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Is No Flex-IT the Best thing for EHR and Healthcare?

Posted on September 24, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Strategically placed during National Health IT Week, 17 healthcare organizations sent a letter to HHS requesting that the meaningful use reporting period for 2015 be adjusted from 365 days to 90 days. Along with that, the Flex-IT act was introduced to congress in order to legislate this change. It’s always hard to predict what congress will do, but many believe that the Flex-IT act will get tagged on to something else and get passed. We’ll see if that indeed happens.

What everyone I talk to agrees is that the 365 day meaningful use stage 2 reporting period is going to be impossible for hospitals to meet. Sure, a few hospitals might make some herculean effort and meet it, but they’ll be so few and far between that they’ll be a rounding error.

What would it mean to healthcare and meaningful use if almost every hospital opts out of the meaningful use program? This isn’t too hard to imagine. A large portion of the meaningful use money has already been spent and the penalties don’t look that bad when you consider the costs and risks associated with the all or nothing meaningful use program.

If the MU reporting period doesn’t change, I think it spells the death of meaningful use. Sure, the program will subsist for those who have attested, but it will be a defunct program with so few participants that the program will have little impact. Plus, we’ll see a wave of efforts to make sure that those penalties for not being meaningful users of an EHR are removed much like has been done with the SGR fix year after year.

The Flex-IT act would at least keep meaningful use on life support. MU 2 is much harder, but with a change to a 90 day reporting period many will do it to avoid the penalties and get the last bit of EHR incentive money. If we want meaningful use to survive, then the Flex-IT act (or something that does something similar) is going to be essential to its future.

I’m just personally not sure that the Flex-IT act is such a great thing for EHR or the industry. Is it better to keep meaningful use on life support or bite the bullet now and have meaningful use die on the vine.

One might argue that meaningful use has accomplished it’s main goal: adoption of EHR software. It’s dramatically accelerated the adoption of EHR software. Would it be such a bad thing for meaningful use to disappear now? With MU gone, we could return to a more rationale EHR market. I guess this is where I’m torn on whether getting the Flex-IT act passed is a good or a bad idea.

What do you think? Is the Flex-IT act a good idea or should we just fall on the sword now as opposed to prolonging the regulation?

Are EHR Complex Because Now We Can Make Them Complex?

Posted on September 22, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

I recently had a chance to do some late night research for this blog at a QuickCare center near my house (4 sutures later and I should be fine).  While I was there I dropped the fact that I was an EHR blogger so I could get them to talk about their experiences with EHR. As expected, they had strong feelings about EHR and we’re happy to share. In fact, the next week they were switching EHR software in a big bang style switchover with 4 hours of training before the switch. God bless them on their conversion.

Although, one of the comments that struck me most was from the nurse who said, “I use to use MEDITECH and it was so simple to use.”  They then went on to talk about the old DOS-like user interface that MEDITECH employed and how easy it was to use.

I’ve been thinking a lot about this response and it made me wonder, Are we making EHR more complex because now we can?  Think about it for a second. In the DOS based world, you couldn’t make an application complex because the interface couldn’t support it.

I’m not suggesting we go back to a DOS based interface. However, maybe there’s some lessons to be learned from that simpler time.

For example, could a number of keyboard commands be integrated into the EHR to make it more effecient. You might remember that the DOS-based environment was all keyboard based which was part of its efficiency. It made for a bit more learning curve, but once you mastered it, it was incredibly fast.

One thing that is missing from EHR today is simplicity. Maybe looking back might help us remember a simpler day.

Epic Wants to Be Known for Interoperability – Are They Interoperable?

Posted on September 19, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Epic has been fighting the stigma of being a closed system for a while now. It seems that Epic isn’t happy about this characterization and they’re coming out guns blazing to try and show how Epic is interoperable. They’re so interested in changing this perception that Epic recently hired a lobbyist to change how they’re viewed by the people in DC.

