One of the key things regulators lacked when working on Stage 2 of meaningful use was solid feedback on how providers were doing implementing Stage 1. The Office of the National Coordinator for Health IT has taken some steps to address that lack of input. On Feb. 7, ONC staffer Dawn Heisey-Grove made a presentation to the Meaningful Use Work Group on an effort to identify and analyze barriers to successfully achieving meaningful use.

ONC asked Regional Extension Centers to begin tracking what they identify as practice-level barriers. So far, responses have been tracked for more than 4,000 practices, Heisey-Grove reported, although only 33 of 62 RECs have entered data, and three are responsible for approximately 1,000 entries. But even if the data are not representative, and do not differentiate between large and small practices, the numbers are interesting to look at.  

RECs identified that 34 percent saw vendor selection as a barrier. Thirty-two percent have electronic health records and are waiting for vendors to complete upgrades. Some have EHRs that are not certified.

“My impression is not that there is a lack of vendors, but an overabundance of choices,” Heisey-Grove said. Many providers are doing a rip and replace, she added.

In the area of attestation process barriers, 76 percent said the Medicaid program was not up and running in their state yet. Most of these were in California, she said.

The area that has the most potential to be valuable to regulators involves barriers related to specific measures, although there didn’t seem to be enough detail yet to be instructive. The two that providers were having the most trouble with were core measures involving clinical summaries and security reviews. Thirty-six percent said they are just waiting for their security risk assessment to take place.

The REC feedback mechanism, if fine-tuned and expanded, could prove helpful in shaping Stage 3 criteria.