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Stage 2 Meaningful Use Tour: From DC to Vegas and Back

by Lauren H. Fifield, Senior Policy Advisor

The 2012 HIMSS Convention seems so long past, yet it was only last week. Or was it last month? Either way, one thing stands out through the fond memories of smoky blackjack tables, icy cocktails and bad food: the HIMSS Flavor of the Year was the federal government, with lots of Meaningful Use.

Every time I turned around, it seemed there was a familiar face from ONC (Office of the National Coordinator of HIT) or CMS (Centers for Medicare and Medicaid Services) standing there: engaged, accessible and ready to explain something I should know. This massive health IT sales and marketing extravaganza (with its crazily lopsided ratio of sellers to buyers) felt like a rather large stage for the feds to explain how they plan to steer the HIT ship.

… Was this reality or were my DC visits just getting to me? Luckily, my inner nerd took home a few copies of the HIMSS12 Daily Insider newspaper. I dug them out, paged through and voila! Proof that I was not imagining things!

February 22 headline, above the fold: Stage 2 announcement expected today

Then, for effect, February 23 headline, again above the fold: Meaningful Use Stage 2 READY FOR PRIMETIME

Indeed, the feds had arrived. And if the number of CMS calls I’ve eagerly awaited and ONC-proposed standards I’ve spent hours contemplating are an indicator, it appears they’re here to stay for a while.

Among the post-HIMSS, government-related issues creating buzz in our world and on the Hill: the ICD-10 timeline re-examination, originally announced by Acting Administrator Marilyn Tavenner in February. Since then, industry stakeholders have weighed in with a variety of opinions, ranging from “Viva la delay!” and “Keep pushing forward, we’ve invested so much already” to “We might as well move to ICD-11”. There are even sites dedicated to stakeholder feedback on the implementation timeline. But CMS has remained quiet.

The Recent EHR Kerfuffle

Another attention-getter is a recently released study featured in Health Affairs: “Giving Office-Based Physicians Electronic Access to Patients’ Prior to Imaging and Lab Results Did Not Deter Ordering of Tests.”

Here are a few references and responses I recommend:

My biggest takeaway from all this had nothing to do with the study or its conclusions: After my friends and family emailed me about the study, I realized that health IT may not be a household topic yet, but it’s finally entering the space of common knowledge. How ‘bout that? Maybe they will ask me about Meaningful Use at Thanksgiving dinner …

New Measures and Standards

Finally, the ONC and CMS gave us two notices of proposed rulemaking (NPRM) on EHR standards and certification criteria and the Stage 2 Meaningful Use measures, respectively.

Since the notices were released in February and subsequent published in the Federal Register on March 7th, my brain has been swimming with measures and standards. Here are a few takeaways at a glance:

  • While there are some unexpected items, there aren’t too many surprises as the ONC and CMS consistently took direction from the HIT Policy and Standards Committees
  • In the Meaningful Use Stage 2 NPRM, there is an increased focus on patient engagement, clinical decision-making tools (more Clinical Quality Measures and Clinical Decision Support requirements) and health information exchange
  • We’ll no longer refer to certified versions of health IT by stage—instead we’ll have the “2011 Edition” and “2014 Edition”
  • The implementation of Stage 2 Meaningful Use will be delayed to 2014.  This delay only affects providers who adopted Meaningful Use in 2011, as those providers will demonstrate Stage 1 criteria for 3 years (2011-2013) before moving to Stage 2 in 2014. The delay does not affect the incentive payment schedule.
  • Except for 2011 MU adopters, providers will report on measures over a 90-day period in their first year and over a full year thereafter. Additionally, aside from 2011 adopters, eligible providers will always perform Stage 1 for two years, followed by two years of Stage 2 and then onto Stage 3. I hadn’t fully understood these adoption timelines, so I wanted to emphasize them.

Want a more in-depth review?  Then, please join me for a live webinar next Wednesday, March 21 at 12:15 p.m. ET. (Register here!) In the meantime, this Meaningful Use Stage 1 & 2 comparison from The Advisory Board Company is helpful and you can find the rules on the Federal Register— here’s the Stage 2 NPRM and Standards and Certification NPRM.

We’ll continue to provide updates about the rules and our opinions. If you’re an athenahealth client, we can chat about all things government at our annual User Conference at the beginning of April. And, as always, we invite your thoughts right here on the blog.

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