Lost op­por­tu­nity?

Ex­ten­sion to speed EHR adop­tion too late for some

Modern Healthcare - - THE WEEK IN HEALTHCARE - Joseph Conn

HHS is gar­ner­ing praise for ex­tend­ing the com­pli­ance date for Stage 2 mean­ing­ful-use re­quire­ments to early par­tic­i­pants in its in­cen­tive pro­gram for elec­tronic health records. But the change likely comes too late to pro­duce the full ef­fect of its stated in­tent to speed the adop­tion of EHR sys­tems.

HHS Sec­re­tary Kath­leen Se­be­lius an­nounced the ex­ten­sion while pitch­ing the ad­min­is­tra­tion’s health IT push as a job cre­ator dur­ing a visit last week to Cleve­land’s Cuya­hoga Com­mu­nity Col­lege, which of­fers cer­tifi­cate and de­gree pro­grams in health in­for­ma­tion man­age­ment.

Se­be­lius said HHS in­tends to give hos­pi­tals, of­fice-based physi­cians and other “el­i­gi­ble pro­fes­sion­als” one more year to step up to the more strin­gent Stage 2 mean­ing­ful-use re­quire­ments of the Medi­care EHR in­cen­tive pay­ment pro­gram if they met Stage 1 re­quire­ments in 2011. An of­fi­cial no­tice of pro­posed rule­mak­ing will be pub­lished in Fe­bru­ary 2012.

The roll­back comes as no sur­prise. In May, a work­group of the fed­er­ally char­tered Health IT Pol­icy Com­mit­tee rec­om­mended the ex­ten­sion for first-year mean­ing­ful users. It was sup­ported by Dr. Farzad Mostashari, head of the HHS’ Of­fice of the National Co­or­di­na­tor for Health In­for­ma­tion Tech­nol­ogy.

Un­der cur­rent pro­gram rules, providers that qual­ify for in­cen­tive pay­ments as Stage 1 mean­ing­ful users in 2011—the pro­gram’s first year—have to meet Stage 2 stan­dards in 2013. The first year of Stage 1 ended Sept. 30 for hos­pi­tals and ends Dec. 31 for physi­cians and other el­i­gi­ble pro­fes­sion­als.

In both cases, providers have up to 60 days af­ter the end of their years to sub­mit needed data and at­test to the CMS that they had met the mean­ing­ful-use cri­te­ria for at least 90 con­sec­u­tive days. That means the ex­ten­sion may be of lit­tle use to hos­pi­tals. The fi­nal day for them to make a sub­mis­sion to HHS was Nov. 30, the day of Se­be­lius’ an­nounce­ment, which would have given hos­pi­tal of­fi­cials who might have been swayed by the roll­back less than eight hours to file their data and at­tes­ta­tions, ac­cord­ing to Marie Copou­los, a con­sul­tant with the Ad­vi­sory Board. The men­tal im­age of which gave her col­leagues there a chuckle, she said.

“Un­for­tu­nately, there won’t be an op­por- tu­nity for additional (hos­pi­tal) peo­ple to get in un­der the wire,” Copou­los said. “There is an op­por­tu­nity for physi­cians. They’re in play un­til Feb. 28.”

This year, the Ad­vi­sory Board be­gan coun­sel­ing clients—even those ready to at­test in 2011—to hold off un­til 2012, cit­ing the time squeeze and the lack of fi­nal Stage 2 mean­ing­ful-use cri­te­ria, which are not ex­pected to be pub­lished un­til sum­mer 2012. Also, the Ad­vi­sory Board ob­served, the in­cen­tive money will be the same whether providers first at­test in 2011 or 2012.

Even if HHS in its new rule al­lowed hos­pi­tals to squeeze into the 2011 pay­ment year— which was not pro­posed—copou­los said the Ad­vi­sory Board would stand pat with its rec­om­men­da­tion to wait.

“Once you com­plete your 90-day reporting pe­riod, the next year is a 365-day reporting pe­riod,” she said. “For hos­pi­tals, it would still mean their 2012 reporting pe­riod has al­ready been un­der way since Oct. 1 this year. Hon­estly, I think where a lot of folks will have to step back and ques­tion whether they’re ready to make that jump right now.”

Richard Umb­den­stock, Amer­i­can Hos­pi­tal As­so­ci­a­tion pres­i­dent and CEO, said in a state­ment that the AHA’S mem­bers “are com­mit­ted to im­ple­ment­ing elec­tronic health records” to sup­port qual­ity pa­tient care, “but the rushed time­lines and com­plex reg­u­la­tory re­quire­ments of mean­ing­ful use have made the process dif­fi­cult.” He added that the de­lay brings the process more in line “with mar­ket re­al­i­ties, such as lim­ited ven­dor ca­pac­ity to work with providers.”

Even with a one-year ex­ten­sion for early adopters, providers won’t be lol­ly­gag­ging.

“It re­ally isn’t an ex­tra year,” said Dr. John Halamka, chief in­for­ma­tion of­fi­cer for Beth Is­rael Dea­coness Med­i­cal Cen­ter, Bos­ton. “Ven­dors will have un­til Oct. 1, 2013, to cre­ate and in­stall cer­ti­fied prod­ucts so that clin­i­cians can be­gin their year-long reporting pe­riod in time for the Oc­to­ber 2014 at­tes­ta­tion dead­line,” he said. “Eigh­teen months to cre­ate new soft­ware, in­te­grate it with health in­for­ma­tion ex­changes and en­sure broad adop­tion does not give us sub­stan­tial free time.”

In Cleve­land, Se­be­lius also an­nounced the re­sults of a National Cen­ter for Health Sta­tis­tics sur­vey of of­fice-based physi­cian prac­tices in­di­cat­ing sig­nif­i­cant in­creases in the use of elec­tronic health-records sys­tems.

The NCHS, an arm of the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, found that 57% of re­spon­dents had a self-de­scribed EHR, up from 51% in 2010; 34% had a ba­sic EHR sys­tem with key ca­pa­bil­i­ties, in­clud­ing pa­tient med­i­ca­tion lists, elec­tron­i­cally pre­scrib­ing, view­ing labs re­sults and im­ages, up from 25% in 2010.

The 2011 re­port omit­ted the re­sults for a third cat­e­gory for providers reporting they use an even more fea­ture-rich “fully func­tional” EHR sys­tem. That fig­ure was only 10% in 2010. Re­port co-author and NCHS re­searcher Es­ther Hing said the ques­tion was asked on the 2011 sur­vey—and the fig­ure rose to 17%—but she cau­tioned that the re­sults are not di­rectly com­pa­ra­ble be­cause the cat­e­gory in­cluded 12 func­tions in the 2011 sur­vey, down from 14 in the 2010 ver­sion.


Se­be­lius wants hos­pi­tals to act faster to adopt elec­tronic health-records tech­nol­ogy.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.