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July 17, 2013 01:00 AM

Despite concerns, officials plan to stay on schedule for Stage 2 requirements

Rich Daly
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    Mostashari

    Despite concerns that some providers are lagging in the adoption of electronic health records, federal officials plan to stay on schedule in requiring hospitals to meet Stage 2 meaningful-use requirements, the officials said Wednesday.

    Democratic and Republican senators representing rural states ran through a litany of concerns and obstacles rural providers face in meeting the requirements of the program that provides financial incentives to adopt and use qualifying electronic health records. The concerns of rural providers include their lesser access to information technology professionals needed to install and maintain the EHR systems and their lower ability to absorb the costs of implementing such digital record systems.

    “Practically speaking, the area that the chairman represents and the area that I represent are both very rural, and these things are just practically speaking going to take a little more time,” Sen. John Thune (R-S.D) said at Wednesday's hearing of the Senate Finance Committee.

    Dr. Farzad Mostashari, national coordinator for health information technology at HHS, discounted the need for a delay in rural providers meeting the program's Stage 2 requirements. Mostashari said his office's regional coordination centers have been so successful in helping rural hospitals that they anticipate 1,000 critical-access hospitals will achieve meaningful use this year, instead of earlier projections that the milestone would not occur until next year.

    “We're open to the dialogue, but I would much rather see rural hospitals be able to move up rather than falling behind,” Mostashari told the panel about a possible delay.

    HHS plans to roll out the rules for Stage 3 of the incentive payment program in 2014.

    The discussion of a possible delay for rural providers came as CMS officials aggressively pushed back on Republican suggestions that a pause is needed in the overall EHR program. Some Senate and House Republicans have called for a pause in the EHR program, which has spent $15 billion since 2009 to incentivize providers to adopt and use digital medical recordkeeping

    Republicans said a suspension could address the concerns of advanced providers that the program is moving too slowly toward interoperability and could also prevent adverse provider impacts when Medicare penalties for not fully complying begin in 2015.

    “A pause in the program would stall the progress that's been hard fought,” Mostashari said at the hearing.

    The panel reviewed a range of successes and shortcomings associated with the program, which plans to spend $33 billion in provider incentives through 2021. Among the problems have been lags in the provision of Medicare data to providers hoping to use it to improve their care, frequently as part of the CMS' own quality improvement programs.

    Dr. Patrick Conway, director for the CMS Center for Clinical Standards and Quality, touted his agency's move toward more frequent, monthly data sharing with providers participating in the various CMS shared savings programs. But Conway agreed to discuss with the committee possible new benchmarks in provider data sharing.

    Also on Wednesday, HHS issued new data on the extent that EHRs have been used for various healthcare tasks, including their role in sending more than 190 million electronic prescriptions, which may help reduce the chance for medication errors.

    The committee plans to further review the progress of the incentive program at a hearing next week with providers and vendors.

    Follow Rich Daly on Twitter: @MHrdaly

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