The Centers for Medicare and Medicaid Services (CMS) is giving providers another year to demonstrate they have met the Stage 2 criteria of the federal government’s incentive program to encourage the implementation and meaningful use of electronic health records. This means that Stage 2 will extend through 2016 and Stage 3 will not begin at the earliest in fiscal year 2017 for hospitals and calendar year 2017 for physicians and other eligible professionals that have completed at least two years at Stage 2. This delay is exactly what occurred with Stage 1 when CMS lengthened it a year since it appeared that the industry would be hard-pressed to build and get familiar with systems capable of meeting the federal payment program’s more strict Stage 2 criteria.
CMS and ONC (Office of the National Coordinator for Health Information Technology at HHS) spokesmen said the delay will allow both CMS and ONC to assist providers in meeting Stage 2 demands for patient engagement, interoperability and information exchange, as well as utilize data collected during that phase to direct policy decisions for Stage 3.
The proposed rules are expected to be released in the fall of next year for the requirements providers must meet for Stage 3 and the 2017 Edition of standards health IT developers must construct and test their systems to match.
The start of Stage 2 was October 1st of this year for those hospitals that have already met Stage 1 criteria for at least the prior two years. Physicians and other “eligible professionals” are to begin Stage 2 on January 1, 2014. A separate rule extending Stage 2 by a year is expected sooner and will be attached onto another, as yet unspecified HHS rule already started on the long rule-making process.
The Stage 2 delay was not unexpected since in September, members of Congress called for a delay of Stage 2. Congress realized there were some severe lags in overall health IT industry readiness for the Stage 2 upgrades. The substantial lag time between developers having a system ready and the ability of provider organizations to implement and reach optimal use with even an upgraded EHR would impact provider readiness to meet the more strict meaningful-use targets in Stage 2.
In another effort to speak to that lag, the CMS proposed a new; “voluntary” set of health IT system testing and certification criteria to be referred to as the 2015 Edition. The current 2014 Edition of testing and certification criteria will remain ‘the baseline” for vendors and developers, but the 2015 Edition criteria would be “responsive to stakeholder feedback, address issues found in the 2014 Edition, and would reference updated standards and implementation guides that we expect would continue momentum toward greater interoperability,” according to the CMS. The 2015 Edition would be voluntary in that neither vendors nor providers would be obligated to create or use the updated technology.
