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D.C. Report: Stage 2 Meaningful Use, November Elections, Health IT Standards

September 29, 2010
by Sharon Canner, Sr. Director of Advocacy
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Meaningful Use Workgroup Focuses on Stage 2. Earlier this week the HIT Policy Committee Workgroup on Meaningful Use discussed requirements for Stage 2, which is scheduled to begin in 2013. Requirements include raising the performance level for computerized physician order entry (CPOE) and electronic prescribing, among other issues. National Coordinator Dr. Blumenthal added that healthcare providers and vendors should expect more complicated requirements on clinical decision support tools and health information exchange. In October, the full HIT Policy Committee is scheduled to release preliminary Stage 2 requirements to be followed in December by a request for comments on the proposal. To view the objectives for Stage 2, click here (scroll down to September 22 and click on “Overview of MU Objectives.”)

Also at the Workgroup meeting, CMS Director of e-Health Standards and Services Tony Trenkle indicated that CMS will soon release clarifications regarding certain inconsistencies in the final rule. He noted that the changes would help guide the Policy Committee as it works on future stages of the Electronic Health Record (EHR) Incentive Program.

November Elections and the HIT Policy Agenda. With elections around the corner, both Democrats and Republicans are focused on promoting their policy agendas. In their Pledge to America, Republicans have vowed to “roll back government spending to pre-stimulus, pre-bailout levels, saving us at least $100 billion. “ It is unclear just how it would affect unspent stimulus dollars and the EHR Incentive Program, but certainly, the public backlash particularly from providers and vendors, would be substantial. Moreover, the Bush Administration initiated a federal focus on HIT and created the original ONC office with strong support from Congressional Republicans as well as Democrats. Meanwhile, the Administration and the HIT Policy Committee is moving forward on preparations for Stage 2 on a timetable that many find too aggressive--April 2011 Policy Committee recommendations followed by the ensuing regulatory process. While the Meaningful Use timeline is a regulatory creation, a change in Congress with intense oversight scrutiny and possibly legislation could force adjustments to the current scenario. Certainly just speculation at this point, but something to watch.

On healthcare, the Democrats are pointing to their accomplishment in passage of healthcare reforms, some of which became effective this month, such as allowing children up to age 26 to remain on the family’s health plan. Encouraging the adoption of EHRs, while still in early stages, is another important milestone. Easily telling the story to the American people, however, remains a challenge.

Hearing on Standards. The third and probably last oversight hearing on HITECH Act during the 111th Congress is scheduled for Thursday by the House Science and Technology Committee Subcommittee on Technology and Innovation. Witnesses for hearing, Standards for Health IT: Meaningful Use and Beyond, will include ONC’s Dr. David Blumenthal; NIST Associate Director for Federal and Industrial Relations Kathleen M. Roberts; Health Privacy Project Director/Center for Democracy and Technology and HIT Policy Committee member Deven McGraw; and HIMSS VP for Informatics Joyce Sensmeier.

The Congress is due to adjourn the end of next week, returning mid-November for a lame duck Congress. Scheduled reductions to Medicare physician payment are a must address issue. The expiring Bush tax cuts are also a likely topic.