A recent tweet highlighted a slide from the Epic user conference (Epic UGM) that shows how many Epic patient records they’re exchanging per month. Here’s the tweet and graph below:

Farzad Mostashari asks a very good question, “Does that graph help?” I find Farzad’s tweet also interesting because just over a year ago Farzad tweeted another Epic interoperability chart when he was still National Coordinator at ONC. I’ll embed the previous chart below so you can easily compare the two graphs side by side:
Epic Data Sharing Chart

I think Farzad is right to be skeptical about Epic’s claims to interoperability. First, it seems Epic is finally making some progress with Epic to Epic interoperability, but Epic to Non-Epic systems is still far behind. Second, Epic loves to claim how they have charts for some huge percentage of the US population (currently about 314 million people). I bet if we looked at the percentage of total Epic charts that have been exchanged, it would be an extremely small number. I also wonder if the charts above count a full patient chart or something simple like a lab result or prescription.

I don’t want to harp on this too much, because this is a step forward for Epic. Even if they’re not as interoperable as they could be and as we’d like them to be, I’m excited that they’re now at least open to the idea of interoperability.

With that said, I wish that Epic would spend more time and effort on actually being interoperable and not just trying to say that they’re interoperable. This includes committing the resources required to support connections outside of Epic. I’ve heard over and over from health IT vendor after health IT vendor about how hard it is to get Epic to work with them in any form or fashion. There’s a way that Epic could scale their effort to hundreds of other health IT vendors, but they haven’t made the commitment to do so.

Think about the opportunity that Epic has available to them. They have enough scale, reach and clout that they could by force of size establish a standard for interoperability. Many health IT vendors would bend over backwards to meet whatever standard Epic chose. That’s a powerful position to be in if they would just embrace it. I imagine the reason they haven’t done so yet is because the market’s never demanded it. Sometimes companies like Epic need to embrace something even if it doesn’t drive short term sales. I think this is one of those choices Epic should make.

I’m sure that lobbyists can be an effective solution to change perceptions in Washington. However, a far more effective strategy would be to actually fully embrace interoperability at every level. If they did so, you can be sure that every news outlet would be more than excited to write about the change.

Meaningful Use Delay (Again): What We Need to Learn from Critical Access Hospitals Before it’s Too Late – Breakaway Thinking

Posted on September 18, 2014 I Written By

The following is a guest blog post by Todd Stansfield from The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Todd Stansfield - Breakaway Group
Take a breather, implies the government’s latest rule for meeting meaningful use requirements of the EHR Incentive Program.  Perhaps that’s not the best plan of action.

On the brink of Labor Day weekend, the Centers for Medicare and Medicaid Services (CMS) finalized the rule for Stage 2 and Stage 3 Meaningful Use, a move designed to make it possible for more healthcare providers to attest this year and beyond. The rule pushes Stage 3 to 2017 and allows providers to meet Stage 2 requirements this year using 2011 certified electronic health record technology, among other things.

While the rule alleviates the challenges of attesting to meaningful use in 2014, it doesn’t solve the more significant problems of the 2015 reporting year, which begins Oct. 1, 2014. That date marks the beginning of the 365-day period over which providers will have to attest to Stage 2 requirements using 2014 certified technology—four times as long as the 90-day span the CMS just relaxed for the 2014 reporting year. Among critics of the ruling is the College of Health Information Management Executives, as the added burden of a full reporting year means “‘industry struggles will continue well beyond 2014,’” according to a Forbes article.

Recent news has sparked hope amid the panic for many healthcare providers. Two weeks after CMS finalized its ruling, Congresswoman Renee Ellmers (R-NC) and Congressman Jim Matheson (D-UT) introduced the Flexibility in Health IT (Flex-IT) Reporting Act, which aims to shorten the Stage 2 reporting window for 2015 from 365 to just 90 days—the same timeframe CMS granted in 2014 after providers struggled to attest. While the move would certainly ease the burden on providers, the Flex-IT Act still awaits Congressional approval before being passed into law.

So far this year, only 5.8 percent of eligible providers attested to Stage 2, according to a Health Affairs article. It’s a markedly low percentage, suggesting that if Congress turned down the Flex-IT Act few providers would be ready and able to attest in 2015.

Providers who are working toward attestation this year and planning for 2015 could learn from those who have been through the process such as Cottage Hospital and Odessa Hospital. Engaged leadership was key to these two critical access hospitals’ (CAHs’) ability to cement proper focus and commitment across their organizations to attest to Stage 2, according to EHRIntelligence and Healthcare Informatics. Both CAHs prove that attesting, however difficult, is certainly possible, and their unique strategies offer a clear path for the approximately 3000 providers eligible to attest.

