What if Your EHR Isn't Certified for Meaningful Use Stage 2?

Neil Chesanow


November 05, 2013

In This Article

Will a "Mass Extinction Event" Wipe Out Many EHRs?

On January 1, 2014, stage 2 of the Centers for Medicare & Medicaid Services (CMS) meaningful use incentive program begins for physician practices.

But there's a major problem. Most of the doctors who met the requirements for stage 1 aren't going to be able to meet the requirements for stage 2. Why? Their electronic health records (EHRs) aren't up to the task. And neither are their vendors.

If your EHR can't handle stage 2, you have a decision to make -- and quickly. Do you keep the current EHR that you paid a king's ransom for a couple of years ago (and toward which you most likely feel a Shakespearean level of rage), or do you replace it with a system that's more user-friendly and can not only meet the requirements for stage 2 but hopefully won't leave you high and dry when the requirements for stage 3 go into effect inexorably on January 1, 2015?

Out of more than 2200 products and nearly 1400 complete EHRs (with practice management components) certified for stage 1 meaningful use criteria, only 75 products and 21 complete EHRs are certified for meeting stage 2 criteria.[1]

"Our very conservative estimate is that about 90% of vendors are not going to be ready for meaningful use stage 2 at the start of January," says Emily Peters, Vice President of Communications at Practice Fusion, an EHR vendor in San Francisco, which has just issued a guarantee to its 100,000 customers that its product will be 2014 meaningful use-ready before the year is out.[2]

However, most vendors are unlikely to ever to meet stage 2 meaningful use requirements, because the market for EHRs is glutted and they don't have a large enough slice of it to justify the investment.

"It's a scary time out there," Peters concedes. "Hundreds of vendors are certified on the market today, which is an unsustainable number of EHR vendors."

As a result, she says, "we're calling this a Darwinian mass extinction event that's happening with EHRs. Going into this sector, we always knew that there was going to be an event at some point: a mass consolidation -- that something had to change. Our perspective is that stage 2 is going to be that event."

Because this is a known and widespread dilemma, and since the Office of the National Coordinator for Health Information Technology (ONC) oversaw the certification of the first batch of EHRs for stage 1, many doctors hoped that the agency would extend the deadline for meeting the requirements for stage 2 until everyone -- or at least most doctors -- had workable tools for doing so.

This is what the American Medical Association (AMA),[3] the American Hospital Association (AHA),[3] the American College of Physicians (ACP),[4] and the Medical Group Management Association (MGMA),[1] among others, urged in formal letters to Health and Human Services Secretary Kathleen Sebelius last summer.

They are still waiting for a reply. Stage 2 goes into effect very soon (January 1, 2014). The clock is ticking. The deadline, as of now, stands.


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