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CCHIT, KLAS might signal new era in EHRs

Two stories that have hit in the last 48 hours illustrate how the status quo in EHRs is being upset.

First off, as John Lynn broke late Tuesday night—first as a rumor and then as a confirmed fact—on his EMR and HIPAA blog, CCHIT, formerly known as the Certification Commission for Health Information Technology, is getting out of the health IT certification business, thus making sense out of the name change. The organization will continue to offer preparatory courses for ONC-sanctioned testing and certification, but no more actual certification.

CCHIT recommended that vendors turn to another authorized testing and certification body, Verizon-owned ICSA Labs, though there are others that still do offer certification, including Drummond Group, SLI Global Solutions, InfoGard Laboratories, and, for e-prescribing technology, Surescripts. Interestingly, CCHIT also announced that it will partner with HIMSS to offer a series of health IT events for vendors and providers. This is interesting because HIMSS was one of the three founding organizations of CCHIT in 2004, and CCHIT was under fire five years ago for maintaining too close of a relationship with HIMSS (also see this link).

When Meaningful Use came along with the passage of the American Recovery and Reinvestment Act in 2009, CCHIT lost its exclusivity in certifying health IT products, as EHR certification essentially became commoditized. Other certifying bodies also have undercut CCHIT on price, so this move really does not surprise me.

The other big story, if you pay attention to things such as vendor rankings, is that Athenahealth just unseated Epic Systems as KLAS Research’s “Best in KLAS Overall Software Vendor” of 2013. Epic had held the top spot for eight years in a row. “The old guard of HIT leaders is finally being displaced by more nimble, innovative models designed for health care’s future—not for its past. The latest KLAS rankings show that closed-system, traditional software offerings are not robust or flexible enough to meet providers’ demands anymore,” Athenahealth CEO Jonathan Bush said in a statement.

I’m not sure I’d go that far, as Epic is still eating everyone else’s lunch in the enterprise market. But, to me, this shows that smaller physician practices that don’t have IT departments are adopting EHRs and want a cloud-based product that is easy to maintain. That certainly heralds a major shift in health IT.

January 30, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

‘Escape Fire’ leaves out IT, ultimately disappoints

I finally got the opportunity to catch the documentary film “Escape Fire,” a good 15 months after it went into limited theatrical release and became available in digital formats. I thought it would be an eye-opening exposé of all that ills the American healthcare industry, particularly for those who somehow believe we have the greatest care in the world. I excitingly ran this graphic when I first mentioned the movie on this blog back in October 2012:

The well-paced, 99-minute film interviews some notable figures in the fight to improve American healthcare — safety guru and former CMS head Dr. Don Berwick, journalist Shannon Brownlee, integrative medicine advocates Dr. Andrew Weill and Dr. Dean Ornish — as well as some lesser-known people trying to make a difference. It goes through a laundry list of all the culprits in the overpriced, underperforming mess of a healthcare system we have now, and examines approaches that seem to be producing better care for lower cost.

I expected the movie to have a liberal slant, but it really stayed away from the political battles that have poisoned healthcare “reform” the last couple of years. About the only presence of specific politicians were clips of both President Obama and Senate Republican leader Mitch McConnell both praising a highly incentivized employee wellness program at grocery chain Safeway that reportedly kept the company’s health expenses flat from 2005 through 2009, a remarkable achievement in an era of escalating costs.

However, filmmakers Matthew Heineman and Susan Froemke did discuss all the lobbyists’ money presumably buying off enough votes in Washington and at the state level that has helped entrench the status quo. They even scored an interview with Wendell Potter, the former top media spokesman for Cigna, who became a public voice against abuses by health insurers because his conscience got the better of him. As Brownlee noted in the film’s opening, the industry “doesn’t want to stop making money.”

Other reasons given for why healthcare is so expensive, ineffective and, yes, dangerous include:

  • direct-to-consumer drug advertising leading to overmedication;
  • public companies needing to keep profits up;
  • fee-for-service reimbursement;
  • the uninsured using emergency departments as their safety net;
  • lack of preventive care and education about lifestyle changes;
  • a shortage of primary care physicians;
  • cheap junk food that encourages people to eat poorly; and
  • severe suffering among the wounded military ranks.

