As Stage 2 of meaningful use (the federal Health Records Incentive Program) is upon us, implementation progress appears to be getting off to a ‘slow start.’ Medical providers who satisfied Stage 1 demands are slowly proceeding to Stage 2.
There are a variety of reasons for many of the roadblocks to a fast start. Unfortunately, hard data of the slowness of getting ‘off the starting line’ is not yet available, still several months into the future.
There is some evidence of the conditions influencing this slow start. From a ‘glass half full’ view, at least Stage 2 progress is happening. It does appear, however, that many of the integral components may have underestimated the demands of a successful migration from Stage 1 to Stage 2.
Primary Issues Fueling Slow Start for Stage 2 Transition
Transitioning from Stage 1 to Stage 2 meaningful use involves some challenging issues that providers and payers must overcome. There is, however, one overriding factor facing all physicians and practices.
- Medical providers must ‘juggle’ numerous healthcare reform issues at the same time, causing ‘detours’ in the transition to Stage 2. If there were one solitary issue, migration to Stage 2 would proceed faster, but multiple issues, involving new EHR requirements, ACA provisions and pay for performance (P4P) demands, needing to be addressed simultaneously are slowing the process.
Unfortunately, there are also companion issues causing further ‘bumps’ in the road to Stage 2.
- Software vendors face tight deadlines in bring their EHR capability to satisfy Stage 2 standards and guidelines.
- Interoperability levels required by EHR standards remain a problem for some vendors.
- Lack of clarity of appropriate testing methods for appropriate usability and compliance of EHR software continues to hold back faster migration to Stage 2.
While some observers and providers continue to question the entire meaningful use initiative for viability and sustainability, more acceptance and agreement is building for its virtues, including its potential ability to make healthcare reform a positive experience. Whether this growing approval level can be maintained over the long-term is a question awaiting an answer.
Solutions for Faster Stage 2 Transitions Are Few
Smoothing and speeding the migration to Stage 2 meaningful use levels is not a problem that inspires numerous solutions. Skeptics can point to the apparent sufficiency of time periods for transition planning between the first stage of meaningful use guidelines (2011) to Stage 2 implementation (2014-2015), leaving little room for empathy. However, the seemingly constant delays in implementation deadlines created more questions than answers in how to streamline the transition to more complete meaningful use standards.
Yet, many physicians support meaningful use, as a viable healthcare reform factor. As one experienced provider says, “I really look at this as an opportunity to get off the hamster wheel.” This physician also states that he has grown ‘tired’ of the disorganized environment pervading healthcare in the past.
Before EHRs, a physician could recommend ad nauseam that a patient have a mammogram, MRI or other test, without knowing if the patient ever had the procedure. EHR standards encourage the provider to order the test—and referral—electronically to the appropriate specialist or imaging facility.
If test results are not received, the physician can discover if the test took place. After learning the truth, the provider can take appropriate action to remedy an unsatisfactory situation.
Supporters of meaningful use initiatives want the process to be successful. Since the project is here and appears to be more firmly established, it is time for the majority of providers to get aboard. If this result happens, it should be its own solution for faster transitions.
Implementation delays will still occur. Installing certified EHR software is the beginning, not the end. Providers and staff must develop the habit of using the software and procedures that become second nature to all. This can only happen over time, but the time to begin is now. The sooner you begin, the sooner you benefit from the results.