The Health IT Policy Committee, an advisory panel to the federal government, is divided over the start date for Stage 2 meaningful use requirements, voting 12-5 June 8 to delay Stage 2 by one year – from 2013 to 2014.
Since its inception in 2009 under the American Recovery and Reinvestment Act, the EHR incentive program has been fraught with controversy over timing, which some claim has been too difficult a hurdle for most healthcare providers to achieve, despite one extension already granted.
[See also: Vendors air reservations about Stage 2.]
The American Hospital Association and other groups have called on the committee to delay Stage 2 until results of Stage 1 have been adequately assessed.
The Centers for Medicare and Medicaid Services (CMS) has only just begun to mail out checks -- some $75 million by the end of May-- to qualified doctors and hospitals for the use of certified EHRs according to Stage 1 criteria.
As Stage 1 incentives are underway, the committee has been scrambling to pull together a rough draft of recommendations to guide the Office of the National Coordinator for Health Information Technology (ONC) and CMS on what to include for Stage 2.
Committee member Marc Probst, CIO of Salt Lake City-based Intermountain Healthcare, was one who voted for more time. "Much more time," he said. Probst would like to see Stage 2 delayed later than the proposed recommendation of 2014.
Intermountain Healthcare is one of the front-runners in the nation to use EHRs to successfully improve population health.
Probst said he suspects most of the providers who received the incentives have been using EHRs for 10 years. All they had to do was "a little tweaking" to qualify for Stage 1 meaningful use, he said.
"Essentially, we have people in a ski race who were three-quarters of the way down the hill," Probst said. "We have to help people at the top of the hill. It's going to be difficult to get people [to EHR adoption]," he said. "It just is."
Judith Faulkner, founder and CEO of Madison, Wisc.-based Epic Systems Corporation had reservations over proposed 2014 start date. "If we don't know how long it will take vendors to do the work, we don't know how long it will take for providers to get up and running," she said.
For Stage 1, federal advisors relied on "giving signals" to vendors throughout the planning process. This was intended to help vendors get underway with what would be needed in EHR products, so they could be ready for providers when the time came.