National Health IT Coordinator Endorses 'Meaningful Use' DelayNational Health IT Coordinator Endorses 'Meaningful Use' Delay

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National health IT coordinator Dr. Farzad Mostashari has endorsed a plan to delay the start of stage 2 of the federal incentive program for Meaningful Use of electronic health records.

Speaking by telephone to an Association of Medical Directors of Information Systems (AMDIS) meeting in Ojai, Calif., this week, Mostashari said he supports the recommendation of the Health IT Policy Committee, a federally chartered advisory panel, to give healthcare providers until 2014 to comply with the second round of standards in the $27 billion program. Last month, the Meaningful Use workgroup of the Health IT Policy Committee, recommended the change.

As it stands now, anyone attesting to Stage 1 Meaningful Use this year would have two years to achieve Stage 2. But a tight timeline in developing the Stage 2 rules would create a "disincentive" for hospitals and physicians to seek Medicare and/or Medicaid bonus payments for EHR usage this year. "It would limit how robust Stage 2 could be," Mostashari told the AMDIS meeting, a gathering of chief medical information officers.

Health IT staff from the Centers for Medicare and Medicaid Services (CMS) said at the AMDIS conference to expect a proposed Stage 2 rule by the end of 2011 and a final rule in mid-2012. Once the new standards, along with companion rules for EHR certification that ONC is developing, become final, technology vendors will have to update and get their products certified for Stage 2 so their customers can remain eligible for the bonuses.

The 2013 reporting period for hospitals would begin in October 2012 (the start date is January 2013 for individual physicians and other eligible providers), so the current timeline leaves little room for preparation. This, according to Mostashari, would encourage providers to put off going for Stage 1 Meaningful Use this year because they would have to rush to get to Stage 2 just two years later.

Beyond the money, Mostashari said the HIT Policy Committee reasoned that rushing the deadlines would run counter to the goals of the the U.S. Department of Health and Human Services' National Strategy for Quality Improvement in Health Care. This strategy essentially follows the "triple aim" of CMS Administrator Dr. Donald M. Berwick to make healthcare more effective, more equitable, and more affordable.

"We need to do a few things to get to where we need to go," Mostashari said about Stage 2 rule development.

Under the plan endorsed by the Policy Committee and now Mostashari, hospitals and doctors that attest to meaningful use in 2011 would have three years to reach Stage 2--and would still earn three years of bonus payments prior to the start of Stage 2, the national coordinator said Wednesday. "Now, there is an incentive for anyone who's ready to go," Mostashari said. "There is no reason to delay" attesting to stage 1.

Officially, CMS runs the incentive program, and the regulations will come from the secretary of HHS, so Mostashari's endorsement does not make the change official. CMS has not publicly said how it will act just yet.

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