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MU Stage 3: Back to the Drawing Board

February 8, 2013
by David Raths
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Responding to public comment, work group seeks to focus on outcome measures

After hearing public comment on Feb. 6 that its proposals for Stage 3 may overwhelm vendors and providers still grappling with Stages 1 and 2, the Health IT Policy Committee’s Meaningful Use Work Group went back to the drawing board Feb. 8 to consider alternative approaches.

Let by Chairman Paul Tang, M.D., chief medical information officer of the Palo Alto Medical Foundation in California, the MU Work Group began considering how Stage 3 might focus on outcomes rather than process measures.

“There is no intention to change Stages 1 and 2,” Tang stressed. But he said the Feb. 6 meeting indicated that providers are concerned about the rapidity of change and how much is on people’s plates, such as ICD-10, accountable care initiatives, MU Stage 2 and new HIPAA rules.

From the beginning, he added, meaningful use was put in place as a preparation for health care reform, to make sure providers had effective tools to effect change in health care delivery, including payment reform. But once the tools are in place, Stage 3 may be a good inflection point to pause and discuss how measures could focus on outcomes. Would it be possible to create an alternative pathway so that health systems that are already achieving measurable improvements and are using EHRs could be recognized for that without having to report data about specific processes? Perhaps measures in Stage 3 could focus on areas where there has been less progress, such as interoperability and patient engagement, he added.

Another idea, Tang said, would be to cluster and consolidate MU measures to simplify the process. At the Policy Committee meeting, there were suggestions that most or all measures be offered as a menu rather than the traditional approach of a mix of core and menu options.

The work group members responded positively to Tang’s idea of researching new approaches. He suggested that the work group spend the next several weeks fleshing out ideas for alternative approaches to Stage 3 and present them to the full Policy Committee on April 3. 

“We heard valid points made at the Policy Committee meeting the other day,” he said. “We have to determine if we can at the same time move toward an outcomes approach, reduce the burden, and increase flexibility and innovation.”

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