US House Leaders Reaction To Stage 2 Meaningful Use Final Rule

Posted on by Frank J. Rosello

Leaders in the U.S. House of Representatives wrote a letter to the U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius on Thursday, October 4, 2012. The letter clearly states that HHS should suspend incentive payments to providers in the electronic health records program and delay penalties to those that do not integrate health IT until the federal department can define clear, interoperable standards.

The U.S. House Leaders believe that the Stage 2 Meaningful Use final rule released on August 23, 2012 from the Centers for Medicare and Medicaid (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) are “weaker” than the Stage 1 rules released three years ago.

Also See: Highlights And Reaction To The Final Rule For Stage 2 Meaningful Use

Another concern expressed in the letter was, “The Stage 2 final rule fails to achieve comprehensive interoperability in a timely manner, leaving our healthcare system trapped in information silos, much like it was before the incentive payments.”

The lawmakers also called on HHS to expect more from meaningful users. “For example, requiring a summary transfer when a patient moves to a different care setting in electronic format only 10% of the time is insufficient,” they wrote, adding that also only requiring radiology and laboratory orders to be electronic 30% of the time and medication reconciliation and electronic prescribing to happen 50% of the time is “woefully inadequate.”

Doesn’t everybody have to crawl before they walk and walk before they run?

It is clear that the lawmakers that wrote the letter do not have clear picture when it comes to the progress being made in HIE’s at the state level and the interoperability of EHR systems. I also find it very interesting that there is no mention in the letter of HIPAA compliance and the ongoing efforts to secure protected health information (PHI) data.  Effectively securing patients PHI data while electronically exchanging and achieving true interoperability is at the core shaping the direction and progress being made in healthcare IT.  Securing patients data is not just a compliance play, it’s the right thing to do for patients.

In addition,  all medical organizations and physicians enrolled in one of the CMS EHR Incentive programs views the incentive payments as a strong business case for EHR adoption and meaningful use.  At the same time, they also understand that the technology is going to help providers deliver more efficient and accurate care to patients which will improve patient outcomes. Furthermore, organizations that have achieved Stage 1 meaningful use and have been paid their first incentive payment understands that meaningful use is about more than just collecting and reporting data.  The drive towards universal adoption of EHR technology and achieving meaningful use is about building an infrastructure that will enable continuity of care and secured seamless transfer of patient information.

ONC chief Dr. Farzad Mostashari also had something to say about the lawmakers letter.  Addressing a conference of chief medical information officers in Chicago, when asked about the letter, said that his office was initially created by executive order by President George W. Bush and has ever since “has enjoyed bipartisan support.” Dr. Mostashari  went on to say, “a few weeks before an election is still the silly season.”  “That’s what they call it in Washington.”

Seventy percent of hospitals have registered for the EHR incentive payments, and 55% have received their first-year payments. Healthcare organizations have made plans and are looking for that money to be paid. Dr. Mostashari also said, “This is a commitment that we cannot lightly pull back.” “It’s not must, ‘you promised,’ it’s the importance of it.” But, he said, rescinding the program would require legislation that would have to pass both houses of Congress, be reconciled, and “the president would have to sign it.” “Sometimes it’s useful to remember how American government works.”

Earlier, in his formal presentation, the ONC chief noted there has been criticism about the lack of interoperability, but he defended the government’s effort, first focusing not only on adoption, but also on development of IT standards that made interoperability technically possible. He closed by saying the criteria for attesting to Stage 2 meaningful use is all about interoperability.

Frank J. Rosello

is CEO & Co-Founder of Environmental Intelligence LLC.

Environmental Intelligence, LLC, is a complete, full-service healthcare IT solution provider. With a team having more than 10 years of proven clinical expertise in delivering end-to-end health IT solutions, Environmental Intelligence provides medical practices and facilities onsite expert IT consulting, installation, and implementation that is focused on physicians, their patients, and the quality of their care.

Contact us to learn more about our Physician Focused – Patient Driven® approach to Health IT.












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