The more that healthcare providers use electronic health record (EHR) systems, the more questions they have about interoperability, optimization, patient portals and the future of the meaningful use incentive program.
The Office of the National Coordinator for Health IT (ONC) has, for that reason, spent recent weeks outlining its vision for the EHR market and, accordingly, alleviating the fears of providers wrestling the pressures of EHR implementation, the ICD-10 conversion, clinical quality measures and evolving care models.
The ONC's statements at the recent Health Information and Management Systems Society's HIMSS 2014 conference suggest both progress and pitfalls in an effort to meet what's increasingly becoming a moving target.
Government Granting Meaningful Use Amnesty to Stressed Providers
The action, as it were, began in December, when the ONC and the Centers for Medicare and Medicaid Services (CMS) announced a one-year delay in the meaningful use timeline. Stage 2, which emphasizes more advanced clinical processes, now ends one year later, in 2016, with stage 3 and its emphasis on improved outcomes beginning in 2017.
With the delay, ONC and CMS essentially admit that they understand how hard healthcare has it. After all, meaningful use represents but one of many deadlines looming over healthcare the industry:
- Providers have until Oct. 1 to make the switch to the ICD-10 code set - and the process has proven more complicated, costly and controversial than anticipated.
- Organizations participating in the Pioneer ACO Model have two years (ending in 2014) to demonstrate shared savings. The process carries so much risk that nine of the original 32 participants dropped out. (Those in the less-arduous Medicare Shared Savings Program must continue to demonstrate lower costs as well.)
- Medicare requires hospitals to reduce readmissions within a 30-day period. Those who do not face reimbursement reductions that increase each year.
- Likewise, through the Physician Quality Reporting System, eligible healthcare professionals who don't report on quality measures face a "payment adjustment" beginning in 2015.
Amid such tumult, the ONC told HIMSS attendees to expect flexibility with meaningful use stage 2 hardship exemptions. Since meaningful use and the ICD-10 conversion have already been delayed once, their deadlines won't be moved again, but CMS says it will extend an olive branch to providers who can't meet stage 2 criteria - they won't receive incentives money, but they won't be penalized, either.
'Pockets of Progress' For Healthcare IT Interoperability Rare
On the sole basis of stimulating EHR adoption, meaningful use has succeeded. The incentive program has awarded more than $20 billion to hospitals and eligible providers, or roughly all of what was allocated in the HITECH Act of 2009. According to CMS, 80 percent of eligible hospitals and 50 percent of eligible providers are participating in meaningful use. (There is no payment cap, so participants will receive what they are due.)
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