CMS released the proposed requirements for stage 3 of the meaningful use program in late March and invited public comment until May 29.
The meaningful use program has received a variety of feedback over its six years of existence. However, now that the program has reached its final phase, the requirements are much more final and public opinion is still evolving.
We asked healthcare executives at the HIMSS15 Annual Conference & Exhibition in Chicago to share their reactions to the MU stage 3 proposal, but in 20 seconds or less. Here's what they had to say.
Note: Responses have been edited for length and clarity.
Mac McMillan, Chairman, CEO and Co-Founder, CynergisTek: From a privacy and security perspective, MU Stage 3 is just a huge step back. Not only did nothing change in the sense that we didn't get new or more stringent requirements, but I think [the government] took a huge step back by redefining the risk assessment associated with the EHR as 'just the EHR.'
Before, you were supposed to assess the EHR and the environment it lived in, whereas [stage 3] is very specific that you are just to assess the risk of the EHR. Before MU came out, we had a lot of people who weren't doing risk assessments because HIPAA didn't have any teeth. MU came along and basically caused people to start doing risk assessments. It was a way to get incentive funds and, on the back end, it was a way to avoid the penalty. So MU stage 2 came along and changed that risk assessment from a one-time affair to an annual affair. Now we have everybody doing them on a regular basis. Organizations are beginning to really do risk assessments. Well, stage 3 comes along and it says, 'We only meant the EHRs.' What that means is there are a lot of organizations out there that will potentially backpedal and start just looking at their EHR opposed to all of their environment, which is what they need to do.
That's wrong for two reasons. First: They won't be compliant with HIPAA, which is the lesser of the two. Second: They will be in much less secure position and their security, over time, will begin to degrade. More importantly, that EHR will become less and less reliable in terms of its security. No one system lives in a vacuum. Security of any system on the network is a product of its own security. If all you're looking at is EHR and no systems touching it, you haven't really assessed the risk of the EHR.
Dick Daniels, Executive Vice President and CIO, Kaiser Foundation Hospitals and Health Plan (Oakland, Calif.): The bar continues to be raised. These are tough things we'll need to deliver on, but I think it will be good for the industry.
Bill Crounse, MD, Senior Director of Worldwide Health, Microsoft: I fully understand the pushback from organizations and clinicians. First of all, you have this whole workflow transformation that you're doing. You have to buy into something that even with government support is still very expensive, and the reporting to adhere to the rules is equally burdensome. The problem was some of the reporting they were asked to do wasn't being supported by the solutions you were buying. I'm encouraged by some of the changes that are now being put out there around stage 3, so I don't want to be critical of the industry or of my colleagues. I understand the pain. It's hard enough to run a medical practice, let alone all these bodies telling you [that] you need to do this and this and this. But I'm hopeful that we're starting to get in tune with the needs of these organizations and the sort of mandates that are being put in place.
Ed Park, Executive Vice President and COO, athenahealth: Confused. Confusing and complex. I think it's an example to simplify, but any time you have something that ends up with multiple hundreds of pages probably misses the mark along the way. There's an awful lot of whimisical lawmaking that occurs that can actually have poor effects downstream. Put it this way: I applaud the effort. I think it's still too complex. This theme of interoperability is important, [but] there are a lot of folks in healthcare that are beginning to wish there was less regulation. I think that it's well-meaning and a good slingshot start, but we can walk by ourselves now, thank you very much, and we can start listening to healthcare as a real market.
Frank Fortner, President, Iatric Systems: "I think there are going to be some really good things coming out of meaningful use 3 from an innovation perspective. I think that you're going to see patient engagement start to move toward the real vision of where that can be. Empowering patients to be a member of their care team, you're seeing that with obviously the patient-generated health data component where they want the patient sending information back up to the chart, that's pretty huge. I'm excited that that's coming. I want to see patients become truly engaged in their healthcare team.
The interoperability in meaningful use 3 is going to be substantive now. We've been putting all the pieces in place for the last few meaningful use phases. Now interoperability is really going to happen. Is it going to be perfect, no. is it going to be tremendously light-years better than what we had a few years ago, yes."