Despite the Centers for Medicare & Medicaid Services' recently published Meaningful Use hardship exemption guidance, hospital CIOs who serve on FierceHealthIT's Editorial Advisory Board said that the incentive program will still put their organizations under tremendous pressure.
Linda Reed (pictured right), VP and CIO at Morristown, N.J.-based Atlantic Health System, called the information provided by CMS confusing in an email to FierceHealthIT.
"A larger concern are the eligible physicians," Reed said. "If you're not affiliated with a regional extension center, or perhaps an [integrated delivery network], many are thoroughly confused about dates, requirements and deliverables."
Reed added that navigating the current process around the Provider Enrollment, Chain and Ownership System is almost impossible.
Indranil Ganguly, VP and CIO at JFK Health System in Edison, N.J., also said the language from CMS was too vague.
"The hardship exemption could be claimed if the hospital was unable to implement Meaningful Use due to 2014 EHR certification delays, but [CMS] leaves it unclear as to what constitutes a delay," Ganguly (pictured left) said in an email correspondence. "A vendor delivering Stage 2 certified functionality today is not leaving a provider with much time to install, test and get adoption to the right level. Is that sufficient to qualify for an exemption?"
Both Reed and Ganguly said they plan to push to attest within the established timeframe, but will look into hardship options should vendor delivery issues persist.
Todd Richardson, senior VP and CIO at Wausau, Wisc.-based Aspirus, Inc., speculated that the exemption language was left vague because many situations were not considered.
"My assumption is that when the initial hardship language was developed, many of the scenarios that have now surfaced were not considered," Richardson (pictured right) said in an email.
For instance, Richardson said that his organization was heading successfully down the Meaningful Use path, only to discover that the vendor upgrade that helped them attest for Stage 1 was a "total disaster."
That upgrade, according to Richards, is "bringing those who implemented to their collective knees," and forcing Aspirus to convert all of its facilities--three hospitals and 14 clinics--to a new EHR system.
"With ICD-10 and the Meaningful Use deadlines staring us in the face, and if you look at your calendars, kicking off an install now … will certainly test our resolve over the next six months in order to be ready for the Oct. 1 ICD-10 date," Richardson said. "I'm seeing a 'hardship exemption' application somewhere in our future."
However, Stephen Stewart (pictured left), CIO at Henry County Health Center in Mount Pleasant, Iowa, called that proposition ambiguous, at best in an email to FierceHealthIT.
"Combine all this with ICD-10 in October, and we are all in for a wild ride in 2014."