Calls for Stage 2 changes grow louder

More than a dozen stakeholders demand shorter MU reporting period for 2015
By Mike Miliard
11:13 AM
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In a pointed letter sent to HHS Secretary Sylvia Matthews Burwell on Monday, a who's-who of industry stakeholders complained of "immediate concerns" about their members' ability to continue meaningful use participation.

[See also: MU Stage 2 offers 2014 flexibility]

The letter, co-signed by an array of groups – including CHIME, HIMSS, MGMA, AHA, AMA and others – was also sent to CMS Administrator Marilyn Tavenner and National Coordinator for Health IT Karen DeSalvo, MD.

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In it, stakeholders reiterate what many of them have been shouting from the rooftops since CMS published its only-mildly-more-flexible Stage 2 final rule, which was announced in late August. The very existence of meaningful use "hinges on addressing the 2015 reporting period requirements," they state.

[See also: New final EHR certification rule drops]

Rather than requiring 365 days worth of attestation data, HHS should "provide for a shortened, 90-day EHR reporting period in 2015, which would give time for providers to continue their transition without having to drop out of the program," they write.

It's not a new complaint. This past February many of these same industry groups, upon seeing the initial proposed rule, offered HHS feedback that the "pace and scope of change had outstripped our collective capacity to comply" with the program.

"Specifically, we said this dynamic inhibited the ability of our members to manage the transition to 2014 Edition Certified Electronic Health Record Technology  and Stage 2 meaningful use in a safe and orderly manner," the letter reads.

While the groups thought their concerns had been heard and would be acknowledged, they add, "we were surprised to learn that flexibilities meant to mitigate 2014 challenges did not also address program misalignment in 2015 and beyond."

The Aug. 29 final rule, mandating a full-year EHR reporting period in 2015, has left the organizations "incredibly concerned" about the "forward trajectory" of the MU program, they write – pointing out that some 3,800 hospitals would be required to implement 2014 Edition certified technology, configured for Stage 2 measures and objectives, in the next two weeks in order to meet the Oct. 1, 2014 deadline.

More than 237,000 eligible professionals, meanwhile, "will need to be similarly positioned by January 1, 2015."

The numbers speak for themselves, the groups argue: As of now, just 143 hospitals and 3,152 providers have been able to meet Stage 2 with 2014 Edition EHRs.

"This represents less than 4 percent of the hospitals required to be Stage 2-ready within the next 15 days. And while eligible professionals have more time, they are in comparatively worse shape, with only 1.3 percent of their cohort having met the Stage 2 bar thus far."

While the stakeholders reiterated their commitment to meaningful use, they urged Secretary Burwell to "take immediate action by shortening the 2015 EHR reporting period to 90 days" – and also by adding more wiggle room with regard to Stage 2's notoriously troublesome transitions of care and view/download/transmit measures.

"Given that we have less than two weeks left in Fiscal Year 2014, immediate attention to these concerns is needed," they wrote. "This additional time is vitally important to ensure that hospitals and physicians continue moving forward with technology to improve patient care. By making such changes, HHS would improve patient safety without compromising momentum towards interoperability and care coordination supported by health IT."

The letter to Burwell, Tavenner and DeSalvo was signed by the following healthcare organizations:

  • American Academy of Family Physicians
  • American College of Physicians
  • American College of Physician Executives
  • America’s Essential Hospitals
  • American Hospital Association
  • American Medical Association
  • Association of American Medical Colleges
  • Association of Medical Directors of Information Systems
  • Catholic Health Association of the U.S.
  • Children’s Hospital Association
  • College of Healthcare Information Management Executives
  • Federation of American Hospitals
  • Healthcare Information and Management Systems Society
  • Medical Group Management Association
  • National Rural Health Association
  • Premier healthcare alliance VHA Inc.
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