Pediatrician Frini Shah and her three physician colleagues at Woodstock Pediatric Medicine in Woodstock, Ga., started preparing for Stage 1 of the Medicaid EHR Incentive Program in September 2011. They successfully attested in April, and the checks have begun rolling in. Yet they're not taking a break from the meaningful use process. Instead, they're already looking ahead to Stage 2.
"We are thinking about things that we will definitely need, and we are trying to get ready to train the nurses as well as train all the physicians as to what they need to do as far as record keeping and documentation goes," says Shah. "Then we'll also have to get a portal, which we don't currently have."
Shah's proactive approach is a smart one. Though Stage 2 doesn't kick off until 2014, the earlier physicians start planning for it, the smoother ride they will have. As internal medicine physician Michael Zaroukian, vice president and chief medical information officer at Sparrow Health System in Lansing, Mich., says, Stage 2 is a "much steeper climb" than Stage 1.
For one thing, you will have fewer options regarding which objectives to fulfill in Stage 2 than you had in Stage 1, as 17 (rather than 15) of the 20 objectives are required "core" objectives. In addition, the objectives themselves are more challenging, both in scope (many of the Stage 1 objectives combine to make up more unified Stage 2 objectives), and in threshold (the percentages required to meet many of the objectives are higher than the percentages required in Stage 1). "There's kind of a 'double jump' in that regard," says Zaroukian, who led the first stage of attestation at Sparrow's ambulatory practices and is now helping them prepare for Stage 2.
Another challenge is that technology that was not necessary to successfully fulfill the Stage 1 requirements, such as a patient portal or secure messaging, is mandatory in Stage 2.
But what might be most challenging of all is that factors not entirely in your control will play a major role in your ability to fulfill the objectives. Will your EHR vendor make the necessary modifications and upgrades to its system? Are your patients actively engaged in their healthcare? These things matter.
To help ensure that you are equipped with the tools necessary to succeed despite these challenges, we asked meaningful use-knowledgeable physicians and consultants to share their preparation recommendations. Here's what they said you should be doing now so that you can thrive when Stage 2 arrives in 2014.
Gauge your readiness
First, contact your EHR vendor to determine whether or not it is upgrading its system to comply with the Stage 2 requirements; and if so, how quickly? "Vendors really had to be prepared for Stage 1 in order to sell their product," says Atlanta-based consultant Elizabeth Woodcock, founder of practice management company Woodcock & Associates. Since you've already bought its product, the vendor may have less incentive to get the ball rolling on Stage 2. "…Having their client/customer base be proactive about [inquiring about their Stage 2 upgrades] will certainly encourage the vendors to move forward," she says.