48 providers ask HHS for an extension on meaningful use deadlines

Health care professionals had a relatively easy time purchasing and implementing electronic health records software through stage 1 of meaningful use, but as the deadlines for stage 2 requirements approach in July, some organizations are losing confidence that they will be able to meet those criteria.

This reevaluation of meaningful use stage 2 requirements has led to an open letter from 48 health care provider groups – the largest collection yet – addressed to Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services. Signed by organizations that have already lobbied for a rethinking of ICD-10 and meaningful use policies, such as the American Medical Association and the Medical Group Management Association, as well as new signers, such as the Children's Hospital Association and the American College of Surgeons, the group of providers asked that, in light of the underestimated stresses they have placed on health care practices across the country, the HHS should revise published meaningful use deadlines.

Immediate action requested
The College of Healthcare Information Management Executives published the letter on behalf of the forty-seven other organizations that represent a cross-section of health care providers in the U.S. CHIME and its co-signers wrote that, while meaningful use has played a critical role in the increased adoption of health care information technology in the industry, the confluence of preparations for both stage 2 and ICD-10 deadlines is placing too much of a burden on practices.

CHIME recognized the 10-year anniversary of passage of the Health Information Technology for Economic and Clinical Health Act as an overall success, but warned the HHS that caution with deadlines is needed to ensure that the progress the industry has worked for remains in place.

"Providers need adequate time to learn how to use the newly deployed technology," the letter explained, citing the multi-level staff training normally required of EHR systems. "If providers move forward, as dictated by the current policy, our concerns regarding rushed implementations are heightened. Furthermore, we believe that an 'all or nothing' approach – where missing a single objective by even a small amount results in failure for the program year – compounds our concerns."

The coalition of providers called for the HHS to extend the final deadlines for meaningful use stage 2 requirements into 2015. With more time for health care organizations to train staff and prepare their networks for 2014-certified EHR software, the coalition believed that the industry would be better prepared to use EHRs to improve patient care. Also, in conjunction with evaluation metrics meant to help providers attest successfully rather than stringent requirements that seek to fail applicants, more organizations will be ready to participate in interoperable IT exchanges.

Success with stage 1 does not mean the same for stage 2
The widespread criticism of stage 2 requirements has come as a surprise to some government officials, especially after the industry-wide success of stage 1. According to data from the Centers for Medicare and Medicaid Services, providers not only registered for incentive programs in high numbers but also drastically exceeded the data reporting minimums.

The CMS' 2013 data indicated that, while the agency required 80 percent of organizations' medication lists, the average reported rate was at 97 percent. When it came to electronic copies of patient health information, which only had a threshold of 50 percent, providers still reported at a 97 percent rate. In fact, the lowest number from providers was a 75 percent rate for timely electronic access – though the CMS threshold was only 10 percent.

While success may have come easy for providers in the past, the CHIME-signed letter may indicate a reality that many health care critics have foreseen for years – stage 2 requirements are much more difficult to achieve.