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Four Ways to Prepare for Stage 2 Rules of Meaningful Use


Though Stage 2 doesn’t begin until 2014, physicians - even those who have not yet attested to Stage 1 - can start preparing now.

Here are four things you should start doing now to prepare for Stage 2 of the Medicare/Medicaid EHR Incentive Programs.    

1. Partner Well
Make sure you are working with the right partner. That means if you are at the very start of the meaningful use process and haven’t yet selected an EHR vendor, do so carefully.

Your success throughout the meaningful use process will largely depend on the vendor you selected. First, make sure that your EHR will be upgraded throughout the meaningful use process (Stages 1, 2, and 3) to comply with the certification requirements in each of the stages.

“If you do not have a vendor currently or are looking to change, make sure your conversations include the Stage 2 requirements as part of the discussions, and mandate [Stage 2] compliance in any contract negotiations,” Nick van Terheyden, MD, CMIO at Nuance Healthcare, told Physicians Practice via e-mail. 

In addition, the EHR you select must be user-friendly. Though this seems like a no-brainer, many practices report dissatisfaction with their first EHR. Research firm KLAS recently found that half of EHR systems sold to physician practices are replacements, according to Medscape. One reason for dissatisfaction with EHRs cited by practices: Unmet expectations and concerns about ability to meet meaningful use. Make sure you make the right EHR vendor choice - the first time.

“There are horrific stories in the industry from Stage 1, and now leading into Stage 2, of offices literally getting crippled by an overly burdensome system - that would either cost too much, impede an office’s work flow, or simply not implement and support an office towards achieving meaningful use,” pediatric physical medicine and rehabilitation specialist Chuck Dietzen, chief medical officer at iSalus Healthcare, told Physicians Practice via e-mail. “Considering the timelines, and the money involved, and most importantly, the patient care - an office has got to fully vet a software provider ... or shall I say a software partner who is experienced, cost effective, and proven.”

2. Partner Up
As Dietzen mentions, your EHR vendor should not only be your provider, it should also be your partner. Keep that in mind while going through the meaningful use process. Your vendor should serve as a valuable resource to you.

If you have already completed Stage 1, begin working with your vendor now to determine how it will assist you with completing Stage 2.

“Work closely with your EHR provider to help you through the [meaningful use] process,” Brian Zimmerman, physician and co-founder of consulting company Physician Technology Partners and current Epic Physician Champion for the emergency department at Miami Valley Hospital, told Physicians Practice via e-mail. “Many of the EHR companies have already positioned themselves well to help with these [Stage 2] requirements.”

3. Start Now
If you have already attested to Stage 1, start preparing for Stage 2 now. Though it doesn’t begin until 2014, those practices that recognize it’s going to take a long time to get ready for participation will have a much easier time.

In fact, according to Laura Kreofsky, principal of healthcare technology consulting firm Impact Advisors, LLC, the key area of risk physicians have for Stage 2 is “complacency, or under-appreciating the level of effort preparing for and performing against the Stage 2 requirements.”

Start digesting the Stage 2 requirements now, determine how you will fulfill them, and plan for the necessary work flow modifications you would need to make.

“Most of the requirements in Stage 2 build off of Stage 1, explicitly or otherwise,” Kreofsky told Physicians Practice. “The requirements that are most nuanced and complicated, such as the summary of care record at transitions of care, will require careful analysis and planning of technology, workflow and practices, and reporting, likely over a several month-period.”

4. Plan Ahead
Know where you stand on the spectrum of Stage 2 participation difficulty level. In other words, some of you should expect a more challenging process than others.

For instance, physicians with many elderly patients may have a harder time fulfilling the patient-engagement related requirements because their patients may be less tech-savvy.

In addition, geography could be a barrier for some of you. “The rural communities, they may have a bigger challenge working with their patient populations who don’t regularly interact with as much technology as more urban patients,” Kreofsky said.  “When you sort of think about technology adoption as a whole it will follow that pattern.”

If you’re among the physicians who will encounter these additional challenges, consider building up a population of highly engaged patients now, so that come 2014, you will be ready.


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