Go Slow on Electronic Records, IT Group Urges

The trade association for hospital IT executives is urging federal authorities to back off on setting the next stage of e-record "meaningful use" standards until more health-care providers have experience meeting first-stage use standards.

Pushing forward, without pause, could result in Stage 2 meaningful use standards that are "unduly ambitious, even unattainable," the College of Healthcare Information Management Executives warns in a letter sent Friday to the Office of the National Coordinator for Health IT. It's a classic case of putting the cart before the horse, CHIME says.

Health-care providers must demonstrate meaningful use to qualify for financial Medicare and Medicaid incentives. CHIME suggests not implementing Stage 2 electronic health record meaningful-use standards until about 30 percent of eligible hospitals and providers achieve Stage 1 meaningful use.

"We believe this approach would strike a reasonable balance between the desire to push EHR adoption and [meaningful use] as quickly as possible and the recognition that unreasonable expectations could end up discouraging EHR adoption if providers conclude that it will be essentially impossible for them to qualify for incentives," the letter says.

CHIME urges ONC and the Centers for Medicare and Medicaid Services to "take all the time needed to produce clear and understandable policies" rather than "imposing some artificial deadline on the movement to Stage 2." Stage 1 standards went into effect this year, with Stage 2 set to begin in 2013.

The group also argues that early Stage 2 proposals made by the Health Information Technology Policy Committee, an advisory group to ONC and the Health IT Standards Committee, are unclear.

Standards and policies must "pass a practicality test" based on "realistic expectations of what motivated providers, including busy physicians and other health professionals, will be able to accomplish," says the letter, which is signed by President Richard A. Correll and Dr. Lynn Vogel, chair of the CHIME board and CIO of the University of Texas's M.D. Anderson Cancer Center. The 1,400 members of the Ann Arbor, Mich.-based CHIME include hospital chief information officers and other top IT executives.