At Cottage, “full support from the top for Meaningful Use” and “an all-hands-on-deck-effort” reportedly consisted of weekly meetings held by project managers and key personnel focused on discussing progress and barriers to success.

In addition to leadership support, both hospitals also reportedly transferred ownership of the initiative from the IT department to staff involved in care delivery. At Cottage, the IT team set up the infrastructure to support the EHR and then handed it over to clinical informaticists who understood the workflow of clinical staff. Clinical informaticists identified areas where the application could not support established workflows. Any discoveries were then reported to the vendor, who adapted the application to how care was being delivered, reversing the usual and inefficient route of providers adapting their processes to EHR functionality.  At Odessa, ownership transferred from a software vendor acting as Odessa’s IT department to their clinical team. While both Cottage and Odessa are fortunate to have vendors capable of meeting the 2014 certification criteria—a rarity among the 58.9 percent of eligible healthcare providers still yet to attest—both organizations are partly responsible for that success. They worked with their vendors to bring the EHR systems up to par with the requirements. This type of collaboration is crucial to establish certification-capable systems and will likely become a trend as more is asked of providers.

Both CAHs were also able to meet some of the most stringent requirements of Stage 2—which includes having 5 percent of patients view, download, and transmit their health information electronically. Cottage and Odessa found this particular requirement especially difficult, yet both were able to overcome it by educating patients, according to a Healthcare IT News article. Cottage reportedly “took down their [patients’] email addresses as they prepared for discharge and . . . [walked] them through the process of logging on and viewing their data.” This highlights that for a requirement solely within patients’ control, providers must take a more proactive approach to get their participation.

For providers to attest in 2015 no matter the reporting requirements, they will have to leverage strong leadership, clinical involvement, vendor collaboration, and strategies that focus on integrating patients in the overall care process. Cottage and Odessa prove these strategies are critical to meeting Stage 2 requirements. Their success has been validated by our research at The Breakaway Group, A Xerox Company, which shows that organizations with strong change leadership, effective education, ways to measure performance, and a means to sustain the effort are the best equipped to optimize their EHR use, and in the case of Stage 2, attest to the new requirements.

Stage 2 represents more than quantifiable criteria, but the start of using EHR systems in ways that can improve care and patient health. For our healthcare industry to ever realize buzz words like “interoperability” and “care continuum,” and for healthcare providers to breathe easier, this is a move we have to make.

Xerox is a sponsor of the Breakaway Thinking series of blog posts.

Epic Hires DC Lobbying Firm To Fight Closed-System Reputation

Posted on September 15, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

For quite some time, everybody’s favorite EMR giant has a “no marketing, no government relations” policy. (In fact, Epic staffers really seem to hate journalists, but maybe they just don’t like me — who knows?)

Anyway, a few weeks ago, reports the ever-watchful HISTalk, it came out that Epic has broken its rule, hiring on DC lobbying firm Card & Associates. While you might think Epic would hire a billion-dollar behemoth, Card is a smallish firm with seven modest accounts and only one healthcare client. It must help, however, that Card is run by the brother of the former White House Chief of Staff under Pres. George W. Bush.

So what made Epic change its standard operating procedure and begin lobbying The Hill? In its federal lobbying disclosure, the EMR firm says that it’s begun lobbying to “educate members of Congress on the interoperability of Epic’s healthcare information technology.”

The timing of the outreach effort isn’t a coincidence, Modern Healthcare astutely notes. As you read this, a team made up of Epic, IBM and a handful of other technology giants are fighting other equally ferocious IT firms to win the roughly $11 billion contract to update the Department of Defense’s clinical systems.

While none of its contract competitors have a strong reputation for interoperability, Epic is seen as much worse, with a RAND Corp. study released in July calling Epic’s systems “closed records.” That had to hurt.

Unless Epic plans to hold health IT classes for Congress over the next several years, I doubt they’ll be able to make their point with largely Luddite Senators and Representatives in Washington on a technical basis. That is, Epic’s lobbyists won’t be able to convince legislators that Epic is interoperable on the merits.

