The Department of Health and Human Services (HHS) announced that Stage 2 of the Medicare EHR incentive program (Meaningful Use) would be delayed until 2014. Under the current requirements, eligible professionals (EPs) that begin participating in the meaningful use incentive program this year would have to meet new and more challenging standards for the program in 2013. If an EP did not participate in the meaningful use program until 2012, they could wait to meet these new standards until 2014 and still be eligible for the same incentive payment. In an effort to encourage faster adoption, EPs are permitted to adopt an EHR this year, without meeting the new standards until 2014.

Read the HHS press release here.

I have worked with a number of clients who purchased EMR systems years ago and they all sit, unused or partially used.

It is interesting but it is so much more than the system itself that plays a role in it’s use, especially with the added levels CMS is requiring under teh MEaningful Use Guidelines they present (albeit in a half-$%^%$ manner).

What exactly do they want and by when?

Even with PQRI, it is a great mystery!  We asssit clients in delivering PQRI codes but try and access the reports from IACS (Individuals Authorized Access to the CMS Computer Services) – Nice Acronym!!

Well here is the answer to that:

The way it works is that an organization has to be first registered into IACS as an Organization. You must first work with the EUS (External User Support) not the IACS.

Once this is established, a Security Official Account has to be established. This can be done through IACS or Quality Net. Usually they tell me it is the President or officer of organization, but need not be.

Once this is done, a Group Administrator needs to be established. This user is yet another account that needs to be established then approved by the Security Official of the Organization. The Security Official cannot be the Group Administrator.  This Group Administrator can then create users and establish roles for those users under IACS (again approved by Security Official).  One of the Roles is access to the PQRI Data.

Now here is another rub, PQRI data is only available (in NY) the November following the year the data is submitted.  So, 2007 data is available in a report in November 2008 and so on.

So how does one know if the data is received, processed, compliant for the specialty and sufficient in the meantime?  Good Questions.  I am seeking answers and will update you when I get some.

Oh Sigh!!

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs will qualify for incentive payments through Medicaid and Medicare. CMS’ plan proposes phasing in meaningful use requirements over three stages between now and 2013.

The first stage of the meaningful use criteria emphasizes:

Collecting electronic health data in coded formats;
Implementing clinical decision support tools;
Reporting clinical quality measures and public health data; and
Using EHR data to track conditions and coordinate care

The Stage 1 criteria call for physicians to submit at least 80% of their orders electronically. The proposed rules also call for health care providers to use EHRs to check for potential drug interactions. In addition, the rule requires health care providers to provide patients with electronic copies of their medical records within 48 hours of a request. A full list of Stage 1 criteria for physicians is forthcoming (from me). Of course we are tracking a moving governmental target and even what is listed below is subject to change in August when CMS issues final determinations.

Originally the Stages were tied to years (Stage 1 – 2011, Stage 2 – 2012 and Stage 3 – 2013). This has changed and is still under discussion as to when each stage will become enforceable. Also, some of the original deadlines (i.e. Jan 1, 2011) to qualify for full Stimulus money has changed and are still in flux until the final rules come out in August (if they come out in August).

The Stage 2 criteria are expected to focus on structured data exchange and continuous quality improvement. CMS is scheduled to release the second phase criteria by the end of 2011.

The Stage 3 criteria are expected to center on advanced decision support and population health. CMS is scheduled to publish the third phase criteria by the end of 2013.

The HITECH Act offers providers up to $44,000 each if they demonstrate meaningful use as will be defined in phases for 2011, 2012 and 2013 (and beyond).

Future stages will involve Patient Portals, Standardized Interoperability, Disease Management, Health Maintenance, Protocol Management, Pay for performance reporting, migration to ANSI 5010 (in 2012), migration to ICD-10 (in 2013) to name a few. The specific implication of each of these is omitted here lest this document turn to a tome.

The AMA has filed suit to exempt physicians from the Red Flag Rules.

http://www.healthcareitnews.com/news/ama-files-suit-against-ftc-over-looming-red-flags-rule

HOWEVER, make special note of the last sentence. The suit does not delay the implementation.