CHIME: Hold off on Stage 2

In a major pushback, the College of Healthcare Information Management Executives, an Ann Arbor, Mich.-based association of healthcare chief information officers and other tech professionals, has called for HHS to stretch the implementation timeline for its Stage 2 electronic health-record system meaningful-use criteria until the industry can report on how well it has managed to meet Stage 1 targets.

In essence, according to CHIME, if the government implements a current set of Stage 2 recommendations, it will be moving too far, too fast.

The CHIME request came in a 15-page letter today (PDF) to the Office of the National Coordinator for Health Information Technology. The letter was signed by both CHIME President and CEO Richard Correll and board chairman Lynn Vogel, who is the vice president and CIO of the University of Texas MD Anderson Cancer Center.

The letter refers to proposals on Stage 2 meaningful-use criteria by the Health Information Technology Policy Committee and its meaningful-use work group. The Health IT Policy Committee is a federal advisory panel to the ONC created by the American Recovery and Reinvestment Act of 2009.

“First, we think it would be far preferable to be in a position to evaluate actual experience under MU Stage 1 prior to considering potential MU objectives and measures for Stage 2,” according to the letter. “Absent such as assessment, we greatly fear that the (policy committee's) proposals for Stage 2 may be unduly ambitious, even unattainable, for many eligible hospitals and eligible professionals."

The policy committee's request for comments on proposed Stage 2 measures is a bit like putting the cart before the horse, the letter continued. Only as of Oct. 1, 2010, could hospitals begin their 90-day demonstrations that they can meet Stage 1 meaningful-use criteria; the clock for physicians and other eligible providers began Jan. 1. Some hospitals have received federal IT incentive payments under the Medicaid portion of the program, which—unlike the Medicare and Medicare Advantage portions—does not require meeting meaningful-use targets the first year.

CHIME advised that “it would be prudent not to move to Stage 2" until about 30% of hospitals and physicians participating in the federal EHR incentive program have been able to demonstrate they have met Stage 1 meaningful-use goals and thus qualified for federal IT incentive payments.