HIT Policy Committee questions Stage 2 measures
As members of the HIT Policy Committee debated the proposed Stage 2 meaningful use regulations on Wednesday, many expressed concerns that the rules would require eligible providers to collect data for too many measures.
That burden poses problems from the start, said some committee members, noting that the cost of $10,000 per measure for physician practices to have their certified electronic health record systems updated makes the 120 proposed new measures unreasonable.
There was also concern that the measures are being collected, but won’t be used by the federal government for some time, if at all, to improve public health.
National Coordinator for Health Information Technology and Committee Chair Farzad Mostashari, MD, agreed. Collecting data that’s not going to be used seems pointless, he said. The federal government needs to connect data collection with the elimination of disparities to show providers “why we’re doing it,” he said.
Paul Tang, vice chair of the committee said Wednesday’s discussion of the proposal was only a start. The committee’s workgroups would consider feedback from the entire committee and return with updated recommendations for the group’s approval at the HIT Policy meeting on May 2. The group’s approved recommendations are due to Mostashari by May 7, Tang said.
The proposed meaningful use Stage 2 rule was released Feb. 23, with the comment period closing in May. The government is expected to release a final rule this summer. The meaningful use rules are used to qualify eligible Medicare and Medicaid providers for federal incentives for electronic health record adoption.
David Lansky, chair of the committee’s quality measures workgroup, said his group was somewhat satisfied with the proposal. A number of the measures recommended by the workgroup made it into the proposed rule.
“We feel good about the framework,” he said of the Stage 2 proposal. “We want to continue to advocate the right framework, but of course, the question now is how to accelerate the ability to use this framework in common care settings.”
On the down side, Lansky said the workgroup did not think care coordination is adequately addressed by the proposal. Members also thought “the availability of some of the measures is pretty thin.”
Very few providers would have cases that would allow them to collect the specified data. “It doesn’t apply to very many physicians,” Lansky said. “We’re not going to be able to see a lot of measured improvement around care coordination if this is the best we’re able to do over the next three years.”
drmurray say: Keep the data collection cart behind the trailblazing horse
The proposed rule on page 13702-13703 specifically states that the purpose of Stage 2 Meaningful use is to "“encourage the use of health IT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible”. No where in the NPRM does it state that the primary purpose of Stage 2 Meaningful Use is to collect data for use by the federal government as is suggested by concerns expressed in this article. Let's keep the data collection cart behind the trailblazing horse so that it does not aimlessly roll down the steepest part of the hill instead of steering toward most beneficial path. Stage 2 objectives draw a sensible roadmap to the next planned destination where we can finally begin realizing the maximum potential value of health IT and EHRs. We currently have the horse trotting around potholes toward the widespread adoption and successful use of EHRs, the development of robust HIE networks, the maturation of EHR product functionalities and an improved understanding of safe EHR usage. If we fail to align Stage 2 activities with Stage 2 goals by taking unplanned shortcuts to collect and use data in hopes of improving care now, I fear the cart will crash and cripple the momentum that Stage 1 has initiated.