Stage 1 Meaningful Use put the onus for success squarely on the shoulders of eligible hospitals and professionals. The same cannot be said of Stage 2 which requires participants in the EHR Incentive Program to not only engage each other but also their own patients.
According to industry expert, the next phase of meaningful use poses a real challenge for eligible providers. In this second installment of a two-part interview, Director of HIM Practice Excellence at the American Health Information Management Association (AHIMA), Diana Warner, MS, RHIA, CHPS, FAHIMA explains which requirements represent the toughest challenges in Stage 2 as well as how participants in the program and the program itself will fare in the year ahead.
Editor’s note: Read part one of this interview here.
How challenging a Stage 2 Meaningful Use requirement is the patient engagement measure?
Getting patients to do that view, transmit, and download, especially depending on your patient population (if you have an elderly population) — people are very concerned about how they are going to do that. Does that mean that they have to get a patient portal now? No, of course not. There are other ways accomplish that. The rule doesn’t say you have to go out and buy a patient portal. There has to be a way that you can engage your patients to be able to view, download, and transmit that information.
Doing that is going to be a challenge. I know larger facilities in their clinic have set up as a test — as a larger facility they can afford to do this — in which when patients leave they ask the patient if they want to be able to access the health information that was just generated by their provider, they sit down with them at a kiosk set up, and they have a member of registration staff help set them up right there and then. As a result, they have a very high utilization in those particular clinics because they do have a patient portal and a process to get patients signed up. Most facilities are going to have the staffing to do that, so that will be a challenge.
What are meaningful use requirements in Stage 2 will present a problem and why?
The summary of care at the transition of care is going to be the other difficult requirement — making sure you collect the data elements that meaningful use has outlined and then transmitting them. There will be challenges for those companies that are exempt from meaningful use, so providers can’t transmit that data to them because they might not have an EHR yet.
And then there is public health reporting. More states are starting to come up and be able to accept that information electronically, so you won’t be able to say you can’t do it because your state doesn’t accept it. So you’re going to start looking at how you can participate in public health reporting and ensuring it’s secure and all that good stuff.
Are you optimistic that eligible hospitals and professionals will succeed in Stage 2?
I am optimistic. It is achievable, but it will be difficult. There are many hoops to jump through, but because CMS shortened the reporting period that should help tremendously, giving people time to get ramped up to get that done. If you have one of the EHRs that is already certified, if you’re a larger organization that has been looking at it since October, it’s definitely more achievable. Physicians will have a harder time. Hopefully, they still have regional extension centers that can help them. I’ve heard in a number of states that those RECs have been helpful.
I don’t know that we’ll see the same numbers that we saw with Stage 1 Meaningful Use. I would like to be optimistic and hope so, but with the EHRs slow to be certified and imagining that not all of those certified for 2011 are going to be certified for 2014 — they’ll be bought up or go out of business — physicians are likely to struggle unfortunately.
Is Stage 2 a make-or-break moment in the life of the program?
I haven’t seen anything that says that we are going to stop if Stage 2 doesn’t go well. Of course it’s in law, too, so I don’t know that this will be make-or-break. Now at the end of Stage 3, depending on how things went and how successful ONC felt the program and the support were, there may be additional stages, but right now they are going to keep pushing through because it is in law.
Overall the government considers Stage 1 Meaningful Use to be a success just by the volume of people who are on systems now — now we have to get them to use it appropriately. That was a huge step. We really saw quite a jump over the last few years. Source
