Is It Time to Press the MU Pause Button?

As the deadline for Stage 2 of Meaningful Use starts closing in, there has been more chatter and discussion about whether eligible professionals and hospitals are ready. On one side of the argument is that a delay in MU Stage 2 would slow the introduction of some important patient engagement features/functions as well as delay health information exchange efforts. These functions are thought to be very important for coordinating care, avoiding redundant tests and procedures, and potentially reducing costs of care.

The other side of the argument (see article on Government Health IT) is that:

  • The two-year cycle of MU changes is too fast.
  • Stage 2 is coming at a time when healthcare providers will be trying to make the switch to ICD-10 — a major challenge in and of itself.
  • There is evidence that EPs are having challenges with Stage 1 of MU. According to the American Academy of Family Physicians (AAFP) 20% of those who attested in 2011 did not do so in 2012 (see AMA Medical News here).
  • The workflow issues to comply with Stage 1 and transition to Stage 2 are more challenging than the Health IT Policy Committee and Office of the National Coordinator realize especially for rural hospitals and small practices.

Still others are suggesting that there be a compromise. Keep the schedule for Stage 2 the same but introduce an option to help EPs and EHs avoid the penalty if they cannot completely meet Stage 2 requirements. Under this scenario, practices that complete the 90-day attestation successfully in 2014 would get the appropriate incentive payment. Those EPs and EHs that used certified EHR technology (2014 EHR standards) but were not successful in attaining all of the Stage 2 requirements could at least avoid the 2015 penalty. This two-tier process is similar to the E-Prescribing incentive program. Recall that for the E-Prescribing incentive program there was a way to avoid the 2014 payment adjustment by submitting at least 10 electronic prescriptions from January 1–June 30, 2013.

What do you think? Full steam ahead? Pause? Create options?

This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP).


One response to "Is It Time to Press the MU Pause Button?"
  • August 11, 2013
    Carol Greenlee

    I think SLOW DOWN is a good message to ONC. Proceed but slow down and provide more support to enable success and improved health care delivery instead of just a race to check the box. As the drop out in those attesting suggests, doctors care about their patients and are selecting to care for their patients and hopefully, care for themselves, by limiting the check the box items that do not add value at this time. I think that we need to move to electronic systems as we need to be able to share information and to track our “populations” in order more effectively help them. However, we can take a lesson from what we are learning in our approach to patient care and taking the patient context into account. Even though a patient may need to stop smoking, eat a healthier diet, take all 3 of his/her BP meds, 2 asthma meds and a statin and exercise; if they aren’t able to afford the meds or don’t know what to eat instead or how to cook it or work exercise in to their schedule or whatever, then they are not going to do it. Taking one step at a time and providing support will get that patient there more certainly than throwing the whole “load” at him/her over and over and putting them into failure mode. The vendors come up with “work-around” methods to get us to MU, these detours are taking us out of the way of good patient centered care, shared decision making and more. WE need to get there with electronic records and systems, but we need to have patient care be in the center, we need the electronics and data to support and not distract from that care. We need more training and help with practice transformation. Just like our patients, we will be more likely to get to a healthy health care system if we do it in a slower supported fashion rather than rushing it and not getting there.

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