Note to government: Slow down on health information technology

A broad range of healthcare industry stakeholders believes the federal government is overreaching in areas affecting health information technology (HIT). Whether it’s the impending stage 2 meaningful use requirements, the 5-year strategic plan of the Office of the National Coordinator for Health IT (ONC), or the proposed rules for accountable care organizations (ACOs), the message is the same: You’re moving too far too fast.

Regarding the stage 2 meaningful use requirements for electronic health records (EHRs), a work group of the Health IT Advisory Committee that is slated to recommend stage 2 criteria to the full committee on June 8 has discussed postponing the starting date of those requirements from 2013 to 2014. Alternatively, the work group said, doctors and hospitals might be required to show meaningful use for only 90 days in 2013, instead of for the full year. The Centers for Medicare and Medicaid Services (CMS) will make a final decision after receiving the committee’s recommendations.

Whether or not they’re postponed, the stage 2 criteria might include the following:

• Some criteria that are optional in stage 1, such as incorporating lab results into EHRs as structured data for 40% of patients, could become core requirements.

• Physicians might have to demonstrate the ability to exchange secure online messages with at least 25 of their patients.

• Hospitals might have to double the percentage of patients for whom medication orders are placed through computerized physician order entry from 30% to 60%.

The American Medical Association and 38 other medical organizations have sent a letter to ONC complaining that some of the stage 2 and 3 criteria under discussion might create insurmountable barriers to meaningful use for many physician practices. The societies particularly objected to requirements that practices collect data that physician practices don’t normally gather.

The College of Health Information Management Executives (CHIME) said one reason the plan will not work is that it’s unrealistic to move on to stage 2 of meaningful use before at least 30% of healthcare providers have met the stage 1 criteria. CHIME, which represents chief information officers of hospitals, also called for ONC to better define privacy and security standards in health information exchanges (HIEs) before HIEs become widespread.

CHIME also criticized the proposed rules on ACOs for, among other things, requiring that 50%  of primary care doctors participating in ACOs show meaningful use of EHRs. CHIME said that would be unachievable in many organizations. The association also said that the provision allowing Medicare beneficiaries in ACOs to prohibit sharing their Medicare claims data with providers would make it difficult for the ACOs to improve the quality and lower the cost of care-the two main goals of ACOs.