Vendors getting started, but still seek guidance on Stage 2

Having read and analyzed the voluminous Stage 2 meaningful use rules, EHR and HIE vendors have started the process of retooling their technologies to meet the certification criteria. Most seem satisfied that CMS and ONC listened to their input, but many are frustrated by some lingering uncertainties.

Leigh Burchell, vice president of government affairs at Allscripts, said the Chicago-based firm was pleased that the rules came out on August 23, rather than later in the fall as some had predicted.

And, as with many other vendors, "unquestionably we were really pleased with the 90 day reporting period. That is an important element that's going to facilitate success in the program. In the frame that it was laid out before, with the full year of reporting, it literally was bordering on something that wasn't doable.

"A lot of people don't realize the time that goes into not only development and testing to ensure a safe development process on the part of vendors, but there's also an excessive amount of work that takes place in the provider organization," she said. "Live environment testing, making sure all your interfaces work and that providers are trained appropriately in all the new measures, that takes time. And you don't want to rush it."

With this shortened reporting window allowing for more flexibility with testing and implementation, "We and our clients, collectively, feel we can be successful, which is great," Burchell adds. 

That said, there will definitely be some challenges, for both developer and provider, when it comes to meeting certain measure.

"As an example," says Burchell, "There's a requirement to incorporate data after receipt of structured documents and then combine with a requirement for clinical decision support for the same data. That's really a different way of looking at things. It essentially means that HIE is going to become actionable for the first time for many providers. And it requires that structured medications, allergies and problem list data are going to have to be reconciled by our systems and then turned around so they're usable for evidence-based decision support."

That offers "enormous value to provider and patients, and we're wholly supportive of the concept, but it's really a different way of looking at the information," she says. "What do we have to do with it when it comes in? And how do we turn it, within a really quick time frame, in the system to become actionable by the provider? It's a change for us, we have to adjust our systems accordingly, and it's also something that's going to require workflow changes by the provider. They're going to have to figure out how to use this and maximize this information in a way that it becomes useful to them during the care process."

[See also: Chart: Stage 2 objectives and measures.]