Why an MU2 Extension Isn't Enough

On Friday, CMS extended the deadline for meaningful use stage 2 attestation by one year, through 2016, with plans to begin stage 3 in 2017. According to a CMS blog post, the delay is partially in response to input from providers, healthcare associations, electronic health record vendors and other industry stakeholders.

The extension can be seen as a response to requests to modify the meaningful use timeline from the Healthcare Information Management Systems Society, the American Hospital Association, the Medical Group Management Association, the American College of Physicians, several hospital CIOs and 17 U.S. senators.

However, several industry groups believe the change falls short of what is needed to ensure enough time for providers to fulfill the requirements and, more importantly, begin to meaningfully use their EHRs to facilitate data exchange and begin to monitor population health.

In a blog post, HIMSS Vice President of Government Relations Tom Leary notes the new timeline does not provide an extension for the first year of attestation. In an August letter to HHS Secretary Kathleen Sebelius, HIMSS had advocated for extending the first year of attestation to April 2015 and June 2015 for eligible hospitals and eligible providers, respectively, due to ICD-10, healthcare reform and other challenges that will be faced by providers in 2014. This would give providers 18 months to achieve the first of the two years needed to move on to stage 3.

"While we appreciate the government's response to stage 2 timing, the current timeline only allows 12 months" to attest to 2014 certification, Mr. Leary writes. "Given the challenges some providers, hospitals and vendors are experiencing upgrading to the 2014 certification, we still need the government to provide the 18-month window to attest to one quarter during year one of meaningful use stage 2." 

The College of Healthcare Information Management Executives also believes the timeline adjustment does not adequately address the large number of projects and deadlines facing providers. CHIME President and CEO Russell Branzell and Board Chair George T. Hickman wrote a letter Monday to Secretary Sebelius, reiterating their request for a start-date extension for stage 2.

"CHIME supports and is encouraged by the decision to extend stage 2 through 2016 and begin stage 3 in 2017. However, stage 2 start-date flexibility is required if our industry is to successfully address the IT-related goals your office has put before us," according to the letter.

Extending stage 2 through 2016 does not help providers in 2014, says Mr. Branzell. Late upgrades from vendors, the simultaneous transition to ICD-10, the cost pressures from healthcare reform — those will all still be there in 2014 when many providers would need to begin attestation. "What came out last week is a one-year delay to the start of stage 3," he says. "It does nothing to avoid the pressures of beginning on stage 2."

Rushing to install upgrades and redesign workflows inherently brings risks to patient safety when there's limited time to test the new systems or adequately train staff, says Mr. Branzell. "The patient safety concerns are very real, and we do not want to see them occur," he says.

Additionally, some providers may simply decide to wait to attest, slowing down the adoption of health IT among the nation's hospitals, the opposite of CMS' goal with the meaningful use program. "I've heard from numerous members that there is a real evaluation going on about whether they'll do meaningful use stage 2 in competition with ICD-10," says Mr. Branzell. "Several prominent health systems are delaying stage 2 based on the amount of time and resources needed to do it effectively."

More Articles on Meaningful Use:

Finding the Gaps: A Strategic Approach to Supporting Successful Meaningful Use Stage 2 Attestation
5 Things to Know About the MU Extension
CMS Proposes Extending MU2 Through 2016

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