Would meaningful use Stage 2 delay ignite ICD-10?

By Tom Sullivan
12:02 PM
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Keeping its “eye on the prize, but feet on the ground,” the advisory panel to the HIT Policy Steering Committee recently took a step closer to pushing back stage 2 of meaningful use. Such a delay, the committee said, would grant providers more time to incorporate other deadline-driven health IT projects – most notable, the massive ICD-10 conversion – into their agendas.

“Timing has been a concern. The plan is aggressive, and rightfully so. It’s not the legislation we’re trying to keep up with, it’s the need,” said Dr. Paul Tang, chairman of the meaningful use work group and CMIO at the Palo Alto Medical Foundation, during the meeting.

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Tang and the committee have been detailing three options of late, the third of which is pushing stage 2 back until 2014. “Option three gives the opportunity to sync up your upgrades for ICD-10 and meaningful use stage 2,” Tang said.

The intent is plausible, according to Mandy Willis, an ICD-10 expert in Seattle.

“ICD-10 is a mandate with a hard cut-over date,” Willis added. “We need to focus on getting it done and doing it well.”

Indeed, whereas meaningful use is an incentive program, ICD-10 is a federal mandate. The Centers for Medicare and Medicaid Services has steadfastly maintained that the Oct. 1, 2013 compliance deadline is firm and will not be altered.

Even still, will putting meaningful use stage 2 on a back burner really prompt healthcare organizations to move that ICD-10 stockpot to the front?

Casting speculative doubt is Robert Tennant, senior policy advisor at the Medical Group Management Association. Such a shift “pre-supposes that the entire industry will transition to ICD-10 by the deadline,” he said. “If you’re banking on the industry to make ICD-10 on time, think again. It’s unlikely that transition will be seamless.”

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ICD-10, of course, is not the only reason to extend stage 2. “They’re looking at moving stage 2 to 2014 because vendors need additional time to make software changes,” Tennant said.

The advisory panel has suggested pulling electronic notes, eMAR (Electronic Medical Administrative Records), and family history into the meaningful use mix in stage 2.

The panel said it will present its recommendations, including extending stage 2, to the HIT Policy Committee in June. A Notice of Proposed Rulemaking will follow by year’s end, and the final rule would be handed out in mid-2012.

That timing raises its own concerns particular to ICD-10. Given the timeline and the fact AHIMA has said the longer health entities delay the more painful ICD-10 will be, perhaps the overarching question is, Would health entities even be wise to wait and see if meaningful use stage 2 is delayed before starting their ICD-10 conversions? Comment below.