The filmmakers also kind of imply that there isn’t much in the way of disease management or continuity of care. Brownlee described a “disease care” system that doesn’t want people to die, nor does it want them to get well. It just wants people getting ongoing treatment for the same chronic conditions.

One physician depicted in the movie, Dr. Erin Martin, left a safety-net clinic in The Dalles, Ore., because the work had become “demoralizing.” The same people kept coming back over and over, but few got better because Martin had to rush them out the door without consulting on lifestyle choices, since she was so overscheduled. “I’m not interested in getting my productivity up,” an exasperated Martin said. “I’m interested in helping patients.”

Another patient in rural Ohio had received at least seven stents and had cardiac catheterization more than two dozen times, but never saw any improvement in her symptoms for heart disease or diabetes until she went to the Cleveland Clinic, where physicians are all on salary and the incentives are more aligned than they were in her home town. As Berwick importantly noted, “We create a public expectation that more is better.” In this patient’s case, she was over-catheterized and over-stented to address an acute condition, but not treated for the underlying chronic problems.

The film also examined how the U.S. military turned to acupuncture as an alternative to narcotics because so many wounded soldiers have become hooked on pain pills. One soldier, a self-described “hillbilly” from Louisiana, got off the dozens of meds he had become addicted to and took up yoga, meditation and acupuncture to recover from an explosion in Afghanistan that left him partially paralyzed and with a bad case of post-traumatic stress disorder. The only laugh I had in the movie was when he told the acupuncturist at Walter Reed Army Medical Center in Washington, “Let’s open up some chi.”

I kept waiting and waiting for some evidence of information technology making healthcare better, but I never got it. After leaving the Oregon clinic, Martin took a job at a small practice in Washington state where she was seen toting a laptop between exam rooms, but, for the most part, I saw paper charts, paper medication lists and verbal communication between clinicians.

What really bothered me, however, is the fact that there was no discussion of EHRs, health information exchange or clinical decision support, no mention of the problem of misdiagnosis, no explicit discussion of patient handoffs, continuity of care, medication reconciliation and so many other points where the system breaks down. You can’t truly fix healthcare until you address those areas.

 

January 21, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

CMS proposes MU2 extension, MU3 start date of 2017

Less than three weeks ago, I reported from the American Medical Informatics Association Annual Symposium in Washington that officials from the Office of the National Coordinator for Healthcare Information Technology were publicly saying it was unlikely there would be a delay to Stage 2 of Meaningful Use.

In October, noting that the federal rule-making process can be arduous, former national health IT coordinator Dr. Farzad Mostashari said, “I think folks should assume that the timelines stick.” He was speaking to the College of Healthcare Information Management Executives a week after leaving government service.

Today, we find out that they knew something we didn’t. The Centers for Medicare and Medicaid Services proposed extending Stage 2 to 2016 and delaying the start of Stage 3 to 2017.

Per ONC:

Under the revised timeline, Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for those providers that have completed at least two years in Stage 2. The goal of this change is two-fold: first, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2; and second, to utilize data from Stage 2 participation to inform policy decisions for Stage 3.

The phased approach to program participation helps providers move from creating information in Stage 1, to exchanging health information in Stage 2, to focusing on improved outcomes in Stage 3. This approach has allowed us to support an aggressive yet smart transition for providers.

 

The delay to Stage 3 was likely. As I exclusively reported in June, ONC’s deputy national coordinator for programs and policy, Judy Murphy, dropped a strong hint that Stage 3 would not start until 2017, saying, “2016 would be a problem.” By pushing back the start of the third stage, we would automatically get an extension to Stage 2, making it a three-year program instead of two.

The start of Stage 2 already had been pushed back a year from the original plan of 2013. From my reading, what CMS is proposing today is not another delay to the beginning of Stage 2. Hospitals that have begun their attestation periods since Oct. 1 may continue and physicians are allowed to start Jan. 1.

CMS said to expect proposed Stage 3 regulations, as well as proposed ONC EHR certification rules for Stage 3, in the fall of 2014.

