By Ken Congdon
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When attestations for Stage 1 of the EHR Meaningful Use (MU) program began in 2011, it seemed like the healthcare industry was on the right path to ushering in a fruitful digital era that would benefit clinicians and patients alike. However, recently, the train of EHR progress has started to come off the rails. Issues clearly began to manifest themselves when the Stage 2 MU attestation period began in 2014. Many healthcare providers believed the leap from Stage 1 to Stage 2 MU was much too severe — particularly the criteria surrounding patient engagement. Providers also began to cite poor software usability and lack of interoperability as clear roadblocks to achieving many of the Stage 2 MU requirements.
When attestations for Stage 1 of the EHR Meaningful Use (MU) program began in 2011, it seemed like the healthcare industry was on the right path to ushering in a fruitful digital era that would benefit clinicians and patients alike. However, recently, the train of EHR progress has started to come off the rails. Issues clearly began to manifest themselves when the Stage 2 MU attestation period began in 2014. Many healthcare providers believed the leap from Stage 1 to Stage 2 MU was much too severe — particularly the criteria surrounding patient engagement. Providers also began to cite poor software usability and lack of interoperability as clear roadblocks to achieving many of the Stage 2 MU requirements.
Providers became increasingly vocal about these obstacles, and Stage 2 attestation rates were shockingly low. In an effort to appease providers, CMS made some key concessions to the Stage 2 criteria — concessions that are not viewed as positive by many healthcare industry stakeholders.
For example, CMS extended the time doctors, hospitals, and tech companies have to meet EHR requirements, slashed how much data they would have to collect, and reduced the number of patients that need to access their EHR data from five percent to just a single person. Patient advocacy groups see these changes as huge steps backward in providing patients with easy access to their personal health data.
Criticism of the MU program continued when the proposed rule for Stage 3 MU was released in early April. Beth Israel Medical Center CIO (and health IT industry thought leader) John Halamka, MD publically criticized the rule, calling it “431 pages of the kitchen sink.” Halamka says the current thresholds proposed in Stage 3 MU are much too high. In his opinion, the rule needs to be rewritten from scratch and “wildly slimmed down.”
The uncertainty surrounding EHRs and the MU program has prompted some states (most recently Minnesota) to allow healthcare providers to opt out of using the technology altogether. None of this looks promising if you ask me. Is the MU program in need of an overhaul? Undoubtedly. Is EHR software where it needs to be to help healthcare providers achieve the Triple Aim? Decidedly not. However, the answer to this dilemma can’t be to revert to paper.
Digitizing health information is essential to identifying trends, improving population health management, and ultimately moving our healthcare system forward. Perhaps the federal government has been over-prescriptive in its effort to help the industry achieve this goal. Nevertheless, this should continue to be our ultimate objective. From where I sit, one major hurdle needs to be overcome to bring EHR technology to the next level — interoperability. Intense focus needs to be placed (at either the federal or industry level) on developing universally accepted standards that enable EHR interoperability. Once we can seamlessly share data among EHR systems, many of the other issues surrounding the technology will resolve themselves.
When attestations for Stage 1 of the EHR Meaningful Use (MU) program began in 2011, it seemed like the healthcare industry was on the right path to ushering in a fruitful digital era that would benefit clinicians and patients alike. However, recently, the train of EHR progress has started to come off the rails. Issues clearly began to manifest themselves when the Stage 2 MU attestation period began in 2014. Many healthcare providers believed the leap from Stage 1 to Stage 2 MU was much too severe — particularly the criteria surrounding patient engagement. Providers also began to cite poor software usability and lack of interoperability as clear roadblocks to achieving many of the Stage 2 MU requirements.
