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Health IT Stakeholders Find Meaningful Use Goals Aggressive

Electronic health record vendors, healthcare providers, and others say Stage Two and Three timelines, targets, and objectives are too demanding, according to a CCHIT survey.

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A poll that gauged the views of 468 health IT stakeholders shows that they view the proposed Stage Two and Three meaningful use objectives and measures as too aggressive when considering the work to be done, the targets to be met, and the timelines in which to achieve the stated goals.

The survey was sponsored by the Certification Commission for Health Information Technology (CCHIT), and was conducted to coincide with the Meaningful Use Workgroup of the Health IT Policy Committee's request for public comment on their proposed Stage Two and Three meaningful use objectives and measures.

Survey participants were made up of providers (36%), electronic health record (EHR) vendors (29%), and others (29%), and the results were summarized in a blog post by CCHIT chair Karen Bell.

The survey findings reflect concerns expressed by several other organizations, including the College of Healthcare Information Management Executives (CHIME), the American Health Information Management Association (AHIMA), and the Healthcare Information and Management Systems Society (HIMSS) EHR Association. These organizations have complained that the meaningful use regulatory schedule doesn't allow vendors and providers sufficient time to perform adequate quality assurance, obtain Office of the National Coordinator for Health Information Technology Authorized Certification Body (ONC-ACB) certification, and implement new software releases as they prepare to meet meaningful use Stage Two and Three criteria.

Bell said respondents rated the objectives and measures with respect to the ease of implementation -- both from the clinical workflow perspective and technological challenges.

At least one-third of the survey respondents said they considered the nine measures and objectives listed below to be too aggressive. Several were considered too aggressive by most of the respondents. All nine procedures are enhancements of existing Stage One objectives and measures, and reflect current experience in the field.

-- Syndromic Surveillance: Over 50% of providers and 40% of vendors and others felt that this was not ready to be a core measure for Stage Two, since public health agencies do not have an infrastructure to accept and analyze data. Syndromic, or clinical, surveillance refers to the electronic collection, analysis, and interpretation of health data about a clinical syndrome that has an impact on public health.

-- Drug Formulary Checks: The target of having drug formulary checks, which compare whether prescribed medications comply with health plan preferences, on 80% of patients seen was not considered reasonable, even for providers who are using an e-prescribing network to retrieve formulary information.

-- Medication Reconciliation: Respondents said few providers in Stage One are assessing all of a patient's medications to avoid medical errors such as drug omissions, duplications, dosing errors, or interactions. Respondents recommended making it core in Stage Two, but not increasing the percent of patients to which it applies (from 50% to 80%) until Stage Three.

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