Industry Associations Differ on Hospital Readiness for Stage 2 of Meaningful Use

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By Alex Ruoff  

Oct. 8 --Two health-care industry associations are at odds over whether hospitals and electronic health record vendors are prepared to meet requirements of Stage 2 of the meaningful use program, which began Oct. 1 for hospitals.

The Healthcare Information and Management Systems Society (HIMSS) released a report in September that found most hospitals are “actively moving towards meeting Stage 2 meaningful use requirements” and will be ready to attest to meeting those requirements in 2014.

However, American Hospital Association Director of Policy Chantal Worzala told Bloomberg BNA Oct. 9 that EHR vendors have been slow to provide upgrades to hospital information technology systems needed to meet the new requirements for the meaningful use program and there are not enough EHR systems certified for use in Stage 2 of the program.

“We don't have as many certified EHRs as folks expected we would have at this time,” she said.

Despite the difference in their opinion over hospitals' readiness to meet requirements of Stage 2 of the meaningful use program, both HIMSS and the AHA have requested an extension to the program's reporting period for hospitals, which runs through fiscal year 2014, from Oct. 1, 2013, to July 1, 2014.

Industry executives and lawmakers this year repeatedly called for delays to the meaningful use program, claiming the requirements for Stage 2 were too onerous for many hospitals.

Hospitals that have attested to meeting requirements of Stage 1 of the meaningful use program must still attest to meeting Stage 2 program criteria to avoid a scheduled Medicare reimbursement adjustment.

Eligible professionals and hospitals that do not meet meaningful use program requirements by 2015, meaning they must report on Stage 2 criteria starting in 2014, will face a 1 percent Medicare reimbursement cut. The penalty is a congressionally mandated part of the program and increases by 1 percent each subsequent year, until 2018, that a health care provider or hospital fails to meet meaningful use program criteria.

HIMSS Report on Readiness

HIMSS Analytics, the research division of HIMSS, surveyed 418 hospitals between January and June of 2013 and found the majority of them already met most of the core requirements of Stage 2 of the meaningful use program.

Stage 2 of the meaningful use program has 16 “core measures” that hospitals must meet in order to qualify for Medicare and Medicaid incentive payments and six “menu measures” that hospitals must meet half of in order to quality for incentive payments.

The HIMSS survey found that more than half of the hospitals surveyed already were capable of meeting the 10 core measures of Stage 2 of the meaningful use program and four menu measures.

The HIMSS survey also found that hospitals were “making in-roads” on the core measures they were incapable of meeting at the time of the survey.

Hospitals surveyed were least likely to be capable of providing patients with electronic access to their health records, a core measure of Stage 2 of the meaningful use program. Less than 7 percent of hospitals surveyed were capable of meeting the measure.

However, 68.4 percent of hospitals surveyed reported they were actively progressing toward being capable of providing patients with electronic access to their health records, a promising sign, according to HIMSS.

“The percent progressing category includes those hospitals that have already begun to move forward in achieving these metrics and those that plan to do so in the near future,” the report said.

“Thus, despite low current readiness rates to achieve metrics such as providing patient electronic access, providing summary of care records for all referrals and the use of the clinical decision support technology to improve performance on high-priority health conditions, there is substantial activity planned for the future,” the report said.

Call for Extension

HIMSS, in an Aug. 7 letter to the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT, asked for a nine month extension to the reporting period for Stage 2 of the meaningful use program (see previous article).

HIMSS renewed the call in the September report, saying an extension “will give hospitals that have not yet had the opportunity to work through all the required technological components the additional time they need to attest to Stage 2 [of the meaningful use program].”

The AHA and the Federation of American Hospitals in July urged lawmakers to extend each stage of the meaningful use program, including Stage 1 and Stage 2, to three years (see previous article).

The two hospital associations said at the time their members were worried that vendors already are behind in developing upgrades and will not be able to deliver the certified technology necessary to comply with the Stage 2 requirements in 2014.

AHA Sees Little Progress

Worzala told Bloomberg BNA Oct. 9 that little has changed since July and there still are not enough EHRs certified for use in Stage 2 of the meaningful use program.

She said this issue has been made worse by the recent government shutdown because the online list of certified EHRs, known as the Certified Health IT Product List, hasn't been updated since Oct. 1.

The ONC updates the Certified Health IT Product List.

The Certified Health IT Product List website notes that although automated functions of the list, such as certification identification number generation, will continue to function during a government shutdown, the list will not be updated.

The website also notes that “ONC Staff and contractors will not be available for technical support, assistance or programming during a government shutdown.”

Testing and certification of EHRs are not expected to be affected by the shutdown as they are performed by contractors, according to the website.

To contact the reporter on this story: Alex Ruoff in Washington at aruoff@bna.com

To contact the editor responsible for this story: Kendra Casey Plank at kcasey@bna.com


The HIMSS report can be downloaded at http://www.himssanalytics.org/research/AssetDetail.aspx?pubid=82107&tid=129.