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Wednesday, Aug. 7, 2013

This Week's News

AMA, AHA call for greater flexibility, eased timeline for EHR meaningful use

AMA, AHA call for greater flexibility, eased timeline for EHR meaningful use

Aggressive timelines and an inflexible "all-or-nothing" approach are setting Stage 2 of Medicare's electronic health record (EHR) meaningful use program up for failure, the AMA and the American Hospital Association (AHA) said in a recent letter to U.S. Health and Human Services Secretary Kathleen Sebelius.

"Our members, and the vendors they work with, report growing concerns that the rapidly approaching start date for Stage 2 is on a trajectory that will not provide enough time or adequate flexibility for a safe and orderly transition unless certain changes are made," the letter states.

Stage 2, which requires all hospitals and physicians to upgrade to an EHR product that is a certified for 2014, begins Oct. 1 for hospitals and Jan. 1 for physicians. As of July 17, only nine complete 2014 edition certified EHR products were on the official federal list of certified vendor products for the inpatient setting, and only 11 products were listed for the ambulatory setting. In comparison, 313 products were certified for the inpatient setting in 2011, and 1,300 were certified for the ambulatory setting.

"The compressed timeline puts providers in a position of rushing to implement, creating conditions that prevent them from optimizing use of the systems and possibly introducing risks to patient safety," the letter states. "Furthermore, some providers are reporting significant challenges with the usability of their current certified EHRs, a situation that will be exacerbated as vendors channel their efforts to managing a nationwide transition to the 2014 edition."

The two groups outline four recommendations to address some of the issues with Stage 2 implementation:

  • Allow providers at Stage 1 to meet the requirements using either the 2011 or 2014 certified edition EHR.
  • Establish a 90-day reporting period for the first year of each new stage of meaningful use to allow product upgrades to take place over time.
  • Offer greater flexibility to physicians and hospitals in meeting Stage 2 requirements to ameliorate the program's "all-or-nothing" approach.
  • Extend each stage of meaningful use to no fewer than three years for all physicians and hospitals.

Meanwhile, the AMA discussed specific examples of usability issues physicians are facing with EHR systems in testimony given last month to the Office of the National Coordinator for Health IT. The AMA also made concrete recommendations for vendor usability standards that should be required under Stage 3 so EHR technology can become a valuable tool for physicians and their teams.