Friday, August 29, 2014

New CMS rule allows flexibility in certified EHR technology for 2014

Today is my one day of Summer vacation, enabled by the large number of people taking a long labor day weekend.

Some things are worth interrupting your vacation.

This afternoon, CMS published he long awaited final rule on Meaningful Use flexibility.

Here’s my interpretation.

Many CIOs tell me that they will be ready for transition of care and patient view/download/transmit for the full year October 1, 2014-September 30, 2015.   However, the ecosystem (trading partners, patient awareness, policy) is not ready for the period July 1, 2014-September 30, 2014.   Thus, the ONC final rule is a welcome relief.

I do have one concern - the rule notes that Stage 1 criteria can be used by those on Stage 2 timelines for

"Only providers who could not fully implement 2014 Edition CEHRT for the EHR reporting period in 2014 due to delays in 2014 Edition CEHRT availability.”

Although certified products may have been introduced into the marketplace, the time to implement, train, and ensure safe use exceeded the Stage 2 time limits.

I hope ONC/CMS/HHS interpretation of delays includes the time needed for successful adoption.


Tom Johnson said...

Thanks for the update. Do you think ONC will continue to lower the bar for MU? I fear a major lose of momentum since the incentives are over and the compliance is low for MU2. Will focus shift back to ICD-10 and POP Health/ACO?

Tom Johnson, CIO Penn Highlands Healthcare

Julie said...

Although there have been some additions and clarifications that will be significant for many, such as the limited exception for Summary of Care measure requiring 10% transmissions be sent electronically, I want to focus on the larger scale flexibility option to not move onto Stage 2 for FY 2014.
I think that many providers and hospitals that have software certified for Stage 2 were hoping to use this as a way to have additional time to meet the more stringent Stage 2 requirements. They will be disappointed by the looks of the final rule. The flexibility does appear to be specific to those with vendors who certification was delayed or did not have the scheduling option to install the certified software.

"Accordingly, a provider’s ability to use these flexible options for CEHRT is based on the provider's inability to fully implement 2014 Edition CEHRT based on these types of issues related to software development, certification and release of the product by the EHR vendor which affected 2014 CEHRT availability."

The rule goes on to give the example if certified software was available from your vendor in January but because of any reason you chose not to install it until later in the year that excuse just will not work. It isn't based on difficult processes or workflows if the software was available to you and you did not adopt it. If it was available early in the year then you needed to move forward. With that being said it isn't surprising that they waited so long to put this option out to the public. It isn't a choice as much as “Hail Mary pass” in the last seconds for those that would otherwise be unable to cross the goal line.
We will see many people using this rule due to vendor certification delays as it was intended. I believe a good number of people who are not able to meet the minimum requirements will also try to utilize this as well. It is a matter time before we see what auditors will want to see to support the claim of allowed flexibility.