CMS should respond more quickly to industry concerns

I'm sure that many providers grappling with the transition to the 2014 edition of certified electronic health record technology are breathing easier now that the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT have proposed a new rule to accept the 2011 edition for an additional year. CMS and ONC finally acknowledged in the proposed rule--announced May 20--that vendors have not had sufficient time to make the requisite coding changes to move to the 2014 edition and that EHR certification bodies have had a backlog in certifying the upgraded products, leaving the hapless providers in the lurch.

It's also a nod to the fact that, through March, only four eligible hospitals and 50 eligible professionals have attested to Stage 2 of the Meaningful Use program in the 2014 reporting year.

I don't mean to be a cynic, but what took CMS and ONC so long to grant this reprieve? The agencies have known for a long time that the healthcare industry was struggling to transition from Stage 1 to Stage 2 of Meaningful Use. Why did all of those pleas for flexibility and support go unheeded for so long? Was it wishful thinking on CMS' part that if it kept the "pedal to the metal" that the industry would catch up? Or was it finally the hard, cold evidence of the paltry number of Stage 2 attesters that finally did the trick?

It's the same issue that I have with this past week's CMS eHealth Summit.  

It's certainly laudable for CMS to hold these eHealth Summits. Niall Brennan, acting director of CMS' Offices of Enterprise Management, in his welcome remarks noted that "these discussions are part of an important dialogue with CMS, professionals and industry," and that CMS hopes to "gain insights from the panels today."

But much of the presentations reiterated information that CMS already knows.

For instance, one panelist pointed out that EHRs reduced face-to-face interactions with patients, that EHRs store data in too many different ways and that having to hire scribes eliminates the cost savings of EHRs. Another noted that providers needed to use more than a portal to engage patients and that health information exchanges need to be "hassle free". Kevin Larsen, medical officer for Meaningful Use at ONC, reported that the agency was working on standards and aligning measures.

In another panel, members of the American Health Information Management Association reported that the association was going to provide resources and tools to help the industry manage their electronic information. They revealed the results of the first benchmark study on information governance, pointing out that most healthcare organizations are woefully deficient when it comes to protecting and managing their data. The numbers were enlightening, but again not surprising. After all, HIPAA has been around for 18 years and people still aren't adequately protecting patient health information.

CMS has many items on its plate. It also has finite resources.

So wouldn't it be better to reduce some of this redundancy to enable more productivity? Did CMS really have to wait this long to grant providers a reprieve on the 2014 edition of certification criteria? How many times does CMS need to hear the same complaints about EHR design and Meaningful Use requirements before responding?  

At some point the "insights" and "dialogue" need to become action items. - Marla (@MarlaHirsch and @FierceHealthIT)

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