By NICK VAN TERHEYDEN

CMS recently announced another change to health IT policy in order to offer healthcare providers greater flexibility. But what will the unintended consequences of this latest change be?

Over the Labor Day weekend, CMS announced that the Meaningful Use Stage 2 deadline will be extended through 2016 in order to offer more options and greater flexibility to providers for the certified use of EHRs.  In the interest of full disclosure, I found the timing to be strange— a rule published over a holiday weekend seems an odd choice, particularly when it is being touted as a benefit to the industry and the impact on healthcare provider organizations and clinicians, alike, is monumental.

Unfortunately, I think the additional flexibility allotted by this rule is the latest example of the unintended consequences of health IT regulations.  In an effort to make things easier and give healthcare providers more leeway, they have, in fact, made the situation unnecessarily more complex.

Agility is not healthcare’s strong suit

It seems at this point, too many options, or waffling between them (for instance the new ICD-10 transition deadline), can be more crippling than stringent regulations, particularly when there is so much on the line.  Healthcare organizations don’t have the wherewithal to vacillate with implementations; they are wrestling with string-tight budgets and constantly shifting rules require large cultural and behavioral changes.  As a result, as Dr. John Halamka noted, health IT agendas are being constantly hijacked by regulatory changes, such as Meaningful Use and ICD-10.

It now seems that hospital administrative teams and physicians again must endure constantly shifting rules that they’ve been coping with for years under Meaningful Use.  As Dr. Ben Kanter, former CMIO of Palomar Health, so astutely noted “A computer system is a tool, just as a scalpel is a tool.  What if a surgeon’s scalpel changed every few weeks?  How is it possible to deliver good care if the primary tool you are using keeps changing on an irregular basis?”

While this latest ruling’s flexibility was meant to be helpful, it was offered to an industry that is not known for its quick ability to course correct.  The announcement made under the cover of the long weekend attests to CMS’ knowledge of this. The danger is that those provider organizations that were on track to qualify or satisfied the requirements for Meaningful Use are now at risk of failing to meet them under the updated requirements.  It now comes down to properly entering the certification process and meeting the requirements on the new timeline: if an organization can’t get certified at the beginning of the measurement period, it most likely will not be able to pass muster.  Certainly if an organization can certify for three months, it can certify for 12.  So the flexibility is a dubious gift for most.

About Dr. Nick van Terheyden
Nick is Chief Medical Information Officer for Nuance where he focuses on improving the usability of health technology for both providers and patients. As a pioneering creator in the evolution of healthcare technology, he brings a distinctive blend of medical practitioner and business strategist to the realm of health IT. After several years as a medical practitioner in London and Australia, he joined an international who’s who in healthcare, academia and business, in the development of the first electronic medical record in the early 1990’s and later, as a business leader in one of the first speech recognition Internet companies. Nick attended the Royal Free Hospital School of Medicine, at the University of London. He is a certified football (soccer) coach and referee as well as a purveyor of fine Scottish Malt whisky.