What strikes me as odd is that this announcement came late on a Friday afternoon. There is no time stamp on the ONC blog post, but CMS’ Travis Broome tweeted this at 4:05 pm EST:

Late Friday is typically when government agencies take steps they don’t want plastered all over the news. I don’t see anything here that is surprising or controversial, and it could be argued that ONC didn’t mislead people with earlier statements because the start dates for Stage 2 are not changing. Did I miss something?

UPDATE: CMS held a webcast about this that started at 1 p.m. EST. That’s still Friday afternoon, but not so late that it looks like they’re trying to bury the news.

 

December 6, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

The ‘Hospital of Tomorrow’

WASHINGTON—I’ve just finished 2 1/2 days of helping US News and World Report cover its inaugural Hospital of Tomorrow conference. My assignment was to sit in on four of the breakout sessions, take notes, then write up a summary as quickly as possible, ostensibly for the benefit of attendees who had to pick from four options during each time slot and might have missed something they were interested in. Of course, it’s posted on a public site, so you didn’t have to be there to read the stories.

Here’s what I cranked out from Tuesday and Wednesday:

Session 202: A Close-Up Look at EHRs — ‘Taking a Close Look at Electronic Health Records”

Session 303: The Future of Academic Medical Centers — “Academic Medical Centers ‘Must Become More Nimble’”

Session 305: Preventing and Coping With Infections — “How Hospitals Can Better Prevent and Cope With Infections”

Session 401: Provider and Patient Engagement — “Hospitals Grapple With Patient Engagement”

The one on infection control was particularly interesting, in large part due to the panel, which included HCA Chief Medical Officer and former head of the Veterans Health Administration Jonathan Perlin, M.D., Johns Hopkins quality guru Peter Pronovost, M.D., and Denise Murphy, R.N., vice president for quality and patient safety at Main Line Health in suburban Philadelphia.

The session on patient engagement was kind of a follow-on to my first US News feature in September.

If you want to read more about the whole conference, including US News’ live blog, visit usnews.com/hospitaloftomorrow

November 7, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: MMRGlobal’s Bob Lorsch addresses the ‘patent troll’ issue

Two weeks ago, I picked apart a terribly misleading, ideologically steeped Fox News story that wrongly linked the initial failure of the healthcare.gov Affordable Care Act insurance exchange to the Meaningful Use EHR incentive program. Among my many criticisms was the reporter’s apparent confusion between an actual EHR and My Medical Records, the untethered PHR offered by MMRGlobal.

In that post, I said, “I haven’t seen a whole lot of evidence that MMRGlobal isn’t much more than a patent troll.”

Bob Lorsch, CEO of that company, posted in the comments that I should put my money where my mouth is and interview him. (I had interviewed Lorsch before, but never wrote a story because of my longstanding policy of not paying attention to untethered PHRs since none that I know of has gained any market traction, despite years of hype.)

As this podcast demonstrates, I took Lorsch up on his offer. It was at times contentious, in part because I challenged many of his statements in the Fox story and to me, and in part because he challenged some of mine.

He asked me a pointed question, whether I still thought he was a patent troll. Based on the fact that MMR actually earned patents on a product it actively markets and didn’t just purchase someone else’s patents for the point of suing others, it’s hard to conclude that he is a patent troll.

Investopedia defines patent troll as:

A derogatory term used to describe people or companies that misuse patents as a business strategy. A patent troll obtains the patents being sold at auctions by bankrupt companies attempting to liquidate their assets, or by doing just enough research to prove they had the idea first. They can then launch lawsuits against infringing companies, or simply hold the patent without planning to practise the idea in an attempt to keep other companies productivity at a standstill.

By that definition, MMR is not. I still don’t think an untethered PHR is a good business model, a belief supported by the fact that publicly traded MMR is a penny stock, currently trading at less than 3 cents per share. I have said that patient engagement, called for on a small scale by Meaningful Use Stage 2 rules, could change the landscape for PHRs—with a better chance in pediatrics than for adult populations—but it certainly will take a few years.

I stand by my original statement that the Fox News story did health IT a huge disservice by latching onto one problem and trying to tie it to an unrelated issue simply because it fits an ideological narrative. As for MMR, well, take a listen and then judge for yourself. It’s a long podcast, but I went through the trouble of breaking it down by discussion point so you can skip around as necessary.

