After a contentious March 11 Health IT Policy Committee meeting, members of the federal advisory committee voted to approve the Meaningful Use Work Group’s Stage 3 recommendations. Those recommendations, which have been scaled back 30 percent from the initial number, will go to the Centers for Medicare & Medicaid Services, which will develop a proposed rule by this fall and a final rule sometime in the first half of 2015.
After earlier feedback from the Policy Committee, the Meaningful Use Workgroup eliminated eight of 26 initial recommendations, including those dealing with care planning, reminders, eMAR, imaging, medication adherence and amendments.
Karen DeSalvo, M.D., national coordinator for health IT, chaired the meeting in which it was clear that there was not consensus about how to proceed. Many members expressed dissatisfaction with the outcome of two years of policy development work — but for very different reasons. Some said the scaled-back measures won’t get the healthcare system to the goal of interoperable systems that help providers focus on population health outcome improvement, despite the billions of dollars invested. Others stressed that providers and vendors are overburdened already and unable to cope with more requirements and that the expectations should be narrowed even further. Several committee members expressed dismay that these decisions were being made with no feedback on how providers were doing with Stage 2.
Paul Tang, M.D., co-chair of the Meaningful Use Work Group, noted that the work group and Policy Committee did not create the timelines. He added that there would be time before the final rule is enacted to include feedback from Stage 2 experiences.
DeSalvo framed the vote for members by stressing that meaningful use is only one of the tools ONC has to advance its health IT agenda. “This is the next chapter of this program, but not the last chapter,” she said. She noted that a yes vote would allow the Standards Committee and others to begin the process of testing the realistic technical opportunities and feasibility of the proposed measures. Several committee members expressed interest in writing letters to accompany the recommendations that would outline their concerns or objections. The next opportunity for public feedback will be a series of listening sessions in April, DeSalvo and Tang added.
DeSalvo also announced that Jacob Reider, M.D., has been named acting principal deputy national coordinator. Reider had served as interim national coordinator after Farzad Mostashari, M.D., resigned and before DeSalvo was appointed. He also served as ONC’s chief medical officer.