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Ready for the next stage?
Providers see challenges ahead in meaningful use

By Joseph Conn
Posted: March 2, 2013 - 12:01 am ET

In Modern Healthcare's quest to track the health information technology zeitgeist, our annual Modern Healthcare/Modern Physician Survey of Executive Opinions on Key Information Technology Issues each year asks questions that could be considered “odds and ends.”

This year, for instance, we wanted to know how optimistic participants were about meeting the challenges of Stages 1, 2 and 3 of meaningful use under the federal electronic health-record incentive payment program created by the American Recovery and Reinvestment Act.

The program is now in its third payment year at Stage 1, with the start of Stage 2 fast approaching beginning Oct. 1.

Some 74% of survey respondents indicated their organizations had either attested to having met the Stage 1 meaningful-use criteria or were confident their organizations would do so in 2012. (The survey was conducted from mid-November 2012 to mid-January 2013.) Another 23% said they wouldn't become meaningful users by the end of 2012, and 4% indicated they were unsure.

Confidence waned somewhat as these leaders looked ahead to Stage 2 and, especially, Stage 3. Asked if their organization would be able to meet Stage 2 by 2014, 62% said it was “highly likely” that they would. Another 20% indicated it was “somewhat likely,” 11% were “unsure” and 8% said it was either “somewhat unlikely” or “highly unlikely.”

Asked about meeting Stage 3 by 2016, only 43% indicated it was “highly likely” and 16% responded it was “somewhat likely.” Roughly one-third (34%) were “unsure” about Stage 3, while just 7% indicated it was either somewhat or highly unlikely.

One of the leaders whose organization has met Stage 1 meaningful use, but is concerned about Stage 2 and beyond is Dr. George Voigtlander, one of just three physicians at the Pawnee Rural Health Clinic, an 11-bed critical-access hospital in Pawnee City, Neb.

Stage 1 was “completed about six months ago,” Voigtlander says, but he gave the hospital's chances of meeting Stage 2 by 2014 as “somewhat unlikely” and Stage 3 as “highly unlikely,” largely because of continued fluidity of Stage 2 requirements and problems with the hospital's EHR vendor.

“We're working toward Stage 2,” he says. “What's actually required is still kind of a muddle. They haven't corrected some of the major defects in the system, the reliability issues. They promise a lot that they don't deliver.”

Some 61% of respondents indicated that ARRA incentives have not helped their organization proceed with an EHR subsidy program for affiliated physicians, compared with 39% who said it had.

Only 25% of respondents said their organizations were directly benefitting from the ARRA-funded Health Information Technology Extension Service program established by the stimulus law to help providers meet meaningful use. Some 47% reported theirs were not helped, and 27% were unsure. (The percentages don't total 100% because of rounding.)

Only 10% of health leaders surveyed reported their organization has an employee who is either a graduate of, or is currently enrolled in, the community college health IT certificate training program, also created under the stimulus law. Some 40% were unsure and the remaining 50% indicated there were none.

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