Podcast details: Interview with Bob Lorsch, CEO of MMRGlobal, recorded Oct. 18, 2013. MP3, mono, 128 bps, 49.5 MB, running time 54:07

2:03        About My Medical Records
3:26        Why he believes his product is better than traditional EHRs
5:00        My skepticism of untethered PHRs
6:28        Lorsch’s interview with HIStalk from February
6:40        MMR’s user base
8:00        Why he thinks MMR could facilitate health information exchange
9:40        Health information exchanges vs. health insurance exchanges
10:15     Patient-centered HIE as an alternative to multiple patient portals
12:20     Physician trust of patient-supplied data, and other workflow issues
15:05     Emergency use case
15:50     How MMR is different from other PHRs
16:32     “Last mile” of connectivity
18:17     His assertion in Fox story that patients lose control of health information and privacy under ACA, despite HIPAA
24:15     MMR carries cyber liability insurance
25:00     Scope of MMR’s patents
26:45     “Likely” infringement of patents
27:45     Lawsuits and licensing
29:30     Patent troll?
31:10     Negotiations with WebMD and others
33:00     MMR’s reputation
35:00     “We build and sell what we have intellectual property rights to.”
36:25     Other vendors ignoring patients?
36:50     Standardization in health IT
38:38     MMR’s low stock price
39:20     Patient engagement boosting PHR use?
42:00     Interest from WellPoint
42:48     Payers building trust with PHRs
44:18     Other features of MMR’s PHR
46:45     Segmentation of sensitive parts of medical records
49:08     Putting me on the spot
50:35     His objective in asserting patent rights
51:15     MMR’s issue with Walgreens
52:25     Revenue sharing vs. licensing

October 31, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Top 10 things wrong with Fox News smear job on EHRs

Today, FoxNews.com published a hit job on health IT and EHRs in the guise of another hit job on Obamacare. I found out about it courtesy of this tweet:

First off, it’s clear that Mostashari feels unshackled from having to watch his words now that he’s no longer national health IT coordinator. Secondly, he’s right. This story contains so many errors and misleading statements that it’s almost funny. Let’s count down the top 10.

10. “Under a George W. Bush-era executive order, all Americans should have access to their medical records by the end of 2014, part of a concept referred to as e-health. President Obama then made electronic medical records (EMRs) central to the success of the Affordable Care Act”

When Bush issued the executive order in 2004 that created the Office of the National Coordinator for Health Information Technology, he set as a goal interoperable EMRs for “most” Americans. The “all” part came after Barack Obama took office in 2009.

9. Though Obama did reiterate the 2014 goal and up the stakes by saying “all Americans,” nobody realistically thought it could happen. After all, the HITECH Act, which created Meaningful Use, didn’t pass until March 2009 and Meaningful Use didn’t even start until 2011. Before the HITECH Act, ONC barely had any funding anyway. For five years, Congress failed to pass much in the way of health IT legislation, even though a federal EHR incentive program had bipartisan support, symbolized by an unlikely alliance between Newt Gingrich and Hillary Clinton.

8. “Doctors, practitioners and hospitals, though, have been enriching themselves with the incentives to install electronic medical records systems that are either not inter-operable or highly limited in their crossover with other providers.”

Meaningful Use was never intended for enrichment, or even to cover the full cost of an EHR system.

7. While systems mostly are not interoperable yet, that wasn’t the intent of Stage 1 of Meaningful Use. Stage 1 was meant to get systems installed. Stage 2, which has barely started for the early adopters among hospitals and won’t start for 2 1/2 months for physicians, is about interoperability. That’s where the savings and efficiencies are supposed to come from.

6. We’re years away from knowing whether Meaningful Use program did its job, though I don’t fault members of Congress such as Sen. John Thune (R-S.D.) for putting pressure on the administration to demand more for the big taxpayer outlay.

5. “‘The electronic medical records system has been funded to hospitals at more than $1 billion per month. Apparently little or none of that money went to the enrollment process which is where the bottle neck for signing up to ObamaCare’s insurance exchanges appears to be,’ Robert Lorsch, a Los Angeles-based IT entrepreneur and chief executive of online medical records provider MMRGlobal, told Fox News.”

