ONC touts progress on EHR adoption but Stage 2 meaningful use achievement is low

A May report from the Office of the National Coordinator (ONC) shows significant progress in hospitals adopting at least a basic electronic health record (EHR) system. However, the same week the report was released, Centers for Medicare and Medicaid Services (CMS) officials revealed that, so far this year, only four hospitals have met Stage 2 meaningful use requirements.

CMS told the Health Information Technology Policy Committee that to date only 30 eligible hospitals have attested to meaningful use of EHRs for the Medicare and Medicaid EHR Incentive Programs for fiscal year 2014. In addition, of these only four have met Stage 2 meaningful use requirements.

The ONC has been under some political pressure to begin demonstrating a return on the incentives the government has paid to providers to encourage EHR adoption. This would come from demonstrating not just broad EHR adoption, but also adoption of the types of EHR features that allow savings through better care coordination, reductions in unnecessary and duplicative testing and services, and most importantly interoperability with other providers’ EHR systems. Meaningful Use Stage 2 includes many of these features, which may be why there has been resistance by CMS and the ONC to heeding the calls of the American Hospital Association and other to delay Stage 2 to allow providers and EHR vendors more time to catch up. Instead of delays, the ONC and CMS have issued instructions on how to seek exceptions to the requirements. By law, all eligible hospitals must attest to meaningful use of EHRs for FY 2014 to avoid reimbursement penalties for not having adopted a certified EHR system by this point.

The threat of EHR incentive payments switching to penalties may indeed be working, however. The ONC's report shows that Hospital adoption of "comprehensive EHR systems" (those with the types of advanced functionality that allow meeting of meaningful use requirements) has increased more than eight-fold in the last four years. In addition, as of last year, nearly all acute care hospitals (93 percent) had adopted EHR systems certified as meeting federal requirements for Meaningful Use objectives.

Other good news touted by the ONC included that 59 percent of non-federal acute care hospitals have now adopted at least a basic EHR system with clinician notes. States leading the pack in EHR adoption included Hawaii, South Dakota, and North Dakota. States with the lowest EHR adoption rates were Utah, Kansas, and Nebraska.