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HIMSS11 Live: Meaningful Use

What can be said about “meaningful use” of electronic health records that hasn’t already been said? Actually, plenty, if the events leading up to Monday morning’s official opening of HIMSS11 are any indication.

Last week, HIMSS honcho Steve Lieber told me in an interview at his Chicago office that most of the confusion about Stage 1 meaningful use has subsided, but that there still was plenty of “uncertainty” about the future. As in, uncertainty about the transition from Stage 1 to Stage 2 of the federal EHR incentive program and uncertainty about leadership, as national health IT coordinator Dr. David Blumenthal prepares to return to Harvard in April. (Yes, it is April. Blumenthal apparently spilled the beans to former Sen. Dave Durenberger a few weeks ago.)

“Everybody’s real clear on Stage 1,” Lieber said. The uncertainty is about future stages of meaningful use, particularly in the transition from Stage 1 to Stage 2. The fact that there will be a new national coordinator is another source of uncertainty, but it just means that there could be further refinements to existing regulations.

Vendors seem anxious to see the Stage 2 regulations so they can begin modifying and recertifying their products to help customers meet the next round of requirements. (Yes, everything will have to be recertified to meet Stage 2 criteria.)

The College of Healthcare Information Management Executives (CHIME) late last week formally asked for more time to transition from Stage 1 to Stage 2 because it’s unclear if many physicians and hospitals are even ready for the first stage. “CHIME believes that it would not be prudent to move to Stage 2 until about 30 percent of (eligible hospitals and eligible providers) have been able to demonstrate EHR MU under Stage 1,” says CHIME’s comment letter. “We believe this approach would strike a reasonable balance between the desire to push EHR adoption and MU as quickly as possible, and the recognition that unreasonable expectations could end up discouraging EHR adoption if providers conclude that it will be essentially impossible for them to qualify for incentives.”

The Office of the National Coordinator (ONC) for Health Information Technology is taking comments on Stage 2 through Friday, a curious deadline given that most of the health IT universe is wrapped up in HIMSS for most of this week.

ONC did try to allay some of the uncertainty on Sunday, though. Chuck Friedman, ONC deputy national coordinator, reportedly told attendees at the HIMSS Usability Symposium that Stage 2 would include EHR usability standards. Whether that is enough to mollify the health IT community seems a little fuzzy.

As 30,000 people descend on the Orange County Convention Center this morning, they are likely to be hit with some conflicting news. On Monday, Lieber will announce results of an annual HIMSS survey showing that about 25 percent of hospital CIOs believe that they have already achieved Stage 1 meaningful use, and another 20 percent consider themselves “easily within reach” of the goal.

Of course, if the HIMSS numbers are accurate, more than half of U.S. hospitals—and countless physician practices—remain outside the several steps away from meaningful use right now.

New data released this morning from physician services vendor athenahealth and online physician community Sermo suggest a higher level of pessimism in ambulatory settings. In a survey of 500 doctors, 64 percent said the financial benefits of an EHR outweigh the cost of implementing the technology, down from 71 percent in 2010. Sermo and athenahealth found a similar drop in the number of physicians who believe that EHRs can help them reduce medical errors.

“The survey paints a story of financial and human capital being expended on potential. And that’s insult to injury given this community is at best tepid about, and at worst confounded by, a litany of other acronyms being pushed at them—like MU compliance, their ability to qualify as an ACO, and the impact of the ACA,” Sermo CEO Dr. Daniel Palistrant said in a press release.

The advice from Lieber is to keep moving forward.

“I think that the area has a degree of uncertainty, but at the practice level, at the implementation level, everybody should by this point have their IT strategic plan in mind. They should have their timetable. Don’t let external events move you off of what works for your institution,” the HIMSS boss said.

Just don’t forget about 5010 transactions—mandatory by January 2012—and the switch to ICD-10 coding in 2013.

This article brought to you by Xerox Corporation: http://bit.ly/f7vdh8.

Neil Versel is a professional healthcare IT journalist. He has been covering healthcare IT since 2000, across a wide range of publications and on his blog, Meaningful HIT News with Neil Versel.

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