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Health IT Group Debates Meaningful Use Reporting

Policy committee's quality workgroup urged to tread lightly in mandating stages 2 and 3 electronic health record requirements.

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The Health IT Policy Committee's quality workgroup should take a less-is-more approach to developing meaningful use stage 2 and 3 reporting requirements, according to committee member and Epic Systems CEO Judy Faulkner.

"I am nervous that the government is going to get into the EHR (electronic health record) design business," said Faulkner, who spoke following the workgroup's presentation to the full committee. "In many cases, Group A likes something, but Group B doesn't, and perhaps Group C doesn't like it either -- I worry that we are becoming Group A and expecting Groups B, C, and D to like what we did."

Faulkner also said she was concerned about the burden meaningful use's stage 1 quality reporting requirements are already placing on EHR vendors. "If you have a vendor who is in good shape, they still need 7,000 hours of work," to make the necessary changes.

She also noted that tweaking software is just the beginning of what vendors must do in response to the requirements -- after a rewrite, they must go back to their customer base and either retrofit the software currently in use or initiate a complete upgrade. "That's a lot of time -- development, testing, and retrofitting -- my feeling is that we need to be careful about these committees not becoming the design committees for what the country will do. We must try to keep our requirements more general so they can do it their own way and have it work."

The quality workgroup -- chaired by national coordinator for health IT David Blumenthal, MD, and co-chaired by David Lansky, president and CEO of the Pacific Business Group on Health -- is charged with providing recommendations on clinical quality measures for stage 2 and 3 with a focus on meaningful use; ensuring that the measures are appropriate and applicable to a broad range of providers; and requiring that each measure use data that can be feasibly collected within the EHR.

Areas the workgroup will be looking for measures include: patient and family engagement; population health/public health; safety; care coordination; overuse/underuse/appropriate care; disparities; and patient-focused episodes of care.

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