A different view
Although many vendors may be welcoming the extension, at least one sees it as a drag on progress.

"We have been against delaying implementation the subsequent stages each and every time, and we are against this delay," said Dan Haley, VP of government relations at athenahealth.

"The fact that the delay is necessary is really a public policy failing," he argued in an interview as the news fell on a Friday afternoon. It suggests that "the bar was too low" for Stage 2 certification.

While some provider groups were calling for an outright delay and some IT groups and vendors were calling for an attestation extension, Haley proposed that doctors not be penalized for failing to meet timelines, but that instead their vendors be subject to a certification review "with the possibility that they be revoked."

“From 10,000 feet, the reason is health IT lags information technology in the rest of the economy and it’s never going to catch up if we keep slowing down,” Haley said. “From a more practical perspective, there are a lot of doctors who are using outdated technology.”

As far as Stage 3, Haley said there is one overriding idea that CMS and the ONC must keep in mind: having very strong interoperability rules.

"Creeping up on a decade and half in the 21st century, meaningful use has to include interoperation between vendor platforms. It’s the single biggest problem,” he said.

“Why is it that in 2013 different EHR vendors can’t talk to one another?”

Whatever the reaction of the HIT industry, physicians, nurses, CIOs and hospital leaders, the extension will give all involved some more time to make their suggestions heard.

Among the issues that will at the top is reducing compliance burden.

"One of the things that would be relatively simple," said Tennant, "is why don’t you take a leaf from the physicians quality reporting system book and allow group reporting?"

"It streamlines the administration on both sides and avoid multiple reporting of the same data," he said.

Another suggestion he has is to expand the hardship exemption of unforeseen circumstances "to include problems with the vendor."

For example, he said, "if an EP attests successfully for Stage 1 but their vendor is unable to certify for Stage 2, that EP shouldn’t be subject to penalty adjustments."