Workgroup to Investigate Stage 2 Timing Glitch

The Meaningful Use Workgroup — a subcommittee of ONC’s HIT Policy Committee — will review the timing of its staging structure in light of a possible glitch which could hinder some healthcare providers from qualifying for incentive payments.

Judy Murphy, RN, a member of the workgroup and VP of information services at Aurora Health Care, said, “There appears to be a groundswell movement which has people sending (blog) postings back and forth. Especially the Advisory Board is recommending that people not look at doing (attestation) for Stage 1 in 2011 because the timing will be such that vendors may not have code ready for Oct. 1, 2012 and, therefore, people will be locked out if they start in 2011.”

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Murphy continued: “I think the concern is that if (Stage 2 requirements) come out in mid-2012, then that would be when vendors find out about it and, hypothetically, someone who qualified for Stage 1 in 2011 would have to start their full year of Stage 2 compliance on Oct. 1, 2012.” Thus, the vendors would have to take the specs and get certified to the new requirements, after which clients would have to take delivery of the software and install it — all in three months.

Paul Tang, MD, VP and CMIO at Palo Alto Medical Foundation and chair of the Meaningful Use workgroup, said there did seem to be a problem with the schedule. “It’s not feasible for people to get the rule, then three months later have it implemented.” Tang asked Josh Seidman, ONC’s acting director of Meaningful Use, if that department wanted the workgroup to weigh in on the matter and, if so, would prepare a list of possible options available to remedy it.

Seidman replied that he certainly would like feedback and would also provide a list of options.

The deadline for submitting comments on Stage 2 of Meaningful Use concluded on Feb. 25, by which time 422 “comment submissions,” actually reflecting thousands of comments, were received, according Seidman. While he said ONC did receive many comments around the timing of Stage 2 in general, “I can’t say a lot focused on that specific recommendation,” he added.

Seidman said he had not yet read all submissions, but related that many focused on the timing and aggressiveness of the Stage 2 measures, with some in favor of the proposed pace and some against.

“Providers and vendors suggested that the Policy Committee recommendations are too aggressive while, on the other hand, many from customer organizations, purchasers, management organizations, healthcare IT advocates, health plans and some non-standard healthcare IT vendors have come in suggesting that there needs to be a lot of aggressiveness in how the Meaningful Use framework moves forward,” he said.

Seidman said he plans to have full analysis of the comments for the Meaningful Use Workgroup — including a “thorough assessment or synthesis of all comments” — a week prior to the group’s next face-to-face meeting on April 5.

Christine Bechtel, vice president of the National Partnership for Women and Families, said she wanted the Meaningful Use incentive payment matrix included in a discussion of any change in the stages, noting that incentives are lower in the out-years. “If you push measures off into later years when the incentives are smaller, that creates a different behavioral response. I want to makes sure we’re clear about the size of the incentives over time.”

Currently, the HIT Policy Committee plans to submit its formal Stage 2 recommendations to ONC in June of this year. CMS will then publish the Stage 2 Notice of Proposed Rulemaking (NRPM) by the end of 2011.

The Meaningful Use Workgroup will hold its next call on March 22.

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