It was fascinating to watch the dialogue unfold earlier this week, as Jacob Reider, M.D., chief medical officer, and David Muntz, deputy national coordinator, both at the Office of the National Coordinator for Health Information Technology (ONC), fielded questions and comments from the audience gathered at the Ojai Valley Inn and Spa in Ojai, Calif. on June 26, for the Physician-Computer Connection Symposium 2013, sponsored by the Association of Medical Directors of Information Systems (AMDIS).
Every year, many of the nation’s leading medical informaticists gather for the AMDIS symposium, and the tenor and overall thrust of the discussions seem to provide a good barometer of where CMIOs and other medical informaticists are at the time of the gathering. I had to put a label on this year’s discussions, it would be a phrase something like “deep in the weeds”/’in the trenches,” right now. What’s clear is that CMIOs and other medical informaticists are virtually overwhelmed by all the mandates hitting them right now, from those coming out of the meaningful use process under the HITECH (Health Information Technology for Economic and Clinical Health) Act, to those deriving from the Affordable Care Act (ACA); the requirements linked to the transition to the ICD-10 coding system; and now, those related to the new enhanced data security requirements under HITECH Act known as the “Final Omnibus Rule” under HIPAA (the Health Insurance Portability and Accountability Act of 1996).
And those sets of mandates don’t even include the requirements related to the voluntary programs their organizations are getting involved in, including accountable care organization (ACO) and bundled-payment contracting development, both as part of the official federal programs under healthcare reform, and under the auspices of private health insurers.
So how is all of this hitting CMIOs and other medical informaticists right now? Like a ton of bricks, basically. As Colin Banas, M.D., CMIO at VCU Health System in Richmond, Va., told me, the comments made by attendees in response to the Reider/Muntz session “reflect how difficult MU2 is,” and CMIOs’ anxieties over tackling Stage 2 of meaningful use in 2014. “We’re a very advanced organization in terms of CPOE, and everyone thought Stage 1 would be a cakewalk for organizations like ours—and it wasn’t,” Banas told me. “Meanwhile,” he added, “MU2—the quality reporting requirements are on steroids. And as advanced as we are, MU2 is turning out to be very, very challenging for us.” Still, he said, there is a basic acceptance that the meaningful use process is not going away. “It’s all about the process challenges now,” he added.