'We could see, frankly, failure of the program'
MGMA executives, too, are concerned about the high hurdles MU has set to date.

"We've raised numerous concerns about where meaningful use is going," MGMA Policy Advisor Robert Tennant told Healthcare IT News, Aug. 28, the day before the final rule was published. "If significant changes are not coming in the program, I think the program risks a lot. We could see, frankly, failure of the program. And, nobody wants that. We want t to succeed, but we don't want practices to have these administrative and financial burdens trying to adhere to these more rigorous Stage 2 requirements.

"It would be a disaster," Tennant said, "if the number of EPs attesting does not substantially increase. Eighteen hundred have attested compared to 400,000 for Stage 1. So, there's something wrong going on – and not just the EPs, hospitals as well. Very few have been successful with Stage 2."

In an interview last July, former National Health Information Technology Coordinator David Blumenthal, MD, widely regarded as the architect of the meaningful use program, was optimistic about progress.

“Well, I take a long view,” Blumenthal told Healthcare IT News. “My belief is that the United States healthcare system was flawed in ways that prevented, or dis-incented the adoption of electronic health records, and that to accelerate that process required government intervention.”

"The intervention was not perfect, Blumenthal acknowledged, "but it accomplished the basic goal of accelerating the adoption and use of electronic health records. It means that most Americans’ health information is in digital form."

[See also: Stage 2: Rubber meets the road.]

Branzell told Healthcare IT News earlier this year that CHIME surveyed CIOs from organizations that were early adopters of health IT. Of the 33 who said they would attest to achieving Stage 2 in January 2014, none did. Close to half of these said they would be delayed significantly, perhaps six months or more.

"It takes a while to get the software in," Branzell explained. "It takes a while to mature it. It takes a while to get the data flowing."

[See also: Stage 2 meaningful use off to slow start.]

When Healthcare IT News Managing Editor Mike Miliard spoke with HIMSS Analytics Executive Vice President John Hoyt at the beginning of August, Hoyt was skeptical about whether many providers would be able to meet Stage 2 within the 2014 timeline.

"I would not expect a floodgate," Hoyt said.  "We should have had more momentum early on. That means there are clearly software and process issues. And it takes a long time to solve those. I think we're going to be looking at a significant deficit."

"These updates to the EHR Incentive Programs support HHS’ commitment to implementing an effective health information technology infrastructure that elevates patient-centered care, improves health outcomes, and supports the providers that care for patients," CMS officials wrote in announcing the relaxed requirements for Stage 2.

The rule also finalizes the extension of Stage 2 through 2016 for certain providers and announces the Stage 3 timeline, which will begin in 2017 for providers who first became meaningful EHR users in 2011 or 2012.

Read the full news release and timeline charts here.

See the final rule to be published in the Federal Register on September 4 here.