The incomparable John Halamka, CIO of Beth Israel Deaconess Medical Center and Co-Chair of the HIT Standards Committee, has a good post up on his blog talking about the future of standards, certification and meaningful use stage 3. Here’s one excerpt about MU stage 3 and EHR certificaiton:
Meaningful Use Stage 3 regulations are currently in draft and will be released as NPRM before the end of the year. My hope for these regulations is that they will be less prescriptive than previous stages, reducing the burden of implementation for providers and vendors.
It’s purely my opinion, but I’m optimistic that simplification will happen, given that the 2015 Certification Rule is likely to decouple Meaningful Use and certification. Certification is likely to be incremental year to year without the tidal wave of requirements we’ve seen in the past. Certification of health IT (not just EHRs) will be with us for a long time and may be leveraged by more programs than just the EHR incentive programs. Imagine that modules for patient generated data (such as wearables), health information exchange (HISPs), and analytics services (such as those used for care management by ACOs) could be certified and used in any combination to achieve outcomes.
I’m really hopeful that Halamka is right and that MU stage 3 will be dramatically simpler. However, in government work, I’m rarely confident that something will be simple. In fact, his comments about ongoing certification are sad too. Anyone who’s had to work with supposedly certified CCD documents from multiple EHR vendors that should be “standard” knows what I mean. Because of examples like this, I’m not a fan of government certification setting the standard, but Halamka might be right that they may use EHR certification to try.
What will be interesting to me is what motivation organizations will have to continue on with meaningful use stage 3. The EHR incentive money will be gone. Certainly the EHR penalties are a pretty sizable motivation for many organizations. Although, probably not as sizable as many think when you compare it against even the MU 2 burden (another reason why MU 3 needs to be simpler). Also, I still wouldn’t be surprised if we had an ICD-10 Delay-esque move by the AMA or some other healthcare organization to remove the EHR penalties. It will be a little harder since the penalties are hard revenue that has to be accounted for, but don’t put it past a good lobbyist.