Most people outside of the healthcare industry are unaware that the Affordable Care Act has nothing to do with the move on the part of the United States government to bring medical or health records into the world of advanced technology.
Concurrently with the debates surrounding the Affordable Care Act the Centers for Medicare and Medicaid began an incentive program to get health care providers moving towards implementing new, interoperable, electronic health records. The government, through CMS, makes incentive payments based on predetermined “meaningful use” steps implemented by providers. Eligible providers are physicians who take part in Medicare and Medicaid. Based on a number of factors the incentives administered by CMS pumps a great deal of money into a facility or physician office that installs a new electronic health record system. While CMS administers the program its design was the responsibility by the Office of the National Coordinator for Health IT.
To measure the effectiveness of the program CMS issued guidelines that we in the industry call Meaningful Use. Meaningful Use has three stages:
Stage 1 – Measured results from 2011 to 2012 and targeted the ability to capture and share data.
Stage 2 – Ends December 21, 2014. During 2014, the standards for Meaningful Use spotlighted on the exchange of health information (HIE- Health Information Exchange), and other benchmarks.
As there is still one month left to the year, the data for 2014 is not reliable. Nevertheless, it seems that less than 2 percent of providers will manage to certify the 2014 Meaningful Use Attestation. The impact is that their incentives are in danger and if they are not ready for 2014, what happens when the next attestation is due in 2016?
Stage 3: 2016
Recently, the American Medical Association (AMA)held its 2014 Interim Meeting. One result of the meeting was a letter to ONC and CMS asking policymakers to begin action immediately to fix the Meaningful Use program. The letter asks for more flexibility and a shortening of the reporting period to help physicians avert penalties.
The most significant problem is the difficulty in sending information from one provider to another in a way that the sender can transmit it in a way that is recognizable to the receiver. In other words, most of the time the data lives in limbo in the originators computers system.
The same week that the AMA asked for regulatory relief, so did the Texas Medical Association. The letter from the Texas Medical Association included the following information:
“In 2012 more than 11,000 Texas eligible professionals (EPs) attested to stage 1; so far in 2014, only 120 EPs have attested to stage 2.”
In a statement about the AMA correspondence to CMS, AMA President-Elect Steven J. Stack, MD, said,
“The whole point of the meaningful use incentive program was to allow for the secure exchange of information across settings and providers, and right now that type of sharing and coordination is not happening on a wide scale for reasons outside physicians’ control. “Physicians want to improve the quality of care and usable, interoperable EHRs are a pathway to achieving that goal.”
The TMA especially wants Core Measures 7 and 17 allowed more time as compliance, according to TMA members causes coercion of patients to use patient portals to communicate with doctors. Doctors with a large amounts of elderly patients may have difficulty using portals.
In their communications, the AMA asked for a reduction in the reporting period from 365 days to a 90-day reporting period. Interoperability remains a large burden too as physicians are dependent on third parties for meeting the interoperability standards.
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