ORLANDO – The American Academy of Dermatology Association joins several dozen physician organizations in imploring the Department of Health and Human Services to slow down implementation of the meaningful use program for electronic health records, saying that the pace is overwhelming doctors’ ability to keep up.
The request comes as more than 35,500 attendees gather for the annual meeting of the Healthcare Information and Management Systems Society to learn more about government and private efforts to digitize the U.S. health care system.
Dr. Dirk M. Elston
In a letter to HHS Secretary Kathleen Sebelius, the physician groups said that doctors are struggling to make the investments needed to meet the federal targets. The groups want the government to give physicians through 2015 to transition to new EHR software and to meet stage 1 and 2 meaningful use requirements. They are also seeking more flexibility in how physicians meet those requirements.
Under the meaningful use program, eligible providers – physicians, nurse practitioners, and physician assistants who meet specific criteria – can receive incentive payments from Medicare and Medicaid. In 2014, the Medicare payment can be up to $23,520.
"The American Academy of Dermatology Association remains concerned that some provisions of HIT implementation, as well as other Medicare reporting requirements, pose an undue burden on physicians to achieve compliance with the regulations," Dr. Dirk M. Elston, president of the American Academy of Dermatology Association, said in a statement.
"Specifically, this year physicians will be required to adopt the 2014 Edition of Certified Electronic Health Record Technology and meet a higher threshold of Meaningful Use criteria. Unfortunately, there are only a few products currently certified to 2014 Edition standards, which could hinder our physicians’ ability to comply with the EHR incentive program, resulting in a loss of incentive payments, but also the imposition of significant penalties," he said. "Therefore, the AADA calls on the Department of Health and Human Services to extend the compliance deadline to ensure that providers have ample time to learn the new technology, and as a result, improve patient care," Dr. Elston added.
Centers for Medicare & Medicaid Services (CMS) officials at the HIMSS meeting said that 267,029 eligible providers have received Medicare incentive payments and 142,801 have received Medicaid payments since the program began in 2011, amounting to some $21 billion in payouts.
Providers will be penalized in 2015 if they do not sign up to be a meaningful user by March 31, said Elizabeth Holland, director of the HIT initiatives group at the CMS Office of E-Health Standards and Services. That date was recently extended by a month. Doctors who have never participated in the meaningful use program have until Oct. 1 to sign up to avoid penalties next year, and many physicians may be eligible for hardship exemptions that give them even more time to sign up, Ms. Holland said.
The physician groups still want more leeway. A big sticking point: Currently, eligible professionals have to adopt the 2014 Edition of Certified Electronic Health Record Technology (CEHRT) and also meet more stringent meaningful use standards by the end of the year. Most providers are still working with the last edition – the 2011 CEHRT. The Office of the National Coordinator for Health Information Technology (ONC) created the CEHRT program to guide providers to EHRs that contain all the elements necessary to achieve meaningful use. The 2014 edition supports stage 2 of meaningful use, which started this year.
"With only a fraction of 2011 Edition products currently certified to 2014 Edition standards, it is clear the pace and scope of change have outstripped the ability of vendors to support providers," according to the letter from the physician groups. If doctors can’t easily move on to the 2014 edition, they might "either abandon the possibility of meeting meaningful use criteria in 2014 or be forced to implement a system much more rapidly than would otherwise be the case."
While physicians worry about the 2014 edition, the ONC on Feb. 21 proposed to move forward again, spelling out standards for the 2015 edition of the CEHRT.
The ONC said that compliance with the 2015 edition would be voluntary – providers would not have to upgrade to be able to get incentive payments.
"This provides the opportunity for developers and health care providers to move to the 2015 Edition on their own terms and at their own pace," Dr. Karen DeSalvo, national coordinator for health IT, said in a statement.
The rule on the 2015 edition will be published in the Federal Register on Feb. 26, and the ONC will take comments at www.regulations.gov until April 28. The final rule will be published this summer.