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We’ve Come a Long Way with Health Information Technology, But Next Phase Will Be Difficult

February 20, 2014 | By: Martin Ciccocioppo

We’ve Come a Long Way with Health Information Technology, But Next Phase Will Be Difficult

During April 2004, President Bush signed an executive order creating the Office of the National Coordinator for Health Information Technology (ONC) and set a goal that: “Within ten years, every American must have a personal electronic medical record.” 

While it wasn’t called the “triple aim” at that time, the overall objective was the same:

  • Use modern technologies to improve the care provided to each patient
  • Use standardized electronic data to improve the process of care 
  • Reduce the cost to our health care system

We’ve come a long way since then. 

Three years after Stage 1 meaningful use became official during 2011, providers have received more than $19 billion in incentive payments: 

  • Nearly 9 out of 10 eligible hospitals have made a financial commitment to an electronic health record (EHR) 
  • Nearly 3 out of 5 Medicare and Medicaid eligible professionals have made a financial commitment to an EHR 
  • Over 340,000 Medicare and Medicaid eligible professionals have received an EHR incentive payment

These statistics demonstrate that Stage 1 of meaningful use can be achieved over time. However, even with significant financial incentives during the early years of the programs, many providers could not, or chose not to, meet Stage 1 requirements.   

New Challenges   

When the Centers for Medicare & Medicaid Services (CMS) and ONC defined Stage 2 meaningful use during September 2012, they changed nearly all of the meaningful use objectives and standards, rewrote some Stage 1 requirements, and required all providers to implement 2014 Certified Electronic Health Record Technology (CEHRT) during 2014.   

Several issues threaten the ability of providers to continue as meaningful users:

  • Limited availability of 2014 certified EHRs 
  • Delays in certified product installation 
  • The burden of meeting new requirements   

If providers fail to achieve or maintain meaningful use during 2014, they will lose EHR Incentive Program payments and will be subject to Medicare payment penalties during 2016.   

Flexibility Needed   

In order to maintain momentum towards greater use of EHRs, we recommend that all hospitals and physicians have the option to make the transition to the 2014 Edition Certified EHR and the Stage 2 requirements (or revised Stage 1 requirements) over the course of 2014 or 2015.   

We have made monumental advances in: 

  • Electronic capture of structured health data
  • Tracking key clinical indicators 
  • Care coordination 
  • Reporting for clinical quality and public health information   

Stage 2 meaningful use and standards for 2014 certified EHRs have set a path for leveraging this wealth of electronic clinical data to support advanced clinical processes of care. 

Unfortunately, the federal government is threatening our ability to move health care forward by forcing the entire industry through a narrow path at the exact same time.   

As we approach the tenth anniversary of President Bush’s call to action, we can be proud that most Americans now see providers who use electronic health records. 

However, the health care industry and EHR vendors need more time to allow pioneers to venture forward, clear obstacles, and widen the path so that, eventually, all providers can move further ahead with: 

  • Improved care
  • Improved outcomes 
  • Empowered patients.



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