Stage 2 Meaningful Use Delay Raises Questions

Posted on June 10, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

This week, federal policymakers gave providers and hospitals a welcome break in complying with Stage 2 Meaningful Use requirements. The Health IT Policy Committee has voted to delay the implementation of Stage 2 for one year, from 2013 to 2014.

The delay, which is relevant for eligible providers and hospitals that already qualified for MU incentives this year, is a welcome reprieve. Since final rules for Stage 2 aren’t likely to emerge until June 2012, many would have missed their deadlines, something that even the Policy Committee admitted.

Now, the matter of getting Stage 2 rules finalized moves to CMS, which will review the draft recommendations and issue final rules. Nobody’s sure what will happen if the agency doesn’t meet the expected deadline in mid-June, but I guess we’ll just have to wait and see.

In the meantime, as blogger Jim Tate correctly notes, the move raises many questions.

For example, will this decision slow down the implementation of Stage 3 MU rules?  Will eligible providers/hospitals actually take advantage of the delay, or get bogged down and burn through the extra time?  If the eligible providers that qualified in Stage 1 stay there for three years will they only get two years of incentives based on meeting those rules?

I would add a few other questions as well:

* Will those providers who qualified for Stage 1 incentives find adopting Stage 2 to be a reasonable, incremental change or a big leap? Is even an extra year enough to make the needed HIT and process changes necessary to meet this goal?

* Over the next two years, will some providers find that it will cost more to meet the added requirements than they’re getting from the government?

* Will the Policy Committee and other federal officials be able to sell Meaningful Use to newly-arriving providers for 2012, or will there be a revolt of some kind?

I suppose you can see from my questions that a) I suspect hospitals and providers would be unlikely to adopt MU-type features on their own and b) that I don’t know if the government’s existing carrot-and-stick approach can keep  them interested.

Honestly, I’ve always been skeptical that a template-like approach like the MU regs is likely to produce the kind of rich data and improvements in care quality that backers hope. I believe there are better ways to foster smart use of the EHRs the government has demanded.

After all, if requiring certain process changes worked seamlessly, they’d work even without digital medicine, and the whole MU issue would be moot. (The EHR system would support those super-cool care processes rather than being replete with specific features set up as proxies for quality care.)

But maybe I’m being a Luddite or a troglodyte or whomever you are when you’re skeptical that something new works. What do you think?