The money wasn’t supposed to go to the insurance enrollment process. The Meaningful Use incentive program was from the HITECH Act, part of the 2009 American Recovery and Reinvestment Act. The Patient Protection and Affordable Care Act, a.k.a. Obamacare, came a year later. Again, someone is confusing insurance and care. They are not the same thing.

4. “Lorsch, at MMRGlobal, offered the U.S. government what it describes as a user-friendly personal health record system for one dollar per month per family – a fraction of what it has cost the taxpayer so far.”

MMRGlobal’s product is an untethered personal health record. No untethered PHR anywhere is “user-friendly,” which is why adoption has been anemic. Without data from organizational EHRs, PHRs are worthless. Besides, the direct-to-consumer approach in healthcare has failed over and over, since people are used to having someone else — usually an insurance company — pick up the tab.

3. For that matter, MMRGlobal is a bad example to use as an alternative to EHRs. (The Fox story is correct in saying that other vendors do have close ties to the Obama administration, though the former Cerner executive’s name is Nancy-Ann DeParle, not “Nance.”) I could be wrong, but I haven’t seen a whole lot of evidence that MMRGlobal isn’t much more than a patent troll.

2. “But this process could have been easier if a nine-year, government-backed effort to set up a system of electronic medical records had gotten off the ground. Instead of setting up their medical ID for the first time, would-be customers would have their records already on file.”

Actually, as I wrote in a story just published in Healthcare IT News, we could have had national patient identifiers 15 years ago, as called for by the 1996 HIPAA statute. But Congress voted in 1998 not to fund implementation of a national patient ID and President Bill Clinton signed that into law. Since then, interoperability and patient matching have been mighty struggles.

1. “‘Plus, unlike under ObamaCare, the patient would be in control of their health information and, most importantly, their privacy,’ Lorsch said.”

Where in Obamacare does the patient lose control of health information? Less than a month ago, I was in Washington listening to HHS Office for Civil Rights Director Leon Rodriguez say, ““There is a clear right [in the HIPAA privacy rule] not only of patient access, but patient control over everything in their records.” This may come as news to some people, but patients own and control the information. They might not know it, but the language is pretty clear.

Already, the Fox story has been reposted in a number of blogs shared all over the Internet, so it’s being accepted as fact in some quarters. If you want the truth, you sometimes have to do the work yourself.

October 15, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: A quick chat with Farzad Mostashari

Friday is the last day on the job for departing national health IT coordinator Dr. Farzad Mostashari, who is stepping down after four years with the Office of the National Coordinator for Health Information Technology, including the last two years as head of ONC.

I was in Washington two weeks ago and stopped by the HHS headquarters for ONC’s Consumer Health IT Summit, the opening event of National Health IT Week, and got a few minutes with Mostashari. (I suppose that was good timing, because I imagine the government shutdown that took effect this week would have canceled the summit and even prevented me from entering the Humphrey Building.) I had the recorder rolling for a brief chat, which lasted less than 15 minutes before Mostashari’s handlers ushered him out to his next appointment. But I did get something.

The interview actually goes on a bit longer than what’s on this track, moving on to a discussion about Food and Drug Administration guidance on mobile medical apps. (You can read about that in this story I wrote for MobiHealthNews.) As it turned out, the FDA issued its final recommendations Sept. 23, which also happened to be the same day new HIPAA regulations—modifications called for in the HITECH Act—took effect.

I might get another chance to talk to Mostashari at the College of Healthcare Information Management Executives Fall CIO Forum at the end of next week, after he officially leaves government service and is allowed to discuss his future plans and perhaps be more candid about his tenure; CHIME has confirmed to me that he will keep his speaking slot. For now, enjoy this short interview.

Podcast details: Interview with outgoing national health IT coordinator Dr. Farzad Mostashari, Sept. 16, 2013. MP3, stereo, 128 kbps, 7.1 MB. Running time 7:44.
0:00 Why he’s leaving
1:20 Different “tribes” of health IT
2:25 Balancing competing interests and the pace of change
4:30 Difficulty of culture change
5:35 Patient control of data and confusion about HIPAA

 

October 2, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

DrChrono and Sermo, what are you thinking?

