EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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HHS calls Stage 3 rule 'flexible, clearer framework' | Healthcare IT News

HHS calls Stage 3 rule 'flexible, clearer framework' | Healthcare IT News | EHR and Health IT Consulting | Scoop.it

It's more of a requisite first step than milestone, but the Department of Health and Human Services sent the proposed rule for meaningful use Stage 3 to the Office of Management and Budget.

There’s precious little detail in these submissions, but HHS foreshadowed the major problems it intends to address with this next, and perhaps final, stage of the federal EHR Incentive Program.

"Stage 3 will focus on improving health care outcomes and further advance interoperability," according to OMB’s website. "Stage 3 will also propose changes to the reporting period, timelines and structure of the program, including providing a single definition of meaningful use. These changes will provide a flexible, yet, clearer framework to ensure future sustainability of the EHR program and reduce confusion stemming from multiple stage requirements."

The Office of the National Coordinator for Health IT also submitted a rule to OMB proposing a new 2015 Edition Base EHR definition, as well as modifications to the ONC Health IT Certification Program, "to make it more broadly applicable to other types of health IT health care settings and programs," another OMB web page states.

ONC’s proposed rule would establish capabilities and criteria, and specify standards and implementation specifications that EHR makers must meet, to "at a minimum support the achievement of meaningful use" for customers including eligible hospitals and eligible providers looking to attest and receive incentives.

OMB ranks both proposed rules as “major” but the in the form’s legal deadline field the status is none.

Stage 3 is expected to begin in 2017.


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Physicians Still Sour on Meaningful Use Attestation Changes | EHRintelligence.com

Physicians Still Sour on Meaningful Use Attestation Changes | EHRintelligence.com | EHR and Health IT Consulting | Scoop.it
The adjustments involved in successful meaningful use attestation still get a thumbs-down from pessimistic physicians.

Physicians are still not sold on the idea of changing their daily workflows to meet the requirements of meaningful use, finds a new study in BMC Medical Informatics and Decision Making.  In a survey of 400 providers at 47 ambulatory practices, the researchers found a general unwillingness among all types of physicians to adapt to the needs of Stage 1 meaningful use (MU), and a general lack of confidence in their organization’s ability to rise to the challenges presented by EHR implementation.

The study cites the importance of effective change management strategies as a foundation for preparing healthcare providers for the impact of EHR implementation and meaningful use attestation.  “In busy practice settings, such change efforts are often difficult to implement effectively. In fact, experts have suggested that without sufficient readiness for change, change efforts are more likely to lead to unrealized benefits or fail altogether,” the authors write.  “With billions of dollars invested in MU and the countless hours spent by providers and clinical staff on MU implementation nationally, unrealized benefits from the program would carry significant financial and opportunity costs for health care systems.”

Resistance to the changes involved in meaningful use is nothing new in the healthcare industry.  The study adds to the anecdotal notion that physicians are particularly unwilling to embrace workflow changes due to new technologies and requirements.  While approximately 83% of nurses and advanced practice providers (APPs) indicated a willingness to change their workflow in response to meaningful use, just 57.9% of physicians reported the same.  Nearly 45% of nurses and APPs believed their organization would be able to address any problems that arose during meaningful use attestation, but only 28.4% of physicians were optimistic about overcoming issues.

Specialists were nearly three times more likely than primary care providers to believe that meaningful use would divert significant attention away from the practice of patient care.  Twelve percent of specialists thought their interactions will patients would suffer, compared to 4.4% of other providers.  However, specialists were no more likely than other providers to believe their organizations were unready to tackle meaningful use.

“These results suggest that leaders of health care organizations should pay attention to the perceptions that providers and clinical staff have about MU appropriateness and management support for MU,” the study concludes. “Change management efforts could focus on improving these perceptions if need be as it is feasible that doing so could improve willingness to change practices for MU.”

The authors suggest that organizational leaders invest in education for their staff about the benefits and opportunities involved in meaningful use.  Creating opportunities to provide guidance, demonstrations, and training for EHR proficiency and documentation measures required for attestation may help to ease trepidation among providers, while indicating a strong sense of support along with a clear implementation framework may help to make meaningful use attestation a more successful prospect.


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