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Stage 3 Meaningful Use Proposed Rule: Is More Time Needed?

By Vera Gruessner

- With the comment period open for providing feedback on the Stage 3 Meaningful Use proposed rule, the Centers for Medicare & Medicaid Services (CMS) along with the Office of the National Coordinator for Health IT (ONC) are likely to receive a multitude of opinions regarding the revision of these meaningful use requirements.

EHRIntelligence.com spoke with Bruce Eckert, National Practice Director at Beacon Partners, to get his perspective on the Stage 3 Meaningful Use proposed rule. Eckert mentioned how Stage 3 will likely advance the utilization of health IT tools even further.

“If the Stage 3 requirements were widely adopted, it would be a significant increase in industry capabilities, a big advancement for healthcare IT and good for the industry in many ways,” Eckert said. “But I think it’s going to be very challenging to bring a significant number of providers up to that level.”

Additionally, Eckert explained that requiring providers to reach the threshold of 25 percent of patients viewing and downloading their health information is a difficult stipulation to achieve. Currently, under Stage 2 Meaningful Use requirements, providers only need to ensure that 5 percent of patients view and access their health records electronically.

“We as an industry have struggled with [a similar stipulation] under Stage 2, so the greatly increased percentage under Stage 3 is likely to be a challenge,” Eckert stated. “I think it’s going to depend on the organization and the demographics. For many of our clients, we found that if they market their portal well, they will get well above the 5 percent of participation. [However,] 25 percent of participation based on today’s experience is high. It’ll take effort.”

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“The counter to that is that policymakers are looking ahead to 2018,” the Beacon Partners representative continued. “In almost three years, society will continue migrating to online activities and part of that is using online services for health-related activities. It’ll be a challenge but I have a bit of optimism about it.”

Bruce Eckert - photoWhen asked whether there will likely be many comments asking to lower this percentage during the comment period, Eckert replied in the affirmative and encourages healthcare organizations to express their opinions formally to CMS during the comment period. The director went on to discuss the importance of health information exchange (HIE) within the Stage 3 Meaningful Use proposed rule.

“It’s really important that our industry figure out how to [accomplish HIE]. It’s a big piece to the puzzle of care coordination and improving the quality of care. We have to make it work one way or another,” said Eckert. “Right now, under Stage 2, Direct Protocols turned out to not be ready for wide-spread usage. I think it will be by Stage 3. By leveraging Direct, I think we can achieve the Stage 3 level by 2018.”

Eckert stated that he is more optimistic about this objective under the Stage 3 Meaningful Use proposed rule and is “fairly positive about healthcare exchange.” However, Eckert was not as hopeful about most providers meeting all Stage 3 Meaningful Use requirements by the January 1, 2018 deadline.

“I think it’s going to be tough [to meet the deadline.] The reason is because we’re going to run into the same problem that we did with Stage 2. The problem is the [short] timeline for the vendors to develop the products,” Eckert explained. “From today until January 2018, there is about 33 months left. That is a little less time than there was from the [release of the] 2014 CEHRT proposed rule until the October 2014 deadline for most organizations to implement 2014 CEHRT.”

“CMS released the flexibility rule in late 2014 to grant extra room at that point because many vendors were either not ready or had gotten systems out late and providers were not able to fully implement these tools,” said Eckert. “I can see the same scenario developing here because the vendor timeline to create the considerably advanced capabilities is relatively short. The big rush to get these capabilities deployed in time is going to be a challenge.”

Eckert also discussed the increased focus on patient engagement under the Stage 3 Meaningful Use proposed rule. Physicians will have more options and tools available to communicate with patients.

“Studies that have been done in the past about patients using electronic messaging finds that it replaces the telephone,” Eckert mentioned. “Patients use electronic communication to ask questions or send information to providers that they would have done via telephone. Electronic messaging is more time efficient for the physician’s office than the telephone is. Providers will really appreciate the change in the Stage 3 rule around secure electronic messaging.”




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