In 2010 with the release of proposed rules for the EHR incentive program, the HIT industry was hurled into a whirlwind and “Meaningful Use” became the buzz word of the day. Now, just the mention of two words and you can hear a silent sigh. Since the Stage 2 rules were released, communities have discussed the complexities of the standards, the need for more time and flexibility, and the lack of collaboration between policy and reality. However, recently these seemingly small discussions have become the crying out of an industry seeing a good idea go horribly wrong.
So far, 50 eligible professionals and 4 eligible hospitals have attested to Stage 2. Even more eye-opening is the fact that a meager 10% of hospitals report having functionality to meet the patient electronic access requirement, and we are rapidly reaching the last reporting period for eligible hospitals this fiscal year. It appears likely that some won’t make it, and even more are dropping out of the MU race.
What about certified EHR technology? In an ONC education session at HIMSS14, attendees voiced concern over policy and time constraints stifling innovation and pushing small vendors out of the market. The numbers seem to support this concern. Vendors are running for the hills claiming they can’t make back the money they have put into the program. ONC assured the crowd this wasn’t their intention, and they hope future policy and more flexible certification allows for others to participate. Last week, a Health IT Policy workgroup approved recommendations to narrow the mandatory certification requirements.
Meaningful Use just isn’t doing it for folks anymore. With the crunch time between EHR coding, certification, and implementation, providers have little time to evolve a workflow that meets the criteria, but provides their ultimate goal: superior quality of care for every patient. What can we do to get the focus back on the patients? Isn’t the overarching goal of MU to improve the quality of patient care?
In an effort to ease providers through 2014, CMS and ONC released yesterday a proposed rule that would provide much needed relief for providers struggling to meet their 2014 attestations. Under this proposal, valid only for 2014, providers in both stages of MU would have the option to submit with 2011 edition certified technology, attesting with the definitions of a 2013 meaningful user. Even more surprising is the ability to submit Stage 1 measures for Stage 2 providers. The proposal would also extend Stage 2 through 2016. This may be a welcome relief, but is it too late?
If providers can bear down and push through to Stage 3 will we see improved outcomes? The jury is still out on quality improvements. I can say from experience, that Meaningful Use has not positively impacted me as a patient. I sit in office visits seeing the MD’s head while she fumbles through her clunky EHR; I couldn’t get a decent cough suppressant during a flu episode due to the drug-drug interaction checks that decided I was allergic to yellow dye; and I have four different logins to four disparate patient portals. I’m engaged in my own health and progress, but I’ve taken things into my own hands instead of including my MD in that process.
Consider this quote from Dwight Eichelberger, MD, Medical director of Informatics at Lancaster:
“The work of the organization is providing health care, not populating an EHR. It is imperative that IT staff understand the clinical scenarios they are supporting – not to simply re-create, or ‘pave the cowpath,’ but rather to understand the end game – what clinicians are actually trying to accomplish.”
Join me at 11 a.m., CT, on Twitter to discuss the following topics during the weekly #HITsm chat. If you’re unable to make the chat, please add your thoughts below in the comments section!
- Will some Stage 2 providers just not make Meaningful Use this year? What will the consequences be if a majority of providers fail to attest?
- Will the newly proposed rule with flexible reporting options in 2014 make it attainable for more providers? Is it too late to adjust course?
- Is Meaningful Use simply policy, or does it also encourage innovation and collaboration?
- How do we encourage innovative technology developers to stay in the MU technology race? Is it too late?
- How will current attitudes towards MU affect future policy and adoption?
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