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Meaningful Use Stage 3 Success Could Rely On Vendors

Posted on May 20, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Today I was reading a report on the Health IT Policy Committee’s review of pending Meaningful Use Stage 3 rules — which would ordinarily be as about as exciting as watching rocks erode — when something leapt out at me which I wanted to share with you, dear readers.

The overview, brought to us courtesy of Medical Practice Insider, noted that proposed plans for the Stage 3 rule would allow providers to attest in 2017, though attesting wouldn’t be mandatory until 2018. What this means, editor Frank Irving notes, is that it would be up to EMR vendors to be ready for providers wishing to attest a year early.

The folks overseeing this discussion, the Advanced Health Models and Meaningful Use Workgroup, seem (wisely) to have had their doubts that vendors could be relied upon to meet the 2017 deadline. At the session, workgroup members proposed a couple of alternative ways of addressing this timeline. One was to make the 2017 deadline go away, requiring instead that EMRs have full 2015 certification by 2018. Another was to allow optional attestation in 2017, but if need be, with 2014 EMR certification.

I don’t know about you, but this whole thing makes me nervous. By “whole thing,” I mean adjusting the rules to deal with the likely resistance vendors will exhibit to keeping their roadmap in synch with federal requirements.

After all, consider the history of EMR vendors’ relationship with providers. As we’ve noted, HHS has paid out about $30B in Meaningful Use incentives under HITECH without insisting that vendors provide interoperability. And what have EMR vendors done?  They’ve avoided developing shared standards for interoperability with an alacrity which amazes the eye.

In fact, some EMR vendors — including top contender Epic Systems — have been slapping providers with fees for data sharing (even if they’ve kind of dropped them for now), at prices which could leave them millions in the hole. If that isn’t dead opposite to what those in public policy hope to see happen, I don’t know what is.

Bottom line, if the good people overseeing Meaningful Use want to see Stage 3 accomplish good things, they’ll need to see to it that the new rules give regulators some leverage when it comes to controlling vendors.

As the whole sad interoperability saga has demonstrated, vendors will not take actions that advance health IT on their own. Unlike in other IT markets, where interoperability and meeting regulatory deadlines have been the signs of a winner, EMR vendors actually have strong incentives to ignore providers’ business imperatives.

With any luck, however, between tougher rules on Stage 3 and public pressure to achieve interoperability, EMR vendors will do the right thing.  They’ve certainly had long enough.

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?


Meaningful Use Sent Back by ONC Head David Blumenthal

Posted on June 24, 2009 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Everyone in the healthcare IT world is sitting and waiting to know the fate of the words “certified EHR” and “meaningful use.” Yes, only a few billion dollars of EHR stimulus money are riding on those 2 terms.

Well, after the Health IT Policy Committee came out with their initial set of recommendations, it was reported that David Blumenthal, National Coordinator for Health IT, said “lively discussion (on the criteria) and considerable input on meaningful use, we decided to send the work group back to work on another set.”

Looks like the new date for more guidance from the Health IT policy committee will be their July 16th meeting.