AHA, AMA: Meaningful Use Requirements Should Be Eased

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This week, the American Hospital Association and the American Medical Association sent a joint letter to HHS Secretary Kathleen Sebelius asking for greater flexibility in the requirements of the meaningful use program, HealthLeaders Media reports (Commins, HealthLeaders Media, 7/25).

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.

In the letter, AHA President and CEO Rich Umbdenstock and AMA CEO James Madara called the meaningful use requirements "overly burdensome" (Bowman, FierceEMR, 7/25). They added, "[W]e believe that the best way to move the program forward and ensure that no providers, particularly small and rural ones, are left behind is to realign the meaningful use program's current requirements to ensure a safe, orderly transition to Stage 2."

The groups offered four recommendations to improve the meaningful use program, including:

  • Allowing health care providers to meet Stage 1 meaningful use requirements using either a 2011-certified or 2014-certified EHR;
  • Establishing a 90-day reporting period for the first year of each new stage of the program for all providers;
  • Offering increased flexibility to providers in meeting Stage 2 requirements; and
  • Extending each stage of the meaningful use program to "no less than" three years for all providers.

They said the policy recommendations could be implemented without making alterations to the law (HealthLeaders Media, 7/25).

AHA's Senate Finance Committee Testimony

Meanwhile, AHA this week also submitted testimony to the Senate Finance Committee, urging lawmakers to provide more flexibility within the meaningful use program.

"Implementation challenges remain for many hospitals, particularly small and rural hospitals," AHA noted, adding, "These groups also have made progress and should not be penalized for not being further along" (Bresnick, EHR Intelligence, 7/25). 

In its testimony, AHA included a report on case studies conducted at four separate hospitals. It noted, "This study demonstrates that successful implementation of current policy requirements for [electronic clinical quality measures] must be redirected so that the EHRs are working for the clinicians rather than the clinicians spending extensive amounts of time working for the EHRs."

Based on the challenges identified through the case studies, AHA recommended:

  • Slowing the pace of the transition to electronic quality reporting with fewer, but better-tested, measures, starting with Stage 2 of meaningful use;
  • Making EHRs and electronic clinical quality measure reporting tools more flexible so that data capture can be aligned with workflow;
  • Improving health IT standards to address usability and data management;
  • Carefully testing electronic clinical quality measures for reliability and validity prior to adopting them in national programs; and
  • Offering clear guidance and tested tools to support successful hospital transition to increased electronic clinical quality reporting requirements (Monegain, Healthcare IT News, 7/25).

Noting that Sebelius has the ability to extend the meaningful use timelines and introduce greater flexibility to the program, AHA wrote, "Doing so would go a long way toward ensuring that we collectively achieve a safe, orderly transition to Stage 2 that leaves no one behind" (EHR Intelligence, 7/25). 

Frank Poggio
Keep in mind that all Stage 1 vendor certifications ‘die’ on 09/30/2013 for inpatient, and 12/31/2013 for Ambulatory. That means although providers can still attest to Stage 1 in 2014 (as late as September), they cannot use a vendors 2011 (Stage1) certification to do it. The vendor system must have passed 2014 test Criteria. As of this week there are very few vendors certified under the 2014 Edition Test Criteria. Why? Because the test criteria, just like the provider attestations, are far more complex and the criteria keep changing. For example, on July 14 ONC issued no less than 14 test script changes/revisions. That impacts almost 50% of the test scripts and clients I have been working with had to revise test applications and redo some software. Here we are some seven months into the program, and three months away for a drop dead date. Clearly there is a ‘train-wreck’ a coming but ONC seems to be oblivious. Frank Poggio The Kelzon Group KelzonGroup.com

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