Hospitals Should Seize the MU Stage 2 Initiative
“Meaningful use” is all about sustained physician adoption of healthcare IT, and the resulting patient care and cost benefits. Stage 1 is what the name implies: the beginning. Although the Proposed Rule for Stage 2 is not expected until the end of CY 2011 and the Final Rule not until summer 2012, hospitals would be wise to take steps now to meet the expanded requirements of Stage 2. Here are five recommendations:
- Focus on the objective more than the threshold in Stage 1. Many of the Stage 1 objectives (e.g., CPOE, problem list, etc.) could be met by creative use of existing systems (such as using ED order entry only for CPOE). But these workarounds won’t suffice in Stage 2 when the thresholds and scope of functionality are expected to increase significantly. Hospitals should focus on implementing systems and processes that will satisfy the overall objective over the long haul, rather than a narrowly-defined Stage 1 threshold that likely will change dramatically in Stages 2 and 3 over the coming years.
- Start to implement Stage 1 Menu objectives as soon as possible. The Final Rule for Stage 1 stated that all Menu objectives shall become Core objectives in Stage 2. The HITPC reaffirmed this recommendation in their June 2011 letter to the National Coordinator. Take advantage of knowing these requirements now so that you can focus on the net new objectives in Stage 2.
- Focus on sustained meaningful use, not individual stages. Stage 2 objectives will impact a much larger percentage of physicians and departments than Stage 1 does. Also, it will require greater usage of advanced clinical applications, over a longer period of time, than Stage 1. Hospitals should not make strategic and technology decisions for these stages independently. Doing so will compress the amount of time hospitals have to select, implement, and train users for Stage 2, and will ultimately result in more disruption to physician clinical workflow and productivity.
- The challenge of Stage 2 is physician adoption. Much of Stage 2 is expected to involve the use of technology that is not new – so what will drive physician adoption beyond current paltry levels for, say, electronic physician documentation? Hospitals simply mandating system use won’t work for non-employed physicians, so something else has to change. Best to start thinking now about what it will be.
- Don’t wait to implement CPOE. Stage 1 requirements for CPOE could be described as “dipping a toe” into electronic order entry. Stage 2 is expected to expand both the threshold (from 30 percent of patients with a med order to 60 percent) and the types of orders to include radiology and lab. So it is critical that hospitals begin implementing CPOE solutions that will support efficient physician workflow for all orders types with an eye toward clearing the greater hurdle in Stage 2.
Of course, hospitals can opt to wait for the Stage 2 Final Rule to be published before looking seriously at how they will address it. But leaders don’t become leaders by waiting for the future to come to them.