Not everyone happy about MU extension

'Health IT lags information technology in the rest of the economy, and it’s never going to catch up if we keep slowing down.'
By Anthony Brino
11:08 AM

After months of physicians, hospitals and IT groups calling for more time to complete meaningful use, the federal government has finally responded. But not everyone is pleased.

On Friday, Dec. 6, hours before the Centers for Medicare & Medicaid Services and the Office of the National Coordinator announced the new timeline, two stakeholders speaking at a CMS eHealth conference made the case for an extension. Whether or not they knew of the pending change, they may be breathing a sigh of relief now, on behalf of their customers and members.

[See also: Execs react to planned Stage 2 pushback]

One concern, said Robert Tennant, a senior policy advisory at the Medical Group Management Association, is that "everything is happening at the same time" – ICD-10, Medicaid expansion, insurance exchange, ACOs and value-based pilots, and meaningful use.

"We need to evaluable the first two stages," Tennant said of designing the policy for Stage 3.

The proposed rules for Stage 2 came out in March 2012, as some providers were still just starting to participate. And the final rules came out in September 2012, "but critical supplemental materials were not available until the fourth quarter," as Shiv Gopalkrishnan, VP and general manager at GE Health System Solutions, said at the CMS conference.

[See also: Keep Stage 2 start as is, says HIMSS]

The timeline for Stage 2 -- as some were predicting for Stage 3 -- was hectic for both users and vendors.

"I think one of the lessons learned is that we really need a lot more time," Gopalkrishnan said.

"Most of the development today happens as test-based development, so until you get the final test scripts and really understand the requirements, our engineers are putting their hands on their keyboards and starting to develop stuff. That really puts a compression on the back cycle, in what it takes to build the software, get it certified and installed.”

“I think we need at least three years between Stage 2 and Stage 3. But that doesn’t mean that we wait for three years; we need intermediate milestones right now,” he said, suggesting that 18 months at a minimum be given for final clinical quality measure specifications and certification test scripts.

Under the revised timeline, which still has some details to be worked out and still has to go through formal rulemaking, Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for providers that have completed at least two years in Stage 2.

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