EHR Meaningful Use for Indiana: Looking Back on 2014

Thursday, December 18, 2014

CalendarIt's been a very tough year for Meaningful Use throughout our state. But while it's hard work, we do see bright spots and continue to believe that use of EHR technology will be the basis of great patient quality and cost improvements in the upcoming years.

Understandably so, physicians aren't real happy with the news that more than one third of eligible professionals (EPs) will face penalties under the Meaningful Use incentives program in 2015. That means that more than 257,000 EPs nationwide will receive notices in the coming weeks that they will be subject to Medicare payment reductions.

At Purdue Healthcare Advisors, we've been working with more than 3,000 of Indiana's EPs and 50 hospitals over the past few years to keep them on track as far as Meaningful use goes. Our clients faced many challenges in 2014. Stage 2 Meaningful Use (MU) has been more challenging than Stage 1 for the majority mainly because vendor implementation has been delayed and both the patient engagement and interoperability measures are harder to meet than they anticipated.

The Flexible Reporting Option Rule, made final by CMS in September of 2014, did take some pressure off of certain clients by allowing them to use 2011 edition certified electronic health record technology (CEHRT), or a combination of 2011 and 2014 edition CEHRT, to meet Meaningful Use for an EHR reporting period in 2014. In addition, our project managers are getting plenty of feedback from clients that strongly suggests we are on the right track in building a solid EHR foundation. For those clients able to meet the patient engagement measures, we've heard some promising stories. Meeting the patient engagement objectives means that patients can securely communicate with their providers electronically, giving them greater access to their provider and their own medical records. Some providers have told us their patient portals are directly leading to enhanced patient safety. Patients can see their medication dosage or list of medication allergies are better able to correct any inaccuracies. Just the convenience of being able to send a message to their provider on their own time – not having to wait on hold – is making for a smoother healthcare delivery process.

But with the looming penalties and software roll out delays, we're concerned that the Flexible Reporting Option Rule has not been as “flexible” as it needs to be. Under the rule, (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) must use the 2014 edition CEHRT in 2015. Will our clients be able to get the latest software in time for all of next year, when they had such a difficult time this year? A few already have told us they won't be able to attest in 2015 for this very reason.

Another looming issue for the 2015 reporting year involves the required 365-day reporting period. Any EP not in his/her first program participation year faces a full-year reporting period in contrast to previous reporting periods of only 90-days. Continuously monitoring all the MU objectives can be tough in Stage 2, especially when EPs are required to register their intent to attest with their state's public health agency. Each agency has different requirements for this process, which can cause major confusion and mistakes that can even derail attestation.

In reaction to this week's announcement that such a large percentage of physicians will be penalized for failing to meet MU, lawmakers are calling for changes to the rule. Giving EPs more flexibility on their journey to becoming EHR meaningful users may be key in preserving their motivation to so, and we'll be closely monitoring these developments.

Better use of EHR technology is a prerequisite for the implementation of population health and patient centered medical home initiatives that will lead to patient-care improvements and healthcare-cost reductions. We know it's a foundation that our clients are committed to building, with or without the associated penalties. Patients, including your family as well as mine, are counting on all of us to continue to meaningfully use EHRs and improve quality of care. Working together, we are confident we can deliver.

Randy Hountz

Randy Hountz, MBA, is director of Purdue Healthcare Advisors and the Purdue Regional Extension Center,which serves the majority of eligible providers in the State of Indiana as one of 62 Regional Extension Centers nationwide.

Writer: Randy Hountz, 765-494-0766,

Tags: Quality Services

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