During a joint hearing of two Federal Advisory Committees in Washington, D.C. on Monday, four influential CIOs stressed the need for more focus on standards development and spoke about the hurdles to attesting to Stage 2.
CHIME members Pamela McNutt, Tom Pagano, Rodney Dykehouse, and Randy McCleese provided testimony on Stage 1 implementation, Stage 2 readiness, and Stage 3 proposed policies. The panel identified objectives related to transitions of care, patient portals, and clinical quality measures (CQMs) as the greatest challenges in achieving Meaningful Use.
According to McNutt, senior VP and CIO at Methodist Health System, these objectives “require significant work to implement after upgrading to 2014 certified software. For example, after delivery of the patient portal we will have to map data elements from the patient record and clinical staff will need to ensure that the data is representing accurately.”
McNutt added that sacrificing accuracy for speed presents significant concerns in terms of the timeline to demonstrate 100 percent compliance of Stage 2 by July 1, 2014 for eligible hospitals.
Pagano, who is CIO at HCA Capital Division in Richmond, and Dykehouse, CIO at Penn State Hershey Medical Center and College of Medicine, stated that vendors are forced into selecting a specific workflow to certify, and providers often find they must either ask for modifications to their reporting logic, or completely change an existing (embedded) workflow.
“We’re not opposed to changing workflow if it is a better workflow, but we are opposed to changing a workflow only to ‘prove’ that we’re meeting the intent of the requirement,” Dykehouse said.
Although current adoption trends for EHRs are promising, with nearly 79 percent of all eligible hospitals and more than 55 percent of eligible professionals having received an EHR incentive payment under Medicare or Medicaid since 2011, the program has its share of flaws. In 2014, more than 500,000 hospitals and physicians are required to upgrade their existing technology to demonstrate meaningful use, creating a significant time crunch.
“The difficultly in achieving meaningful use, beyond the new, more complex objectives, is compounded by the short timeframes allowed for hospitals to implement 2014 certified EHRs,” said McCleese, VP of Information Systems and CIO at St. Claire Regional Medical Center.
To alleviate this short timeframe, CHIME recently called for an extension of Stage 2 to ensure momentum toward widespread adoption of EHRs was maintained; flexibility was granted to hospitals and physicians striving towards meeting program requirements of their respective stage; and policymakers had ample time to assess and evaluate programmatic trends needed to craft thoughtful Stage 3 rules.
“The EHR Medicare and Medicaid Incentive program has played a major role in advancing the adoption of health IT in the US, yet certain changes are needed to assure this initiative enables improvements in care quality, increases affordability, and improves healthcare outcomes,” said CHIME President and CEO Russ Branzell. “To accomplish these goals, CHIME strongly encourages HHS to amend existing timelines for 2014, thus promoting a safe, orderly transition to Stage 2 that leaves no one behind.”