But lobbyists may very well be able to break the ice on The Hill, and sell the idea that those mean, bad old health IT competitors haven’t been telling the truth about Epic. The pitch can include the somewhat matronly CEO, Judith Faulkner, who doesn’t look like the most powerful woman in healthcare or a competitor that would gladly bite your head off and spit it down your neck. Then they can roll out Epic’s pitch that its systems actually are interoperable (between other Epic installs at least). If it sticks even a little bit, whatever the $1.7 billion company spent will have been worth it.

Frankly, I find the idea of portraying Epic as an underdog in any way as downright laughable, and I bet you do too. But I simply can’t imagine another pitch that would work.

The Various Approaches to Mobility in Healthcare

Posted on September 9, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

I’m about to head down to the CTIA Super Mobility Week conference. I try to attend a few conferences each year that aren’t directly related to healthcare and health IT in order to get a broader perspective on what’s happening in the rest of the world. I think this will be one such case (although, they do have some mHealth sessions and exhibitors as well).

As I started to think about mobility and where it’s headed, the industry is all about the smart phone and smart mobile devices. I think it’s an incredibly powerful concept and one that will only become more important. However, I think that many people are taking it too far. While I love my smartphone and its capabilities, I still love the productivity that’s possible with a great desktop setup with dual monitors, a mouse and a keyboard. I’m not sure we’ll replicate that in a mobile world and I’m not sure we should.

In fact, it’s one of the trends I hate most about many of the website designs that are coming out lately. They are going all in on mobile and in the process they’re killing the productivity of the desktop experience. It’s a travesty and continues to annoy me with many of the applications I use on a daily basis.

We can apply this same principle to healthcare IT. Often we need to step back and ask ourselves if something really needs to be mobile or not. Plus, if we decide to make something mobile, we need to ensure that those who still use the same application in a non-mobile environment have their workflow optimized as well.

At the end of the day, we need to create a much more sophisticated approach to mobile computing. There are many times when a doctor or nurse really need whatever they’re working on to be mobile. There are extreme benefits to having a point of care device which allows the nurse or doctor to document at the point of care. However, there are just as many times when mobility is actually a hindrance to the required workflow.

What are you doing in your organization to leverage the amazing mobile technologies that are out there while still maintaining the optimized workflow?

The Importance of Defining a Legal Health Record with Mary Beth Haugen, RHIA, MS

Posted on September 8, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

In this interview, we sat down with Mary Beth Haugen, founder and CEO of Haugen Consulting Group, about the intricacies and challenges of the legal health record and how it’s been impacted by EHR and other healthcare technology. Plus, we give HIM leaders some firepower on how to convince hospital leadership that defining the legal health record is important for every healthcare organization. Enjoy the video below.

Why Don’t We Hear More from Epic, Cerner, or MEDITECH?

Posted on September 4, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Epic is notorious for being “closed.” In fact, people talk about Epic being closed in so many ways, it’s hard to keep up. However, I think they are mostly seen as closed because of Judy’s decision to almost never talk to the media. In fact, it’s pretty rare that any one from Epic talks to the media. I remember when it was groundbreaking news when someone at Forbes did an interview with Judy.

Obviously, opening yourself to the media isn’t essential to making an enterprise sale. Judy and Epic have done quite well without opening themselves up to the media. In fact, their closed approach has in some cases gotten them more media coverage (see this blog post). Regardless of what you think of Epic, they are largely perceived as a black box that we don’t know nearly enough about. They have been more open with who they are and what they do in the past couple years than they ever were before, but that’s really not saying much.

While many love to talk about Epic’s closed nature, are any of the other hospital EHR vendors like Cerner or MEDITECH much more open? Last I checked, I have’t seen any of the CEOs of these companies blogging about their company and sharing their company’s culture and approach to the future publicly like we see in so many other tech companies. I haven’t seen many of the top leadership at any of these companies active on Twitter or other social media. Do any of these companies really show us any of their humanity? I can’t think of any that do.

The same isn’t true in the ambulatory world. We know all about athenahealth from Jonathan Bush who’s never afraid to bear his soul. SRSSoft and SOAPware have had really active CEOs who’ve openly shared their view of the EHR industry. Those are just a few of the examples. Why don’t we see the same from hospital EHR vendors?

