HIMSS suggests Stage 2 extension

By Mike Miliard
10:56 AM

With an array of industry groups anxiously calling for a delay of meaningful use Stage 2, HIMSS has made the case for a more nuanced approach, asking federal officials to launch Stage 2 on schedule but extend year one of the attestation period.

Drawing on data from the HIMSS Analytics database, the HIMSS Board of Directors said that the timeline and certification challenges faced by eligible hospitals (EHs), eligible professionals (EPs) and technology vendors necessitate a longer attestation window.

That period should extend through April 2015 and June 2015 for EHs and EPs, respectively, they said. Such an extension would encompass 18 months in which those groups could attest to meaningful use requirements for one quarter.

But the program should start as planned, HIMSS argued in an Aug. 15 letter to Department of Health & Human Services Secretary Kathleen Sebelius, Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner and National Coordinator for Health Information Technology Farzad Mostashari, MD.

“In our Call to Action, HIMSS asks the healthcare community – providers, hospitals and vendors – to come together in their execution plans for the 2014 certification process and implementation of 2014 certified products," said Carla Smith, executive vice president of HIMSS, in a press statement.

"We have recommended an extra six months to achieve year one of meaningful use Stage 2, which is a brief amount of time when considering our ultimate and joint goal of successful implementation of health IT to support care coordination and healthcare transformation," she said.

Data from the more than 5,400 hospitals in the HIMSS Analytics database show the legitimacy of concerns of hospitals and tethered physician practices preparing for Stage 2.

Up to 68 percent of EHs, and 41 percent of tethered ambulatory facilities have purchased the necessary software to attest to the 2014 certification requirements, but there are concerns that many are waiting for the necessary upgrades to the certified version, said HIMSS officials.

Recent months have seen several high-profile industry groups and politicians calling for a delay in Stage 2.

In May, the College of Healthcare Information Management Executives wrote a letter to a group of Republican Senators in which it "formally and strongly recommend a one-year extension to Stage 2."

Those extra 12 months "will give providers the opportunity to optimize their EHR technology and achieve the benefits of Stage 1 and Stage 2," wrote CHIME President and CEO Russell Branzell and Board Chair George Hickman. "It will give vendors the time needed to prepare, develop and deliver needed technology to correspond with Stage 3; and it will give policymakers time to assess and evaluate programmatic trends needed to craft thoughtful Stage 3 rules.”

In July, a group of panelists testifying before the Senate Finance Committee echoed those concerns, saying that the program is becoming too prescriptive, too fast – and could lead to a divide in which hospitals with more financial resources would be at an unfair advantage compared to small and rural facilities.

"The program is reaching an inflection point," said John Glaser, CEO of Siemens Health Services. "The requirements for Stage 2 are more stringent."

Colin Banas, MD, CMIO at Virginia Commonwealth University, agreed. "Slowing down is prudent because the literature and experience has shown that these things take time," he said.

The American Academy of Family Physicians recently asked CMS to delay Stage 2 by a year, lest the program "outstrip the capacity of many certified electronic health record technology vendors and ambulatory family medicine practices."

The timeline for physician compliance was too tight, wrote AAFP Board Chair Glen Stream, MD. "2014 brings a perfect storm of regulatory compliance issues for family physicians that, we fear, may derail health information technology adoption and substantially interfere with our shared progress toward achieving better care for patients, better health for communities and lower costs through improvements to the healthcare system," he wrote.

Read HIMSS' letter to Sebelius, Tavenner and Mostashari here. Read its Call to Action statement here.

HIMSS will continue to focus on this call to action as part of its activities for National Health IT Week, Sept. 16-20 in Washington, D.C., officials said.