Stage 2 MU: A bridge too far?

Providers find meaningful use to be more than they'd bargained for
By Mike Miliard
10:32 AM
Bridge over ocean

It turns out this stuff is really hard, after all.

About this time last year, we ran an article titled, "Stage 2 changes may be rude awakening." In it, one hospital IT honcho made the point that, with attestation for meaningful use still off in the distance, most providers were blissfully ignorant of just how difficult the process would be.

Too few people "really, truly grasp the magnitude of some of the changes," compared to Stage 1, he said.

Here we are, more than halfway through 2014, and the numbers are starting to roll in. They're anything but impressive.

In July, the Centers for Medicare & Medicaid Services released statistics showing that just 3 percent of eligible hospitals and 1 percent of eligible providers have attested to Stage 2 so far.

[See also: "CMS reports paltry numbers for Stage 2"]

Pointing out that these figures represent an exclusive class of organizations that had 2014-certified EHRs in place and ready to go by Jan. 1, Elisabeth Myers, policy and outreach lead at CMS' Office of e-Health Standards and Services, argued it's "dangerous to apply interpretations" to such early returns.

Agree with that or don't, but there's no sugar coating the fact these numbers are lower than folks at CMS and ONC would prefer to see.

Even as recently as this past February, when the health IT industry was gathered in Orlando for HIMSS14, few suspected the attestation numbers would be this underwhelming.

"I was more optimistic," says John Hoyt, executive vice president of HIMSS Analytics.

"We were even doing research at the end of last year, and this past January, in our leadership survey, and we were getting huge numbers of respondents telling us that they were going to attest by the end of 2014," says Jennifer Horowitz, HIMSS Analytics' senior director of research. "For me, it will be very interesting to see what those numbers look like, come the end of the year."

In May, HIMSS released its "2014 Meaningful Use Stage 2 Readiness Assessment," and even then the report found "the provider community generally seems to have a positive view of their ability to meet the deadline."

Some 71 percent of hospitals expected to attest by the end of 2014, while just over 22 percent said they'd do so in 2015.

Asked whether they're running on "installed 2014 certified EHR product(s)," 75 percent of hospitals said, 'yes'; a bit more than 20 percent were "presently completing installation."

But there are sticking points, says Tom Leary, vice president of government relations at HIMSS. And they tend to be the same measures across all providers.

"View/download/transmit and transitions of care are the two most referenced, both anecdotally and in the survey," he says, referring to the 5 percent threshold for patient access to health data and the 10 percent threshold for electronically transmitting summaries of care.

[See also: "Electronic transmission: Not so simple"]

The feds have taken note – to some extent.

"We hear from the government that their attempt to fix the 2014 reporting requirement is their attempt to address the challenges providers are having with implementing the upgrades, and then more specifically view/download/transmit and transitions of care," says Leary.

The requirement for electronic clinical quality reporting is another persistent pain point.

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