Who's to blame for Stage 2's slow start?

It would have been a pleasant surprise to hear that the transition from Stage 1 to Stage 2 of the Meaningful Use program, after all of the hoopla, was going well.

Unfortunately, that's not the case at all.

Stage 2, in fact, is off to a very slow start. The Centers for Medicare & Medicaid Services reported this week that only 50 eligible professionals and four eligible hospitals have attested to Stage 2 of the Meaningful Use program in the 2014 reporting year. 

We're more than halfway through the reporting period for hospitals, a third of the way for professionals. 

Providers, vendors, Congress warned about this for months. Just because almost 95 percent of hospitals have registered for the Meaningful Use program doesn't mean that they can meet the higher bar set in Stage 2.

Officials from the Office of the National Coordinator for Health IT even alluded to the disparity between EHR adoption and Stage 2 readiness the day before CMS revealed the numbers, although they were careful not to say so expressly. In a blog post, Matthew Swain, a program analyst for ONC's Office of Economic Analysis, Evaluation and Modeling and Erica Galvez, ONC's Interoperability and Exchange Portfolio Manager, noted that "significant work remains" in heath information exchange, and that ONC anticipated that exchange of care summaries will increase as hospitals move to the 2014 edition of certification criteria (meaning that hospitals aren't there yet).  

They also admitted that only 10 percent of hospitals could provide patients with the ability to transmit information from their medical record to a third party. A deeper dive into ONC's data reveals that only about one-fourth of hospitals have the ability to enable patients to download information from their electronic health record. These are fundamental tenets of Stage 2.   

It doesn't really matter who's to blame. In part, it's the vendor community, which, even with good intentions, just couldn't meet the timeline. In part, it's the providers, who could have prepared more, adopted earlier and had a better attitude. And in large part, it's the government, which--unless Stage 2 gains momentum--has inadvertently set providers up to fail.

That's a loss not only of Meaningful Use incentives, but Medicare reimbursement revenue.

What should be done now? Sit back and hope for a surge in attestation in the latter part of the reporting period? Or does the industry need to be bailed out with another quick fix, like the delay of ICD-10?

Either way, some providers will be penalized, the decision will be politicized and controversial, and some of the big issues--like EHRs and patient safety--will be left unaddressed.

Shocker. - Marla (@MarlaHirsch and @FierceHealthIT)