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Friday, January 17, 2014

Meaningful Use Stage 2 is off to a bumpy start

As reported on MedPage Today
Few Docs Ready for Stage 2 'Meaningful Use'
Jan 17, 2014, David Pittman, Washington Correspondent, MedPage Today

WASHINGTON -- Roughly one physician in eight has an electronic health record (EHR) system capable of supporting most requirements for Stage 2 of the "meaningful use" program, a government survey found.

Only 13% of office-based physicians reported an intention to participate in the EHR incentive program and had a system meeting 14 of the 17 Stage 2 core objectives, according to a report released this week from the CDC's National Center for Health Statistics (NCHS).

About 56% of all physicians intended to participate in the EHR incentive program but didn't meet the core objectives the NCHS asked about.

"Meaningful use" refers to provisions in the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which authorized incentive payments through Medicare and Medicaid to clinicians and hospitals that use electronic health records in a meaningful way that significantly improves clinical care...

Over on THCB, Incoming ONC head Dr. Karen DeSalvo tried to put a positive spin on the state of health IT in her recent piece Survey Says: EHR Incentive Program Is on Track. Be interesting to hear what she has to say next week at the ONC Annual Conference in DC.

Below, the typical invective hurled by the anti-HIT trolls, this one from Dr. DeSalvo's post.


Sources tell me that the ONC funded Nevada State HIE (run out of DHHS, not may be about to fail. It won't be the first one, but it will sure be another multi-million dollar waste of taxpayer money.

Speaking of wasting money:


Do providers have the EHRs for Stage 2 Meaningful Use?
Jennifer Bresnick, January 20, 2014

Providers may be lacking one big, basic ingredient for a successful Stage 2 attestation: a certified EHR capable of meeting the Meaningful Use objectives.  The National Center for Health Statistics (NCHS) has released a new data brief that highlights the relatively small number of providers operating on an updated EHR as the industry enters the second stage of the EHR Incentive Programs.

While 69% of office-based physicians reported that they intended to participate in meaningful use during a survey in 2013, only 13% of those providers also had an EHR system capable of supporting 14 of the Stage 2 core and menu objectives.  While this number seems exceedingly low, one should note that the survey was conducted between February and June of 2013, long before the majority of EHR vendors had even finished developing their 2014 ONC certified technology.

However, it is no secret that it’s been an achingly slow process to get the new technology through the testing and verification process.  Tight deadlines and major upgrades are slowing the adoption process for providers who have already spent big bucks on their 2011 systems...

Were I a Medicare EP who began attestation in 2011, I'd have by now collected $38k of the full $44k incentive reimbursement potential (not counting the sequester deduction now applied to the payments), ~86% of the total available. It sure looks to me that the combination of costs for Stage 2 upgrades -- certified software update, workflow alterations, administrative expenses -- may well eclipse any remaining potential reimbursements.

A doc I know responds:


And the hits just keep on coming...
Why specialists don’t like their EHRs

The list of reasons why specialists don’t like their EHRs could go on for pages, but what it really comes down to is this: most EHRs try to satisfy everyone’s needs, an impossible feat in a world with hundreds of medical specialties. Hospitals and primary care practices can sometimes make a one-size-fits-all EHR work, but specialists have a much harder time adjusting to having an EHR as part of their workflow.

A recent Black Book Rankings survey found that specialists are much less happy with their current EHR than family physicians are. However, most physicians place the blame on themselves. The top three reasons for considering a vendor switch all have to do with picking the right EHR:

  1. Solution does not meet the individual needs of the practice, including workflow (80 percent)
  2. The practice did not adequately assess its needs before selecting the original EHR (79 percent)
  3. Design of EHR is not suited for the practice specialty (77 percent)
Moving forward, specialists are taking a lot more care in picking their next EHR, focusing on more than just qualifying for government incentives. According to Black Book, here are the top five “must haves” for a replacement EHR vendor:
  1. Vendor viability (84 percent)
  2. Provider data integration and network data sharing (83 percent)
  3. Demonstrable return on investment (78 percent)
  4. Adoption of mobile devices (75 percent)
  5. HIE support and interoperability
With the EHR market in a constant state of shuffling out the unpopular EHRs, practices are most concerned with an EHR’s past success and future prospects. Practices want proof now, not just promises...

More to come...

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