Sure, Stage 2 Meaningful Use Regulations Are Great. That’s Why Providers Want A Two Year Delay In Their Implementation.

Fierce Health IT reports that “nearly 50 of the nation’s most influential provider organizations–including the College of Healthcare Information Management Executives, the American Medical Association, the American Hospital Association and the Medical Group Management Association–are asking for a front-end extension to Meaningful Use Stage 2…” In fact, they sent a letter directly to U.S. Department of Health & Human Services Secretary Kathleen Sebelius expressing just that. Let’s sum up the demands of these agencies, which combined amount to a staggering portion of the entire healthcare industry.

    1. A timeline extension through 2015 granted to providers so they can actually implement the 2014 Edition Certified EHR software and meet Stage 1 and 2 requirements (i.e. these new requirements are so amazing that we’ll need more time to actually adhere to them)
    2. Make Meaningful Use requirements more flexible so that “as many providers as possible” can benefit from the program (i.e. these requirements are so good that not enough people will be able to enjoy the benefits of the program)

You can read the full letter to Sebelius here. Here’s our favorite excerpt.

“Over the next seven months, more than 5,000 hospitals and 550,000 eligible professionals must adopt the 2014 Edition of Certified Electronic Health Record Technology (CEHRT) and meet a higher threshold of Meaningful Use criteria. Failure to do so will not only result in a loss of incentive payments, but also the imposition of significant penalties. With only a fraction of 2011 Edition products currently certified to 2014 Edition standards, it is clear the pace and scope of change have outstripped the ability of vendors to support providers. This inhibits the ability of providers to manage the transition to the 2014 Edition CEHRT and Stage 2 in a safe and orderly manner.

“We are concerned this dynamic will cause providers to either abandon the possibility of meeting Meaningful Use criteria in 2014 or be forced to implement a system much more rapidly than would otherwise be the case. The first choice limits the success of the program to achieve widespread adoption of EHR, while the second is highly disruptive to healthcare operations and could jeopardize patient safety.”

Line by line, let’s look at red tape miring the situation:

1.) Failure to [meet a higher threshold of Meaningful Use criteria] will not only result in a loss of incentive payments, but also the imposition of significant penalties.

Okay, so the government slaps on some self-aggrandizing idealism i.e. Meaningful Use, and forces hospitals to upgrade already clunky technology, so that they themselves can stand before the public and say, “Look! We fixed healthcare.” Fact is, this isn’t fixing healthcare. One of the key problems with healthcare is that IT IS A SUBSIDIZED INDUSTRY THRIVING ON COLLUSIVE PRICING. It’s in the nature of the beast: people don’t generally plan on needing treatment (primary care, they can, and should, but hospital trips are usually not planned in advance). As a result, prices are arbitrarily set, and can fluctuate widely from region to region. Oh, and now if providers don’t adhere to more “rigorous standards” for Meaningful Use they will face tax penalties. Who’s going to pay for these tax penalties? Most likely it will be passed on to unknowing consumers.

2.) With only a fraction of 2011 Edition products currently certified to 2014 Edition standards, it is clear the pace and scope of change have outstripped the ability of vendors to support providers.

Let’s paraphrase this for the organizations: dear government, we appreciate your idealism but it contradicts reality.

3.) We are concerned this dynamic will cause providers to either abandon the possibility of meeting Meaningful Use criteria in 2014 or be forced to implement a system much more rapidly than would otherwise be the case.

This is also called, ah-hmm, damned if you do damned if you don’t.

4.) The first choice limits the success of the program to achieve widespread adoption of EHR, while the second is highly disruptive to healthcare operations and could jeopardize patient safety.

This is a bit trickier, but let’s break this down carefully. First, the government adds more EMR specifications, to ensure that hospitals benefit, by willfully adding tools for doctors/patients to “benefit” (these EMR benefits are hotly contested, though). Now, after all of this EMR INTENT, the results might actually be LESS of said EMR INTENTION. This is what we call red tape. Where our government “works” at fixing something, so well, that it causes less of the thing to actually happen. Makes perfect sense, right? Wrong. Because the second result is even worse. Subsidies might motivate hospitals to implement regulation-complying machines, regardless of whether these machines ACTUALLY help. In fact, the concern is that due to their increased complexity, these machines could in rare cases COST LIVES (again, let’s not panic, everyone is not going to die because of a new EMR). Yet as rare as deaths may be, these new machines, with their gratuitous complexity, are definitely going to cause more headaches — for the docs adjusting to their use, and the patients on the other side.

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  1. Pingback: Sure, Stage 2 Meaningful Use Regulations Are Great… « Hippocrates Shrugged

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