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Striving for Stage 2

Scott Mace, for HealthLeaders Media, August 13, 2012
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This article appears in the August 2012 issue of HealthLeaders magazine.

The debate continues to rage: Are meaningful use requirements too specific or too vague? On target or wide of the mark? It still depends on who you ask.

"If these guidelines remain this rigid, this inflexible, this one-size-fits-all, there may well be a number of physicians who try in good faith and fail," says Steven J. Stack, MD, chair of the board of trustees of the American Medical Association and an emergency physician with Lexington, Ky.–based Saint Joseph Health System.

"It actually ends up creating a lot of unnecessary overhead to offer options," counters John D. Halamka, MD, MS, the CIO of the Beth Israel Deaconess Medical Center in Boston.

During the meaningful use rollout in 2011, allowable options in the specification diluted the interoperability between systems. The rules governing Stage 2, also now known as the 2014 edition of meaningful use, specify one way to implement content, domain vocabularies, and transport, Halamka says. "Every time you offer options," it's actually more work and less interoperability."

Attesting for meaningful use 2014 edition requires providers to interoperate, and with health information exchanges being in their infancy, providers may be hard-pressed to meet those interoperability requirements.

"We recognize that to really get meaningful meaningful use takes time," says Farzad Mostashari, MD, ScM, national coordinator for health information technology within the office of the U.S. Department of Health and Human Services secretary.

Previously, Mostashari said that meaningful use would be successful this year if CMS paid 100,000 providers in 2012 for attesting compliance with the 2011 meaningful use guidelines. "Now it looks like we're going to smash that 100,000 mark," he says. In a June 19 press release, HHS reported that more than 110,000 eligible professionals and over 2,400 eligible hospitals have been paid by the Medicare and Medicaid EHR Incentive Programs.

Some attestations have been more easily won, as institutions that have built their EMRs for years can fine-tune them to meaningful use requirements. Others are dramatic come-from-behind affairs occurring in recent months.

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