Hospital CIOs: Meaningful Use flexibility rule 'too little, too late'

Despite the Centers for Medicare & Medicaid Services' efforts to add flexibility to the Meaningful Use incentive program through a finalized rule announced last Friday, many hospital CIOs on FierceHealthIT's Editorial Advisory Board remain frustrated about what lies ahead.

Linda Reed (pictured right), vice president and CIO at Atlantic Health System in Morristown, New Jersey, called the rule--which allows eligible providers to use 2011 edition certified electronic health record technology (CEHRT), or a combination of 2011 and 2014 edition CEHRT to meet Meaningful Use for an EHR reporting period in 2014 for the Medicare and Medicaid EHR incentive programs--"too little, too late" in an email to FierceHealthIT.

The rule also imposes a year-long reporting period for Stage 2 in 2015, despite pleas from several provider groups--including the College of Healthcare Information Management Executives, the Medical Group Management Association and the American Hospital Association--to allow a 90-day reporting period in 2015, as well as in 2014.

"The issue for us is not the upgrade but the View, Download and Transmit and transition of care requirements," Reed said. "The whole Direct process was a mess as the vendors used different processes and even within vendors there was not clarity as to how to work with direct. The best thing they could have done for us was to shorten the second Stage 2 reporting period to 90 days."

Indranil Ganguly (pictured left), vice president and CIO at JFK Health System in Edison, New Jersey, agreed, saying he didn't think the government fully understood the challenges being faced by providers aggressively pursuing Meaningful Use.

"It will be interesting to see what impact this has on the program in terms of organizations deciding on whether or not to continue to pursue Meaningful Use," Ganguly told FierceHealthIT in an email.

Donna Staton, vice president and CIO at Warrenton, Virginia-based Fauquier Health told FierceHealthIT that her facility's biggest challenge has been Transfer of Care summary utilization by other facilities.

"A lot of this capability is dependent on other facilities in our region and their capabilities," Staton (pictured right) said in an email. "Those are often skilled nursing facilities, and they are not as advanced in their ability to receive this information as part of their workflow."

Roger Neal, vice president and CIO at Duncan (Oklahoma) Regional Hospital told FierceHealthIT that depending on location, there are other hurdles to overcome, such as interfacing immunization and lab results with a state's department of health. Neal said the Oklahoma State Department of Health requires that each facility and provider validate at least three scenarios from their systems on the National Institute of Standards and Technology validator, regardless of EHR certification status.

"Many people do not do a lot of these test scenarios in-house," Neal (pictured left) said, via email. "Most rural facilities do basic lab results and immunizations and don't have the talent to work these interfaces and the NIST validation tool until three scenarios are met with zero errors. There is a giant roadblock trying to get any facility or provider in Oklahoma validated."

What's more, Neal said that getting cooperation on such efforts is next to impossible.

"OSDH does not have the resources to help anyone work through problems, so they kick you to the Centers for Disease Control and Prevention or the Office of the National Coordinator for Health IT for help, which results in you getting a 'read the guide' memo," Neal said. "It's very frustrating and won't be resolved any time soon. So, large blocks of Oklahoma providers are in trouble--including me--unless we can figure something out to meet the state qualification process."

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