The American College of Physicians, in a letter addressed to federal health officials Thursday, says that the "very aggressive" timeline and "overly ambitious" objectives of Meaningful Use Stage 2 threaten to limit the success of the overall program.
In the letter--sent to U.S. Department of Health & Human Services Secretary Kathleen Sebelius, Centers for Medicare& Medicaid Services Administrator Marilyn Tavenner and National Coordinator for Health IT Farzad Mostashari--ACP Medical Informatics Committee Chair Peter Basch (pictured) adds that relying on "evolving and draft standards" and untested technology could create "unintended consequences" and "additional costs" for physicians.
"As Meaningful Use has become more prescriptive of certain workflows, it has become less relevant to internal medicine subspecialists," Basch writes. "We are concerned that subspecialists may not adopt and fully realize the potential of certified [electronic health record] products if the requirements of the program do not allow for the unique workflows required by some subspecialists."
The letter outlines five areas of concern for ACP members, including:
- The Stage 2 timeline: ACP recommends an extension of at least one year or "perhaps even longer" for Meaningful Use Stage 2. "The implementation of software by a practice does not mean that the practice is prepared to use it appropriately or to make the care process changes needed to accomplish the objectives," Basch says.
- Clinical quality measures: ACP believes that the clinical quality measures reporting process won't be ready in time for Stage 2. According to Basch, there hasn't been "sufficient time either for the new e-measures to be tested and validated, or for a determination if the output of the EHR systems is an accurate representation of the performance of the [eligible providers]."
- ICD-10 and physician quality reporting systems: The implementation of the former means that physicians will need new or updated EHR systems on Jan. 1, 2014, to comply with data collection requirements for the latter.
- Scoring Meaningful Use measures: ACP calls the "pass-fail" requirements "counter-productive." Basch says that a "partial scoring" or "tiered" system would be more fair and representative of what providers can realistically accomplish. "Not every measure is absolutely appropriate and of equal value to every practice situation," he adds.
- Planning for Stage 3: ACP believes that "deeming" should be the "preferred pathway" for most providers in achieving Stage 3 of Meaningful Use. "There are better ways for EPs to prepare for and to deliver better outcomes than logging activities that may or may not have direct impact on the quality, safety or value of care," Basch says.
ACP joins a chorus of other organizations and legislators in calling for changes to the Meaningful Use program. For instance, last month, the Medical Group Management Association asked HHS to extend reporting for Stage 2 by at least one year and delay the penalties to be imposed on providers who are not meeting the Meaningful Use requirements.
Meanwhile in July, the American Medical Association and American Hospital Association asked for an extension of each stage, a softening of the requirements and greater flexibility in meeting those requirements.
To learn more:
- read the ACP letter (.pdf)