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.

Healthcare has always been a highly regulated industry, but in the last few years requirements for implementing and documenting digital healthcare systems have been piling up so fast that IT organizations have little time for anything else -- including making sure the systems they already have in place are being used effectively. The InformationWeek Healthcare IT Priorities Survey of 322 technology pros at healthcare providers shows "meeting regulatory requirements" is the No. 1 initiative on participants' minds. Most of the other items at the top of the list, such as implementing or upgrading electronic health records (EHR) systems, are also largely driven by federal government requirements.

 "The priorities we're trying to deal with right now are those being mandated," says Randy McCleese, CIO of St. Claire Regional Medical Center. "We can't do anything else. We have put everything else on the back burner except for those things that absolutely have to be done."

Against the crushing wave of requirements, what's most neglected by IT organizations is optimizing how healthcare providers use all the technology they've bought of late -- "and we've been provided with a lot of functionality in the last three to four years," says McCleese, who's also chairman of CHIME, the College of Healthcare Information Management Executives. "We've put all this technology in place quickly to meet the requirements, but we have not had a chance to make sure it's working effectively."

On a scale of 1 to 5, with 5 a top priority, survey participants give regulatory requirements a mean rating of 4.5, and 65% rate it a top priority. Managing electronic medical records systems gets a mean rating of 4.2 and is a top priority for 53% of health IT pros.

The EHR vendors most frequently used, Epic and Cerner, appear to be cementing their market dominance. Thirty-seven percent of providers cite Epic as the EHR their organizations are implementing or planning to implement, up from 27% last year. Cerner is the choice of 22%, up from 16% last year. Yet the percentage of participants saying their EHR strategy is to rely on a "comprehensive system from a single vendor" is down slightly to 56%, compared with 62% last year.

The federal government encouraged EHR adoption with incentive payments, funded as part of President Obama's stimulus plan approved in 2010, as well as the threat of reduced Medicare reimbursement for organizations that fail to digitize. Incentives are tied to standards measuring "Meaningful Use" of EHRs, and that Meaningful Use program has progressed from requiring initial adoption of EHR in Stage 1 to a more ambitious set of requirements in Stage 2. Stage 2 went into effect this year, requiring capabilities to exchange electronic records with other institutions and to make records available to patients online. About nine of 10 providers say they're very or somewhat confident they'll hit the Stage 2 end-of-2014 deadline.

The Meaningful Use program also encourages the use of health information exchange technology, starting with the ability to exchange Direct Protocol messages, a type of secure email that can include structured attachments such as medical documentation to ensure continuity of care. However, grander plans to build state and regional HIE data hubs have stalled

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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,
User Rank: Author
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?
David F. Carr
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David F. Carr,
User Rank: Author
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.
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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