CMS, ONC extend meaningful use

Revised timeline would extend Stage 2 through 2016
By Tom Sullivan
03:10 PM

A joint CMS and ONC blog post today divulges the government's intentions to extend the timeline for meaningful use Stages 2 and 3.

“Under the revised schedule, Stage 2 would be extended through 2016 and Stage 3 would begin in 2017 for those providers that have completed at least two years in Stage 2,” explained acting national coordinator Jacob Reider, MD, and Rod Tagalicod, director of the CMS office of health standards and services.

“The goal of this change is two-fold: first, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2; and second, to utilize data from Stage 2 participation to inform policy decisions for Stage 3," they write.

CMS plans to release proposed rulemaking for Stage 3 in the fall of 2014 and corresponding ONC proposed rulemaking for the 2017 Edition of the ONC Standards and Certification Criteria will also be released in the fall of 2014, which will outline further details for this proposed new timeline.

[See also: Keep Stage 2 start as is, says HIMSS.]

The final rule with all requirements for Stage 3 would follow in the first half of 2015. Stakeholder comments will be reviewed and considered before the release of the final rules, according to today's announcement.

Brian Ahier, of Advanced Health Information Exchange Resources was not surprised upon hearing the news.

“I would have been more surprised had they not done this,” Ahier said. “Based on what the AHA, AMA and associations have been saying, it’s not like they’re going to get a lot of pushback from the industry on this.”

[See also: Meaningful use penalties could be difficult to avoid in Stage 2.]

Case in point: Beth Israel Deaconess Medical Center.

That flexibility is also very welcome at Sharp Healthcare in San Diego.

“Any additional time would be most helpful,” said Elizabeth Renfree, director of interoperability at Sharp Healthcare in San Diego. “At Sharp as with many other organizations we have been working to prepare for Stage 2, but are still waiting on code updates from our vendor that will not be delivered until January. In addition we have significant workflow processes to implement to meet the Transition of Care and the View, Download, and Transmit measures.

Reider and Tagalicod explained that the new timelines will enable more analysis of feedback from Stage 2 stakeholders, more data on Stage 2 adoption and measure calculations, further consideration and more time to prepare for Stage 3 requirements. And more flexibility for certification.

“Our first step under this new approach would be to publish a proposed rule for a 2015 Edition of certification criteria. We intend for the 2015 Edition certification criteria to improve on the 2014 Edition certification criteria in several ways,” Reider and Tagalicod added, including addressing issues in 2014 certification, using updated standards, and implementation guides with a focus on continuing to drive interoperability.

“We expect to propose that the 2015 Edition would be voluntary in the sense that providers participating in the EHR Incentive Programs would not have to upgrade to 2015 Edition EHR technology and no EHR technology developer who has certified its EHR technology to the 2014 Edition would need to recertify its products,” the officials continued. “Our intention would be for the 2014 Edition to remain the baseline certification criteria edition for meeting the Certified EHR Technology definition.”

Anyone paying attention to the Senate Finance Committee hearings over the summer should not be entirely surprised that CMS has opted to extend the timelines.

Indeed, Sen. Orrin Hatch called for a pause to meaningful use. Marty Fattig, CEO of Nemaha County Hospital, in Auburn, Neb., said that “progress is being made but the digital divide between urban and rural hospitals persists.” And Siemens Health Systems CEO John Glaser suggested the industry should “step back, take stock, keep the program going but revise where we need to.”

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