CHIME 2015: Public health reporting, patient engagement top Meaningful Use concerns

Hospital CIOs discussed concerns and areas of priority for the updated Meaningful Use Stage 3/2015 modification rule Thursday morning at the College of Healthcare Information Management Executives forum in Orlando.

Liz Johnson (pictured right), CIO and vice president of applied clinical informatics at Tenet Healthcare in Dallas, emphasized worry over misleading public health reporting flexibility options for Stage 2 relayed by federal officials.

Johnson explained that one of the expectations outlined by federal officials was that hospitals would not be asked to do anything in 2015 not already required, but that they also would be given a heads up for new modifications that would be required in 2016.

"Everything else but public health measures was given an alternative exclusion," she said. "With public health measures, if you're in Stage 1, you have to meet two of four measures; if you're in Stage 2, you have to do three of four. The difference is, in the past, once you met one and you had an exemption for another because you were not able to do it--say your state is not able to exchange immunizations or collect immunizations--you were done. Now, what needs to happen between now and the end of the year is, you need to exhaust all possibilities."

For example, Johnson continued, if a hospital has met three measures for Stage 2, but one of those is an exemption, it needs to go out and look at the fourth option and either get on board with it or exhaust it.

"That is a very short timeline," she said. "We clearly understood that coming in 2016, this was going to be part of the requirement, but in 2015, we're already two weeks into the final 90 days. We need time to find appropriate registries to get letters of intent, or letters of contract or letters of participation with them."

Pam McNutt (pictured left), senior vice president and CIO at Dallas-based Methodist Health System, expressed concern over the 365-day reporting timeline for Stage 3, as well as the increasing patient engagement threshold.

"We've found in the past, and are going to continue to find, that being a full year compliant is very difficult to do with new measures," McNutt said. "[And] the patient engagement threshold has been bumped up to 10 percent."

She also called the increasing transition of care threshold "troublesome."

"For us, honestly, we're throwing our CCDAs out into a black hole," she said. "We have Direct Messaging, we have people signed up; are they actually accessing these boxes and doing anything meaningful with it? No. I don't know, maybe this will encourage it, but it seems like it's rather high from where we are today."

Johnson also spoke about the importance of complying with the security assessment portion of Meaningful Use, stressing that CIOs can't simply slap a new date on an old report and expect that auditors won't take notice.

"We actually acquired a hospital and when we were looking at their data for Meaningful Use, we looked at their security assessment for the second year and it was one of those where they just put a new date on the top; we gave back the money," Johnson said. "We didn't wait for somebody to come tell us to give back the money. We gave back the money because we knew it would not pass if we were audited."

She added that CIOs should not take the 60-day comment period for the rule lightly, particularly if they have concerns.

"It is your right and your responsibility to comment," she said. "If you don't comment … at my house it's called 'don't vote, don't [complain].' Don't comment? Don't come back and tell us it didn't work out for you."