At the April 3 Policy Committee meeting, Paul Tang, M.D., vice chair of the committee, outlined the work in progress. He said at this inflexion point, ONC must take into account progress and momentum in health IT usage as it thinks about stage 3. “So the thinking is we are recognizing the benefits, let’s back off on the reporting cost of doing so,” Tang said. “It has been a forced march, and that has meant fewer resources available for vendors and providers to innovate and address local priorities.”
Policy Committee member Christine Bechtel, vice president of the National Partnership for Women & Families,described ongoing efforts to consolidate MU objectives to reduce the total number of things you have to report on. “We want to eliminate the “check-the-box” things that should be de facto ways people use HIT.” The consolidation subgroup started with all 43 objectives originally proposed for Stage 3 and consolidated them to 25. All the criteria still would be included in EHR certification requirements, so the features would be available without regulators micro-managing their use. An example is recording structured lab results. That requirement is really already included in the criteria around creating care summaries and view, download and transmit data.
Tang then described how the meaningful use work group is considering “deeming” that some high performers or those showing significant improvement on clinical quality measures meet MU requirements. “You cannot be a good performer on these measures without effective use of health IT,” he said. “If you demonstrate you are doing well by patients, we will let up in terms of requirements to promote innovation and reduce the burden.”
Tang acknowledged that there might not be enough outcome measures in some specialty areas for those providers to deem, but those clinicians can still use the original pathway to MU, he said.
“We are trying to reward good behavior, reduce the burden and let the market pull people along.”
The committee’ s response was positive, with several members saying the plan has the potential to increase flexibility while making the MU program less burdensome.
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