The Meaningful Use Surprises

The final rule for meaningful use stage 2 should be out any day now and while most of care community anxiously awaits the announcement, the industry experts are expecting little to no changes from the proposed rule, released earlier this year. The stage two of meaningful is to build on the stage one objectives ensuring that providers are able to utilize EMR technology in a constructive manner and add value to the care process. The focus of the second stage will be on ‘advanced clinical processes’. Keeping in line with this theme, stage 2 is expected to feature clinical decision support, electronic data sharing and patient engagement as its main components.

Farzad Mostashari, the National Coordinator for Health Information Technology admitted that there could be some surprises in store for providers looking to attest for the meaningful use stage 2 saying, “I think that it would probably come as a little surprise we will pushing on standards based exchange and on patient engagement aspects in addition to continuing really what was in stage 1.”

Health information Exchange seems to be the most significant concern at this point in time. Providers were aghast with the proposed rule and its interoperability requirements, with most admitting that there electronic medical records simply did not possess the capability to comply with stage 2. There was a definite gap between the technology available to providers and what CMS was anticipating. Dr. Mostashari in response to the concerns raised by the medical community expressed that the ONC does listen to the concerns carefully. He explained, “We have been at this for a while now and we have to really balance the needs of the situation against how fast the industry and providers can adapt to change.”

The ONC has also outlined a plan for standardizing health information exchange and will seek to accomplish three major aspects within this year, which includes a common set of rules for governance of HIEs. This also reflects the CMS stance on health information security with the meaningful use stage 2 proposed requirements.

Patient engagement is an important aspect of the healthcare reform. With the government set on introducing a preventive care culture across the nation, health system interoperability will undoubtedly benefit patients by making care more accessible and affordable. The proposed stage 2 rule adds follow-up reminders, patient education and patient access to electronic medical records as core measures. The public response has been positive with patients being allowed to access their own information for downloading and personal use.

While there has been no indication as to whether CMS has relaxed the attestation period from one calendar year to 90 days as suggested by AHA, most providers are hoping for some sort of relief from the authorities. For now it seems that the best bet is to make sure that you retain what you have learned during the first attestation period and go from there.


3 thoughts on “The Meaningful Use Surprises

  1. I do consider HIE to be extremely important, though I’m really not sure whether Stage 2 will actually make HIE viable. But I have another concern that to me is far more important that none of the rules seem to deal with; what happens when your vendor – especially a cloud based vendor, goes belly up leaving you without your data – or even if you have it, you probably have no way to very quickly sign up for another EHR and load up that data (we’re talking a day or two) and resume operations. Because if you’ve been using EHR a while, and all of a sudden you don’t have your EHR, don’t have your data, or have it but have no way to access it, how can you practice medicine?

  2. Patient engagement is most difficult because many of our older patients dont want to access the portal. They don’t like the reminders and prefer the personal touch of a call. In addition, those patients who need it the most use it the least. Medicaid and low income use it the least because they loose Internet, phones get disconnected and they cannot afford to be “electronic.”

    I would like to see some tort protection in these rules…many of the vendors and servers…are not secure…as we would like to think they are or profess to be. Even the government, VA, and others have security issues. What if we have a major power outage..( example on July 20th Surescript was having major problems for example). It seems we are spending lots of money on implementation and rules, most of healthcare issues are social issues of housing, nutrition and transportation…..we could save a lot of healthcare dollars I’d we provided more social services like they do in other countries and stop blaming providers for things out of our control.

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