|HIMSS11 Live: Meaningful Use
|February 21, 2011
|What can be said about “meaningful use” of electronic health records that hasn’t
already been said? Actually, plenty, if the events leading up to Monday morning’s
official opening of HIMSS11 are any indication.
Last week, HIMSS honcho Steve Lieber told me in an interview at his Chicago office
that most of the confusion about Stage 1 meaningful use has subsided, but that
there still was plenty of “uncertainty” about the future. As in, uncertainty about
the transition from Stage 1 to Stage 2 of the federal EHR incentive program and
uncertainty about leadership, as national health IT coordinator Dr. David Blumenthal
prepares to return to Harvard in April. (Yes, it is April. Blumenthal apparently
spilled the beans to former Sen. Dave Durenberger a few weeks ago.)
“Everybody’s real clear on Stage 1,” Lieber said. The uncertainty is about future
stages of meaningful use, particularly in the transition from Stage 1 to Stage
2. The fact that there will be a new national coordinator is another source of
uncertainty, but it just means that there could be further refinements to existing
Vendors seem anxious to see the Stage 2 regulations so they can begin modifying
and recertifying their products to help customers meet the next round of requirements.
(Yes, everything will have to be recertified to meet Stage 2 criteria.)
The College of Healthcare Information Management Executives (CHIME) late last
week formally asked for more time to transition from Stage 1 to Stage 2 because
it’s unclear if many physicians and hospitals are even ready for the first stage.
““CHIME believes that it would not be prudent to move to Stage 2 until about 30
percent of (eligible hospitals and eligible providers) have been able to demonstrate
EHR MU under Stage 1,” says CHIME’s comment letter. “We believe this approach
would strike a reasonable balance between the desire to push EHR adoption and
MU as quickly as possible, and the recognition that unreasonable expectations
could end up discouraging EHR adoption if providers conclude that it will be essentially
impossible for them to qualify for incentives.”
The Office of the National Coordinator (ONC) for Health Information Technology
is taking comments on Stage 2 through Friday, a curious deadline given that most
of the health IT universe is wrapped up in HIMSS for most of this week.
ONC did try to allay some of the uncertainty on Sunday, though. Chuck Friedman,
ONC deputy national coordinator, reportedly told attendees at the HIMSS Usability
Symposium that Stage 2 would include EHR usability standards. Whether that is
enough to mollify the health IT community seems a little fuzzy.
As 30,000 people descend on the Orange County Convention Center this morning,
they are likely to be hit with some conflicting news. On Monday, Lieber will announce
results of an annual HIMSS survey showing that about 25 percent of hospital CIOs
believe that they have already achieved Stage 1 meaningful use, and another 20
percent consider themselves “easily within reach” of the goal.
Of course, if the HIMSS numbers are accurate, more than half of U.S. hospitals—and
countless physician practices—remain outside the several steps away from meaningful
use right now.
New data released this morning from physician services vendor athenahealth and
online physician community Sermo suggest a higher level of pessimism in ambulatory
settings. In a survey of 500 doctors, 64 percent said the financial benefits of
an EHR outweigh the cost of implementing the technology, down from 71 percent
in 2010. Sermo and athenahealth found a similar drop in the number of physicians
who believe that EHRs can help them reduce medical errors.
“The survey paints a story of financial and human capital being expended on potential.
And that’s insult to injury given this community is at best tepid about, and at
worst confounded by, a litany of other acronyms being pushed at them—like MU compliance,
their ability to qualify as an ACO, and the impact of the ACA,” Sermo CEO Dr.
Daniel Palistrant said in a press release.
The advice from Lieber is to keep moving forward.
“I think that the area has a degree of uncertainty, but at the practice level,
at the implementation level, everybody should by this point have their IT strategic
plan in mind. They should have their timetable. Don’t let external events move
you off of what works for your institution,” the HIMSS boss said.
Just don’t forget about 5010 transactions—mandatory by January 2012—and the switch
to ICD-10 coding in 2013.