Encouraging Data for Meaningful Use Advocates

Oct. 22, 2013
The debate and drama over meaningful use won't end any time soon, even after Farzad Mostashari's bold declaration that a timeline alteration to Stage 2 isn't likely to come. While those in favor of changing the program will push ahead, recent data falls on the side of those in favor of keeping it intact.

Last week, while our own Mark Hagland was covering the CHIME (College of Healthcare Information Management Executives) Fall CIO Forum in Scotsdale, Ariz., Farzad Mostashari, M.D., the former National Coordinator for Health IT, dropped a bombshell.  

Mostashari told the audience of CIOs that the likelihood of the government altering the Stage 2 timeline for meaningful use was close to nil. The week before, at the AMDIS (Association of Medical Directors of Information Systems) Fall Symposium in Boston, I heard something similar from industry luminary, John Glaser, Ph.D., the CEO of Health Services for Siemens Healthcare.

Let’s be honest, though: the drama and debate over Stage 2, and meaningful use in general,  won't end anytime soon. We’re going to see both sides of this debate move ahead with their agendas. Whether it’s concerns over vendor readiness, a potential widening gap between rural and urban hospitals, or a focus on interoperability, it’s doubtful that the people who are pushing for an extension of some sorts are going to give up easily.

Meanwhile, I saw some interesting data that should give food for thought. The data was presented in a Health Affairs blog as a meaningful use status update. On top of giving the usual slate of numbers of providers that have attested to meaningful use Stage 1, it looked the types of hospitals that have achieved meaningful use.

The researchers, one of whom, to be fair, was from the Office of the National Coordinator for Health IT (ONC), reported that the “highest rates of meaningful use achievement have been among small rural hospitals (76 percent) and medium (72 percent) and large (77 percent) hospitals.” For critical access hospitals (CAHs), the number wasn’t as far behind as some might think, at 61 percent.

According to Jennifer King, chief of the research and evaluation branch in ONC’s Office of Economic Analysis, Evaluation, and Modeling, and Julia Adler-Milstein, assistant professor of health information at the University of Michigan’s School of Public Health, the gap between those CAHs and leading hospitals narrowed substantially at the end of the 2012 reporting period. Furthermore, they say all CAHs (97 percent) are either registered with the Medicare or Medicaid EHR Incentive Programs or engaged with a Regional Extension Center (REC). This suggests they are working towards attestation and we may see another surge at the end of 2013.

In addition, the researchers said there was no difference in Meaningful Use achievement by hospital safety net status or by ownership, system membership, or teaching status. The only difference? Hospitals in Western part of the country seemed to lag behind the Northeast, Midwest, and South.

The reported success of Stage 1 of course means little for Stage 2, which is a significant leap forward technologically for many of these providers. Still, if you are a proponent of the program, these numbers are encouraging.

When those 17 Republican senators asked Department of Health and Human Services (HHS) Secretary Kathleen Sebelius for a one-year extension to Stage 2, the second thing they mentioned was their concerns over the digital divide for small and rural providers. It’s a worthy concern, but the data here fights against that notion. It suggests that if there is a digital divide, it’s not as big as one might have thought.

Certainly, the industry has a ways to go, especially in terms of interoperability and usability of the systems. That is undeniable. Also yes, there still is a divide, and the industry has to work on tightening that gap. And yes, vendors may not be fully ready for Stage 2 (even though recent HIMSS Analytics data suggests that the providers’ outlook on their lack of readiness might not be so grim). 

Overall, though? It’s important to not let perceptions paint the full picture. The perception is that the entire meaningful use process continues to be highly problematic. In this case though, the data seems to be pointing to a different reality (in terms of Stage 1). And after all, this is a data-driven industry.

As always, I want to hear your thoughts. Feel free to leave comments below or respond to me on Twitter by following me at @HCI_GPerna.

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