Electronic Health Records

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Senate to Recommend Pausing “Dreaded” Stage 3 Meaningful Use

By Jennifer Bresnick

Stage 3 Meaningful Use may be put on hold if recommendations from a hearing today on interoperability and information blocking are brought to HHS Secretary Sylvia Burwell.

Stage 3 meaningful use

The Senate Committee on Health, Education, Labor, and Pensions (HELP), chaired by Senator Lamar Alexander (R-TN), heard comments from several health data experts, including hospital leaders and EHR vendor representatives, who explained the obstacles facing the healthcare industry as it attempts to break down data siloes and integrate electronic health records into a seamless care continuum focused on health information exchange.

Senator Alexander, skeptical that the industry can overcome the many barriers to true interoperability, including active information blocking, expressed frustration about the questionable impact of the EHR Incentive Programs on the ability of healthcare organizations to provide safe, quality, effective care.

“If I found myself suddenly at the Vanderbilt University Medical Center emergency room and the doctors there wanted to get my paperwork from the hospital and doctors I usually use —information blocking means that there is some obstacle getting in the way of my personal health information getting sent to them,” Alexander said.

“This could happen a few different ways: My usual hospital refuses to share my information. The electronic systems at both hospitals don’t talk to each other. My usual hospital says it will charge Vanderbilt a huge fee to send my electronic records. My usual hospital says it can’t share them for privacy reasons. Or, my usual hospital won’t send them because they cite concerns about data security.”

While HHS has spent more than $30 billion since 2009 on the meaningful use program, attempting to get providers to adopt EHRs and exchange data between business partners, the results have been less than satisfactory, according to many lawmakers.  After CMS released the proposed Stage 3 Meaningful Use criteria in March, stakeholders across the industry have criticized the framework for being too ambitious for providers to cope with.

“[A] hospital told me that Stage 1 and Stage 2 worked ‘okay,’ but they were ‘terrified’ by Stage 3,” Alexander said during the hearing.  “My instinct is to say to Secretary Burwell, 'Let’s not go backwards on EHRs, but let’s not impose on physicians and hospitals a system that doesn’t work, in which they spend most of their time dreading.’  Half the doctors are now paying penalties rather than participating.  We want something that physicians and hospitals buy into that helps patients, rather than something that they dread.”

During a news conference after the hearing, Alexander said that putting Stage 3 Meaningful Use on hold would be among his recommendations to the administration.  While Alexander stressed that “no one wants to turn back” on EHR adoption, Stage 3 may not be the most effective way to bring better health IT use into the nation’s varied and complex healthcare system.  

Alexander has been one of the most vocal proponents for “rebooting” the meaningful use system and retooling legislation to better meet the needs of providers who are not able to successfully attest to the program.

The Senate HELP Committee has held four hearings on the progress and pitfalls of the EHR Incentive Programs.  Staffers have also been meeting regularly with healthcare experts and representatives from the administration to work on strategies that will help to improve meaningful use for providers.



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