The federal government is already at work on second and third stages of meaningful use requirements, according to David Blumenthal, MD, national coordinator for health information technology. These stages will be used beginning in 2013 and 2015 to qualify providers for health IT adoption incentives.
At a Wednesday meeting of the Health Information Technology Policy Committee, Blumenthal said the Office of the National Coordinator (ONC) is starting to work now on requirements for 2013 and 2015 to allow time for better planning.
Lawmakers "didn't leave us time or a lot of reflection and a lot of careful forward planning" for Stage 1," he said. "And we want to do better than that this time. We want to make sure we have more time to consider our longer-range strategy."
Qualified providers can begin using meaningful use Stage 1 requirements to collect data beginning in January 2011. With the final Stage 1 meaningful use rule coming out last July, this hasn't allowed providers and vendors much preparation time, Blumenthal conceded.
"For those of you who are trying to react to the first stage of meaningful use, we aren't going to change the targets," he said. "We are mindful of the fact that the first go-around was very rushed."
Blumenthal said Stage 1 of meaningful use focused on health IT adoption. Stages 2 and 3 will need to focus on infrastructure and interoperability.
Paul Tang, chair of the Meaningful Use Workgroup outlined a tentative schedule for the planning. His workgroup plans to present a draft of meaningful use Stages 2 and 3 requirements to the Health IT Policy Committee by Nov. 19. It will revise the draft after it receives comments from the committee, providing another draft by March 2011. The committee should have final recommendations for ONC by the third quarter of 2011.
The Centers for Medicare and Medicaid Services is slated to release a notice of proposed rulemaking on Stages 2 and 3 of meaningful use by the fourth quarter of 2011, Tang said.
As part of a preliminary discussion, most members of the Health IT Policy Committee agreed that Stage 2 should be geared toward preparing providers for Stage 3. This means that Stage 2 will not be an incremental step from Stage 1, but more of a stepping stone to Stage 3, according to Tang.
Some members of the committee voiced concerns with this plan. Paul Egerman said, "When we did Stage 1, we did signal a lot of things to people. In Stage 2 we need to make sure we visit everything we signaled in Stage 1. If we don't then people won't trust our roadmaps."
Committee member and Epic Systems CEO Judith Faulkner urged ONC to push for an earlier delivery of Stage 2 requirements. Vendors and hospitals need more time to prepare. "The sooner, the better," she said.
