After Anxious Wait, Stage 2 Meaningful Use Draft Rule Published

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After promises to see official drafts of the proposed Stage 2 Meaningful Use EHR rules today, the scuttlebutt from HIMSS12 was that some technical hang-ups in the federal release process would delay the document at least another day; possibly until Monday. Then, just before the end of the working day on the East Coast, the Office of the Federal Register published the draft online as a PDF file. The wait between Wednesday's sneak peek at the rules and the late Thursday publication of the draft rule did little to ease anxiety on the convention floor in Las Vegas, according to Pamela G. McNutt, Senior VP and CIO at Methodist Health System in Dallas, TX, and a fellow of the College of Healthcare Information Management Executives (CHIME). Despite all the official previews offered thus far, she says, the devil is ever in the details.

Meaningful Use Top Topic at HIMSS

“Meaningful Use Stage 2 kind of hijacked the conference,” McNutt said today. “All anybody’s doing is jumping into conference halls, awaiting what this is going to look like—especially the vendors. “Literally, all they’ve given us is one sentence per measure today to tell us what they’re going to be,” she said. The abbreviated timeline for vendors—to digest the as-yet-unpublished formal regulations, integrate the necessary functionality into their products to bring themselves into compliance, and then line up their customers for upgrades—is a source of some anxiety, she said. “You have to be ready to show a full year of compliance by October 1, 2014,” McNutt said. “For me that means I have to have everything ready to go in about a year and a half.” The Thursday slate of CMS-led “deep dives” into various sections of MU2 have brought “tons of stuff; mainly good things,” McNutt said, including flexibility in set options for hospitals getting up-to-date with menu objectives. “You can pick and choose a lot of measures based on your setup,” she said.

Putting EHRs and PACS Together

One of the biggest options is the ability to contextually link patient EHRs with web-based PACS systems. It seems like a simple condition, but McNutt says it may prove to be a hurdle simply based on the scope of such a project. “If I’m looking at my record and I want to see an image of my broken ankle, can I click on a button and bring up my images?” she said. “That’s not a piece of cake. “It’s a revenue opportunity for imaging vendors, but it’s also going to put a lot of strain on them because they’re going to get hit with a lot of requests to hook this up,” McNutt said. “That’s why this is all part of the stimulus package.” Other data issues included integrating imaging reports into health exchanges, a feature McNutt said is likely “already in your EMR somewhere” from a transcription service or voice imaging technology. “They made certain kinds of data exchanges, like linking into an HIE, a mandatory measure—and it has to be live, not just a test,” she said. “That’s the one that will probably get a lot of comments because there’s different levels of readiness across the country from that kind of thing.” Radiologists should also note that for the first time, ordering physicians will now need to send more than half their radiology orders electronically through a computerized provider order entry (CPOE) system in order to qualify for Stage 2 Meaningful Use incentive payments. To view the draft Stage 2 Meaningful Use rule, click here.