Free, mobile ambulatory EHR developer DrChrono made a minor ripple of news this week, claiming to be the first vendor to release an EHR for the new Apple iOS 7. But that’s not why I’m writing this post. I’m calling out DrChrono co-founder and COO Daniel Kivatinos for this tweet:

I was quick to respond on Twitter.  


Indeed, the HITECH Act and Meaningful Use are about the Triple Aim of producing safer care, improving population health and lowering overall healthcare costs. The incentive money isn’t supposed to make physicians rich or even cover the cost of the typical EHR. (Yes, “free” EHRs have costs in terms of changing physician workflows and interfacing with practice management systems, and the advertising may cause patients to lose trust in their doctors, as John Lynn seems to have found with Practice Fusion.) Frankly, I don’t want to go to a doctor who views Meaningful Use as “cashing in.” That’s not “meaningful” in the spirit of the incentive program.

I’m making a big deal out of this because this is not the first time DrChrono has made misleading and hyperbolic statements. As I wrote a couple years ago, the company claimed its patient check-in app was “groundbreaking,” despite a lot of evidence to the contrary. The same post also had a video from DrChrono in which the vendor explained to physicians how they could qualify for Meaningful Use “tax breaks.” The incentive payments aren’t tax breaks. In fact, the money counts as taxable income.

The video is still up on YouTube, and it’s been viewed more than 57,000 times. That’s 57,000 times people have heard a patently false statement. DrChrono, stop misleading clients or you won’t have any clients left to mislead.

Also from the “what were they thinking?” department, physician social network Sermo marked the start of the NFL season this month with the launch of the “Pro Football Injury Challenge.” I know this because I received this e-mail:

Sermo injury challenge

Yes, I know I’m not a doctor. Sermo sent a follow-up a few days later saying that I received the invitation in error. But actual physicians still are competing against each other in kind of a fantasy football injury pool. Do you find this as tasteless as I do?

 

September 20, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Patient engagement: Check me out in ‘US News’

I’ve just had my first story published in a major national magazine, or at least the online version of one, namely US News and World Report. It’s about patient engagement strategies for hospitals and medical practices in the context of EHRs, for the magazine’s “Hospital of Tomorrow” feature, and I’m getting good feedback so far. Needless to say, I’m pretty excited. Check it out here.

Also, I’ll be presenting on Tuesday at 11:30 a.m. EDT at the American Telemedicine Association’s Fall Forum in the non-American (but very North American) city of Toronto. It’s there because this year’s ATA president is Dr. Ed Brown, president of the Ontario Telemedicine Network, right there in the T.O.  Steve Dean of Falls Church, Va.-based Inova Health System’s Inova Telemedicine Program and I will be counting down a top 10 of mobile apps we deem to be prominent, successful or highly useful. (The description in the online program is wrong as of this writing.)

September 7, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

I sense a delay in MU2

I have no evidence to back this up, but I have a sneaking suspicion that the feds are giving serious thought to delaying some of the timelines in Stage 2 of Meaningful Use.

The pushback has been building for some time, and advanced in the past couple of weeks with the opinions of three important industry associations.

The American Association of Family Physicians called for a one-year delay and proposed separating providers into “three distinct cohorts,” depending on what year they first met Meaningful Use standards. HIMSS wants the attestation period for the first year of MU2 extended to April 2015 for hospitals and June 2015 for physicians and other “eligible professionals.” The MGMA asked CMS not to penalize physicians who reach Stage 1 but can’t make it to Stage 2 when penalties are due to start in 2015.

All cited the short timelines for vendors to get their products ready and certified for Stage 2.

And then there was the big news this month, the resignation of national health IT coordinator Dr. Farzad Mostashari, seemingly without warning. I can’t take credit for this idea, but an industry insider I spoke with this week suggested Mostashari may have wanted out because he didn’t want to be in charge of a watered-down or delayed program. Again, I have no evidence to support the idea, but it sounds absolutely plausible.

I welcome your thoughts on this matter.

August 22, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.