Forces coalescing toward Stage 2 meaningful use


From the standpoint of the Office of the National Coordinator for Health IT (ONC), 2012 was a banner year, especially in the adoption and meaningful use of EHRs. Health information exchange and patient engagement tools -- such as the Blue Button feature to download personal health data -- also made headway toward becoming a reality, paving the way for meaningful use stage 2.

Across the Medicare and Medicaid meaningful use programs, 82 percent of hospitals, or 4,193, have registered for meaningful use, while the majority of hospitals have received payments under the health IT incentive program, according to Farzad Mostashari, MD, the national health IT coordinator.

For eligible physicians and professionals, nearly 336,000, or 64 percent of the total 520,000 who would qualify for meaningful use incentives have registered and half of them have been paid.

Earlier this month, at the annual meeting of ONC programs and grantees, Mostashari underscored the importance of information. “We believe that there is truth in data and information, that information is power. If you know, you can do better. If you can manage information and data, you can do better. If you can learn from what you do, you can do better,” he said.

Through November 2012, according to the most up-to-date statistics from the Centers for Medicare & Medicaid Services, 162,925 Medicare and Medicaid physicians and professionals and 1,116 hospitals signed up to participate in the EHR incentive program. During 2012 through November, 61,548 physicians, professionals and hospitals received incentive payments.

Fewer providers signed up and were paid in 2012 compared with the rush of early adopters in the first full year of meaningful use reporting in 2011. However, providers may report into early 2013 to be counted in the 2012 data.

Medicare and Medicaid EHR payments reached $9.32 billion to 176,561 physicians and hospitals through November since the program’s inception. For 2012 through November, CMS paid out $4 billion compared with $5.3 billion in 2011.

The year also brought more certainty to the Obama administration’s healthcare policies with the president’s re-election, the Supreme Court decision to uphold most of the president’s signature health reform law, and the publication of the final rule for meaningful use stage 2, which signaled to providers and health IT vendors the expectations for health information exchange and patient involvement to improve individual and population health.

The programs that ONC established to help providers do the hard changes to attain meaningful use have also taken root. “With the regional extension centers, we leave nobody behind. We’re going to go where it’s hardest,” Mostashari said. “And Beacon communities have ripped the shroud from the belief that healthcare can’t change."

Transformation is happening, according to Mat Kendall, director of ONC’s Office of Provider Adoption Support (OPAS). “What’s amazing is that all these accomplishments start coming together,” Kendal said at the ONC annual meeting. He described how meaningful use support efforts have expanded in the following areas:

  1. Regional extension centers have enrolled 140,000 primary care providers, with 100,000 of them practicing with EHRs, and 33,000 who have gotten to meaningful use
  2. 43 states have established health information exchanges
  3. 60,000 providers from 11,000 organizations are enabled for Direct point-to-point exchange and conducted 80 million exchanges between July and September
  4. More than 600 people have signed up to participate in the Standards & Interoperability Framework to solve problems with exchange
  5. 8,500 providers across the country are working with the 17 Beacon communities from Maine to Hawaii and establishing and using health IT to help improve care for patients with chronic conditions
  6. ONC-funded community college and university workforce programs have trained 16,000 students as health IT professionals, with thousands more in the pipeline
  7. ONC’s certification team has certified 1,600 EHRs and modules.

“Health information exchange state grantees tackle probably the hardest challenge we have in business incentives and trust, the formidable barrier of ‘why should I share information with you?’" Mostashari added. "State leadership has said we need policies, trust and services to help get us beyond parochial interests and perverse business models. Those payments are also changing."