Meaningful Use Timeline
All four people testifying expressed concerns about the timeline of the Meaningful Use stages and suggested extending each stage to three years from two years. Pressure to achieve Meaningful Use standards could either rush implementation or cause hospitals to drop out of the program, said John Glaser, CEO of Health Services at Siemens Healthcare.
"We are rushing through the steps without adequate time to ensure the resulting standard implementation guidelines actually work," he said.
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The existing timeline adds increased pressure on rural hospitals that are already struggling to keep up, said Marty Fattig, CEO at Nemaha County Hospital in Nebraska. Health IT vendors aren't as readily available to rural hospitals for implementation and maintenance because there isn't as much money to be made there, and rushed implementation can hurt patient safety.
Challenges Facing Rural Hospitals
The challenges facing rural hospitals were repeatedly addressed in the testimony. Due to their smaller size and geographic location, there are specific constraints causing rural hospitals to lag behind their urban counterparts when it comes to IT advancements.
Rural hospitals have limited cash flow and long-term capital for EHR implementation and maintenance. Many lack a skilled workforce as highly trained physicians and IT personnel are leaving for higher salaries at larger hospitals or companies. There are a limited number of vendors willing to work with small hospitals because there isn't as much money to be made at small hospitals compared to larger ones. This delays the implementation and maintenance of EHR systems.
"There is a real risk of a two-tier 'have' and 'have not' system," Glaser said.
A solution could be additional support for rural and critical access hospitals, either through incentives specifically for those hospitals, or through a grant program.
Electronic Sharing Of Medical Records
Health records not only need to be digitized, but they also should be accessible and sharable if they're going to spur a big improvement of quality and cost of care. In order to prioritize the electronic sharing of health records, the government can advance the requirements and expectations for standards adoption and collaboration with the private sector, said Janet Marchibroda, director of the Health Innovation Initiative at the Bipartisan Policy Center in Washington. This collaboration would include the development of a national strategy for electronic sharing that would raise awareness of the benefits.