“One of our principles is not topping out,” said Dr. Paul Tang, vice chairman of the federally chartered Health IT Policy Committee and co-chair of its meaningful-use work group that met Tuesday. The work group spent most of the meeting going over feedback from the full committee on its first draft of proposed Stage 3 meaningful criteria.
“We sort of stopped around 80%,” Tang said. “There's always going to be legitimate reasons why we can't get to 100%.”
For a provider to fall short of 100% by a percentage point or two and lose a payment or to be encumbered by the need to seek waivers would be detrimental to the program, which aims to boost improve quality of care and lower healthcare cost through health information technology adoption and use, Tang concluded.
The discussion on upper limits of effective measurement came as the meaningful-use work group discussed its recommendation not to raise the target percentage on a requirement that providers use their EHRs to record and chart changes in a patient's vital signs, including blood pressure, height, weight and body mass index. The Stage 1 meaningful-use measure is to record vital signs in an EHR for 50% of patients age 2 and older. For Stage 2, the percentage jumps to 80%, and that's where it should stay for Stage 3.
If a provider is capable of achieving 80% of a compliance target, they're capable of doing more and probably will, Tang reasoned.
“People don't stop and say let's don't go beyond 80,” Tang said.
The work group reviewed 51 proposed criteria types, which could become the hoops through which hospitals, physicians and other “eligible professionals” must jump to qualify for future EHR incentive payments and avoid Medicare penalties. The Stage 3 rules are slated to become effective in 2016.
The work group also sought to provide clarification in response to a policy committee question about giving patients the ability to provide information to their provider's EHR from home or mobile medical monitoring devices, such devices measuring blood glucose levels, blood pressure or weight.
“Our intent, when we use the word provide, it essentially says, make available, not force people to use” the function, Tang said. “In the future, we hope this new data will be used.” It could even be incorporated into an EHR's clinical decision-support functions, Tang said.