ACP urges meaningful use Stage 2 delay

Raises concerns over infrastructure, technology readiness
By Bernie Monegain
10:33 AM
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The American College of Physicians has become the most recent group to press the government for a delay in Stage 2 meaningful use requirements, citing among several other concerns, EHR certification and implementation issues.

The ACP describes itself as the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 137,000 internal medicine physicians, related subspecialists and medical students.

[See also: AAFP urges meaningful use delay] and [CHIME seeks Stage 2 delay, defends MU.]

“An aggressive timeline combined with overly ambitious objectives may unnecessarily limit the success of the entire Meaningful Use EHR Incentive Program,” the ACP warned in a letter to Department of Health and Human Services Secretary Kathleen Sebelius, Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner and National Coordinator for Health Information Technology Farzad Mostashari, MD. The letter was signed by Peter Basch, MD, chair of the ACP’s Medical Informatics Committee.

ACP recommends that requirements become less prescriptive to allow eligible professionals of all specialties to be creative in applying the technology to the unique characteristics of their practice, specialty and patient population.

[See also: Keep Stage 2 start as is, says HIMSS.]

"ACP supports the guiding principles of meaningful use to help physicians deliver quality, patient-centered care," Michael S. Barr, MD, who leads ACP's Division of Medical Practice, said in a news release. "However, the reliance on evolving and draft standards, technologies for which integration is not yet completely tested, developing infrastructure, and upcoming regulatory requirements add complexity and uncertainty for physicians."

ACP's letter addresses specific concerns in five areas: the Stage 2 meaningful use timeline, clinical quality measures, ICD-10 and Physician Quality Reporting System, commonly known as PQRS, scoring meaningful use measures and planning for Stage 3 meaningful use.

  • Stage 2 meaningful use timeline – ACP supports providing more time for providers to begin their reporting on Stage 2 measures given that system certification and vendor implementation issues abound.
  • Clinical quality measures – ACP says there has not been sufficient time either for the new e-measures to be tested and validated or for a determination if the output of the EHR systems is an accurate representation of the performance of the EPs.
  • ICD-10 and PQRS   ACP cautions that 2014 will be a difficult and frustrating year for physicians no matter what happens with Stage 2 meaningful use since every practice will be using ICD-10 and will need a new or updated EHR system ready to go on Jan. 1, 2014, in order to meet the data collection requirements for PQRS and combined PQRS/EHR Incentive reporting using e-measures.
  • Scoring meaningful use measures   ACP supports switching to a scoring system that recognizes the differences in practices and the differences between incentives and penalties and recommends "moving to a partial scoring or tiered system in Stage 2 with a higher score required for an incentive and a lower threshold required to avoid a penalty."
  • Planning for Stage 3 meaningful use   ACP urges a focus on activities that have a true measurable outcome on quality, safety and value of care, rather than a system that creates an unnecessary administrative burden that does not directly impact real practice improvement.