During the show our host, Jim Tate, and guest, acclaimed Standards expert Keith Boone touched upon a number of different areas on how Standards and Interoperability requirements are shaping up for Stage 2 and beyond. One thing made clear by both host and guest – a Stage 4 or more is a definite possibility, already hinted at in the NPRM.
Other highlights from the show include:
The final rule for delaying ICD-10 will arrive in late August/early September. Keith fully expects a one year delay. Keith expects the ONC Certification Rule will follow ICD-10, capping off with the final CMS Stage 2 Meaningful Use in September.
While proposed Stage 2 requirements aren’t seen as a huge lift from Stage 1, Stage 2 will move providers to one dominant standard for the patient summary, the CCD. Also expected, the bar will remain high in the Final Rule for getting patients engaged. Keith pointed out that one huge issue in Stage 1 was the failure to pick single standards in several areas, opting instead to give many options. That course will be corrected in Stage 2, reducing the number of options.
There is ongoing development for Stage 3 by the ONC Standards & Interoperabilty Initiative, including the Health eDecisions project on CDS. Getting particular attention is patient originated data, giving patients the ability to upload into an EHR.
On the heels of the news that over 100,000 providers have received EHR incentives, Keith suggested that EHR adoption is following a “logistic curve” with adoption now entering the mid-linear point in terms of speed. As a point of reference here from wikipedia: in a logistic curve, the initial stage of growth is approximately exponential; then, as saturation begins, the growth slows, and at maturity, growth stops.