Workgroup on 'Meaningful Use' Reviews Draft Criteria to Align With Federal Initiatives

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The Office of the National Coordinator for Health Information Technology's workgroup on “meaningful use” continued May 3 to review proposed criteria for Stage 2 of the meaningful use program by incorporating the goals of other federal health initiatives into the proposed objectives.

Specifically, the workgroup assessed whether Stage 2 meaningful use criteria are aligned with the Department of Health and Human Services' National Quality Strategy and the recently proposed rule on accountable care organizations, Paul Tang, chair of the workgroup and Palo Alto Medical Foundation chief medical information officer, said.

Criteria related to medication safety, clinical decision support, recording patient demographics, and checks for drug-to-drug interactions all are related to care quality and patient and population health, workgroup members said.

To align with the National Quality Strategy and a national prevention strategy that is mandated by the Patient Protection and Affordable Care Act, meaningful use criteria for Stages 2 and 3 of the electronic health record incentive programs should focus on improving health at a community level, Eva Powell, director of health IT programs for the National Partnership for Women and Families, said.

Collecting demographic data will also be important to improving population health, Neil Calman, workgroup member and president and chief executive officer of the Institute for Family Health, added.

The National Quality Strategy was published March 21 by HHS. The proposed rule for accountable care organizations was released March 31 by the Centers for Medicare & Medicaid Services and was published in the April 7 Federal Register (76 Fed. Reg. 19528).

Continued Analysis of Timing Options.

Meaningful use workgroup members also continued to discuss how timelines for the meaningful use program might be adjusted to address concerns by hospitals, IT vendors, and physicians about the currently envisioned timeframe for Stages 2 and 3 of the programs.

One possible new option for alleviating the short timelines could be to allow 2011 early adopters of electronic health record technologies to delay moving to Stage 2 a year, meaning 2012 would still be Stage 1, not Stage 2, Tang said.

This new option, however, could present unintended consequences and disincentives, because it would put pressure on the short timeline for Stage 3 meaningful use criteria, and it would not advance the goals of the meaningful use programs or other federal health initiatives, Powell said. For example, Powell said, under this timeframe, care coordination objectives and information exchange objectives would not be required until 2014.

Steve Posnack, federal policy division director at ONC, requested that the workgroup continue to explore all of the timing options, and also analyze the disadvantages to those options.

Key factors to consider before changing the meaningful use timeline include:

• stalling the programs' momentum;

• meeting the program needs and policy needs of health reform;

• determining the feasibility of the option (for vendors and providers);

• assessing the operational complexity of the timing option from an HHS point of view;

• considering the requirements of the ICD-10 transition; and

• analyzing the financial implications to providers if delays in the meaningful use programs occurred.

Other timing options the meaningful use workgroup is considering involve shortening the reporting period for attesting to meeting the meaningful use requirements, phasing in new meaningful use criteria, and delaying the meaningful use programs by a year.

The workgroup plans to have timeline recommendations for the June meeting of the HIT Policy Committee.

By Genevieve Douglas

Additional information about the meeting and workgroup are available at by clicking on the May 3 entry for the meaningful use workgroup.

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