Improving stage 2 meaningful use rules: Groups offer advice

Healthcare industry leaders offered their support of the proposed rules for stage 2 of meaningful use and electronic health record (EHR) systems in a series of submitted comments-provided more clarification and flexibility are added.

In comments submitted with 98 state and specialty medical societies, the American Medical Association (AMA) says it supports widespread EHR adoption and use by physicians. The group questioned, however, whether successful physician participation is possible in light of the cumbersome criteria proposed.

The AMA recommends several changes to the rules, including:

creating more flexibility for meeting measures,

incorporating more focus on measures that are within physicians’ control,

eliminating back-dating of the meaningful use and quality program requirements, and

establishing an appeals process for both programs.

“Overall, the proposed stage 2 requirements need to provide more flexibility to foster widespread EHR adoption,” says AMA Board Chairman-elect Steven J. Stack, MD. “Physicians are at varying stages of implementing health [information technology] into their practices and should get credit for making a good faith effort to meet the meaningful use requirements.”

Among other groups signing the letter with the AMA were the American College of Osteopathic Family Physicians, the American College of Osteopathic Internists, the American Osteopathic Association, and the Medical Group Management Association.

The American Health Information Management Association (AHIMA) filed two letters in response to stage 2 meaningful use, one with the U.S. Department of Health and Human Services (HHS) and another with the Office of the National Coordinator for Health Information Technology.

AHIMA says a more “consistent approach to nationwide interoperability” is needed and that the definition of a base EHR should be expanded to include the ability to produce a health record for legal, business, and disclosure purposes.

AHIMA says that it supports many of the stage 2 meaningful use and EHR proposals but stresses the need for consensus-based quality measurement reporting and consistency for all federal programs whose requirements overlap with meaningful use.

Comments submitted by the Healthcare Information and Management Systems Society contain several suggestions for the proposals, including:

the addition of a 90- to 180-day reporting period for year 1 of stage 2 in 2014;

a protracted timeline for meaningful use stage 2 to ensure that providers and vendors have the time they need to prepare for the transition;

reconsideration of a rule that requires providers currently in stage 1 to meet all of the new criteria changes to stage 1 by 2014.

Other suggestions include encouraging use of mobile technologies to support patient engagement and additional alignment between federal and state quality reporting requirements.

The Certified Commission for Health Information Technology (CCHIT) also made several recommendations, including developing standardized testing tools to assess the ability of EHR technology to transmit health data, and developing common criteria for eligible providers and eligible hospitals to avoid confusion. CCHIT also suggests using a standardized tool to ensure that clinical quality measures are EHR ready, tested; that EHR modules be certified to the full set of existing security criteria; and that vendors be given a 180-day period in which to test newer versions of code sets when they are adopted.

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