Stage 2 changes are unlikely, says ONC

Jodi DanielJodi Daniel

At AMIA town hall, officals acknowledge that, 'It's easy to lose sight of why we are implementing things.'

Wish there could be a delay of Stage 2 meaningful use? Talk to the Centers for Medicare & Medicaid Services, not the Office of the National Coordinator for Health Information Technology. And don't hold your breath.

Responding to a written, anonymous question from an attendee at the American Medical Informatics Association Annual Symposium, Jodi Daniel, director of ONC Office of Policy Planning, would not explicitly discuss prospects for easing the Stage 2 compliance timeline.

"We are very focused on making Stage 2 work," Daniel said Monday during a town hall-style session with ONC leadership, and said any question of a possible delay should be directed to CMS, which wrote the rules for and administers meaningful use.

"They would have the authority to do that, but it would require a regulatory change," Daniel said. The regulatory process requires a notice of proposed rulemaking, followed by a mandatory public comment period, after which time CMS would review the comments and finalize the rule.

It could take a year or more, so the implication was that changes to Stage 2 are highly unlikely.

Acting national health IT coordinator Jacob Reider, MD, who led the town hall, said ONC is working especially hard to reach the "little folks" – independent community hospitals and small physician practices – that lack inside-the-Beltway contacts and don't "know how to interact with us." ONC is tasked with helping providers of all sizes and stripes achieve meaningful use, with the ultimate goal of producing safer, more effective care at lower cost – otherwise known as the "triple aim."

Reider discussed what he called ONC's "5+1 guiding principles": open, transparent inclusive decision-making; "eye on the prize" (the triple aim); "feet on the ground" (realism, rather than shooting for what Reider likened to "Star Trek"-esque science fiction); fostering market innovation; being open to all, including the "little folks" and – the "plus one" – putting patients and their interests at the center of all activities.

"People sometimes get a little jaded about patients from the physician side," he noted. He suggested clinicians think about the kind of care they want their own mother to have.

"The mom part is a good reminder," said Reider, who took over the ONC reins early last month, following the departure of Farzad Mostashari, MD.

"We're gonna get there," he continued. "We are on that trajectory. We're not there yet. I understand that, but we are gonna get there."

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