Healthcare // Policy & Regulation
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5/19/2014
09:06 AM
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Healthcare IT Priorities: No Breathing Room

Regulatory requirements have gone from high priority to the only priority for healthcare IT.

in many places. About a quarter of survey respondents (24%) say their organizations aren't participating or planning to participate in any HIE. Among those snubbing this approach, 49% see "no business or medical need for it" and 24% say they're "waiting for vendors to solve interoperability issues first."

Meaningful Use and other federal programs, as well as the accreditation programs governing healthcare organizations, all come with a constellation of metrics that providers must gather and report.

Does the overall direction of the regulatory push make sense?

"I will give you a flat-out, unqualified 'yes,' " McCleese says. "Had it not been for Meaningful Use, we probably would still be struggling to find the funding to do electronic medical records. For the patient's sake, safety's sake, we have to get there."

This is a case of "be careful what you ask for, you might get it," McCleese says. After years of lobbying for the government to instigate change, "all of a sudden, we got it all at once. We really need 10 to 15 years, in my mind, to really absorb this. What we're being given is five years. Still, this is pushing us in the direction of where we, as an industry and for the patients, where we need to be."

John Halamka, CIO of Beth Israel Deaconess Medical Center and a well-known physician/technologist who has advocated for the digitization of healthcare data, calls Stage 1 "a tide that caused all boats to float. What's not to like?" However, Stage 2 has shifted the focus to "more prescriptive regulation" that has reshaped the workflow of healthcare and required EHR vendors to put many of their software improvement plans on hold in favor of meeting government dictates.

"You run the risk of being overly prescriptive," Halamka says. Confirming that "compliance takes more of my day than ever before," he hopes to see regulators shift to a greater emphasis on "what you must achieve and not necessarily how you must achieve it." That would create room for the best of both worlds, including "compliance and innovation at the same time."

While regulation of healthcare IT is hardly new, the burden has gotten worse in the last five years, says Larry Helms, CIO at Valley-Wide Health Systems, a network of physician practices in Colorado. "Our focus and our strategy have been sidetracked. We're distracted from the actual work we're trying to do, which is give the best patient care to our patients."

In addition to putting energy into Meaningful Use requirements, Valley-Wide is participating in the patient centered medical home (PCMH) program, which tries to improve quality and lower the cost of healthcare by emphasizing primary care and better coordination of care across providers. PCMH is another program promoted by the federal government, with incentives

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David F. Carr oversees InformationWeek's coverage of government and healthcare IT. He previously led coverage of social business and education technologies and continues to contribute in those areas. He is the editor of Social Collaboration for Dummies (Wiley, Oct. 2013) and ... View Full Bio

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David F. Carr
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David F. Carr,
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5/21/2014 | 10:29:31 AM
More flexibility from regulators on Health IT deadlines
How significant is this announcement to healthcare CIOs feeling overextended?

CMS and ONC Release NPRM Allowing CEHRT Flexibility and Extending Stage 2

Today, CMS and ONC released a notice of proposed rulemaking (NPRM) that would allow providers participating in the EHR Incentive Programs to use the 2011 Edition of certified electronic health record technology (CEHRT) for calendar and fiscal year 2014. 

The NPRM will grant flexibility to providers who are experiencing difficulties fully implementing 2014 Edition CEHRT to attest this year. The proposed rule would allow providers to use EHRs that have been certified under the 2011 Edition, a combination of the 2011 and 2014 Editions, or the 2014 Edition.

Beginning in 2015, all eligible providers would be required to report using 2014 Edition CEHRT.

2014 Participation Options
Under this proposal, valid only for the 2014 reporting year, providers would be able to use 2011 Edition CEHRT for either Stage 1 or Stage 2, would have the option to attest to the 2013 definition of meaningful use core and menu objectives, and use the 2013 definition CQMs.

Providers currently working on Stage 1 in 2014 would be able to demonstrate:
  • Stage 1 (2013 Definition) using 2011 Edition CEHRT, or using a combination of 2011 and 2014 Edition CEHRT; or
  • Stage 1 (2014+ Definition) using 2014 Edition CEHRT.

Providers currently working on Stage 2 in 2014 would be able to demonstrate:
  • Stage 1 (2013 Definition) using 2011 Edition CEHRT, or using a combination of 2011 and 2014 Edition CEHRT;
  • Stage 1 (2014+ Definition) using 2014 Edition CEHRT; or
  • Stage 2 (2014+ Definition) using 2014 Edition CEHRT.

Extending Stage 2
The proposed rule also includes a provision that would formalize CMS and ONC's recommended timeline to extend Stage 2 through 2016. If finalized, the earliest a provider would participate in Stage 3 of meaningful use would be 2017.
David F. Carr
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David F. Carr,
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5/20/2014 | 12:53:00 PM
What health IT requirements have been crowded out by regulatory requirements?
Do you agree that it's become difficult for healthcare organizations to set their own health IT agenda? What have you put on hold while scrambling to meet the requirements of Meaningful Use and other government programs?
Research: Healthcare IT Priorities
Research: Healthcare IT Priorities
Meeting regulatory requirements barely inched out managing digital patient data as the top priority for our 363 healthcare provider IT pros.
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