political riptides, there could be harm done,” Bria added.

AMA

The American Medical Association applauded the decision to extend Stage 2 of the MU program while urging the federal government to also reconsider the Stage 3 deadline.

The decision “was a welcome reprieve,” according to AMA. “From the beginning, the AMA has urged the federal government to adjust the program’s timelines to ensure a safe, orderly transition so electronic health records can be widely adopted and implemented throughout the healthcare system.”

However, the association remains “deeply concerned about the program’s current pass/fail approach to demonstrating Meaningful Use. We continue to advocate strongly for greater flexibility in the participation requirements.

“An October 2013 Rand Corp. study commissioned by AMA found that many physicians are dissatisfied with EHRs and the technology as it interferes with the quality of face-to-face time spent with patients. Physicians need well-designed systems that meet the Meaningful Use criteria, and also helps physicians as they move into new payment and care delivery models. We continue to urge the federal government to take these concerns into account when certifying systems,” said Steven J. Stack, MD, immediate past chair, AMA, in a statement.