I think the reason why is that it’s never been part of the culture of these companies. Changing that is a really hard thing to do. I don’t see it happening anytime soon. The closest we came to it was when the CEOs of many of these companies joined in the ALS Ice Bucket Challenge. Watching those videos made those companies a little more human. I think that’s a great thing for these companies.

While these companies have proven that you don’t need to engage their community in public to be successful, I’d suggest that the company that does start to do this will be at a distinct advantage. If the existing companies don’t decide to do it, then don’t be surprised if a new company disrupts the market with a more open and human approach. The incumbent EHR vendors won’t know what hit them and likely won’t be able to change the culture fast enough to fight them off.

Assuming you’re working on and doing amazing things for your customers, transparency can be an amazing marketing tool. If you’re not, then it’s better to hide in the shadows.

The Unsustainable Financial Realities of Hospitals

Posted on September 3, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

There’s a great blog post up on the Medsphere blog which talks about the challenging financial realities that hospitals are facing today. I especially like this summary list of the unsustainable healthcare business based on a Moody’s analysis of hospitals:

  1. Private insurers did not increase payments to hospitals.
  2. Medicare reduced payments due to federal budget cuts.
  3. Demand for inpatient services declined as outpatient care options rose.
  4. Retail outpatient options now compete with hospital clinics.
  5. Patients with higher copays and deductibles chose not to seek care.
  6. Hospitals are buying up physician practices.
  7. The costs of electronic medical record systems are impacting the bottom line.

As we talk about why healthcare in the US costs so much money, we always talk about programs that will lower the costs of the healthcare we provide. I often point out that while we love to talk about lowering the costs of healthcare, from a hospital perspective that translates to lowering the revenue they generate while keeping their costs the same. This is the real challenge we face in trying to lower the costs of healthcare. There are really large organizations that stand to lose if we lower the cost of healthcare.

The shift to Accountable Care Organizations and Value Based Reimbusement is a step towards dealing with the issue. If done right, these programs allow a hospital organization to get paid a similar amount while lowering the number of patients they see. The concept is good, but when you get into the details it’s much more complicated with a lot of odd incentives. Plus, I think it’s likely not nearly enough to save many of these hospitals that are already struggling. These programs are new and often just lead to the rich hospitals getting richer.

Unfortunately, as the list above shows, the EHR has been a cost pressure as opposed to a cost saver. Long term, the EHR has the potential to really lower costs, but in the interim many hospitals are suffering under the costs associated with EHR.

It’s not a pretty financial picture for most hospitals. What do you see on the horizon that could change this outlook?

CMS Issues Final Rule on EHR Certification Flexibility, MU Stage 2 Extension, and MU Stage 3 Timeline

Posted on August 29, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

I can’t figure out what government process leads to final rules being regularly published at the end of the day on Friday. I know that Neil Versel from Meaningful Health IT News has hypothesized that they release it late on Friday when they want to bury the news. Maybe that’s the case, but the EHR certification flexibility doesn’t seem like something they’d want to bury. Regardless of the odd timing, CMS has just published the final rule that provides flexibility around EHR certification in the meaningful use program.

In their announcement, I’m not noticing any changes from what was in the proposed rule, but with some time we’ll know for sure if there’s any gotchas hidden in the final rule. No doubt many a meaningful use expert have just had their Labor Day weekend ruined by the announcement of this final rule.

Unfortunately, after the proposed rule was published most people loved the flexibility, but decided that it was too late for them to really benefit from the changes. I’ll be interested to see how many organizations will really benefit from these changes.

More importantly, the rule still includes the nebulous asterisk, “Only providers that could not fully implement 2014 Edition CEHRT for the EHR reporting period in 2014 due to delays in 2014 Edition CEHRT availability.” For EHR vendors that are already 2014 certified, this little asterisk feels like ONC is letting all the EHR vendors who didn’t perform well off the hook. It’s basically rewarding EHR vendors who can’t or have chosen not to keep up. Maybe that’s why the rule was published late on a Friday.

One could make the case that ONC was more worried about the doctors/hospitals whose EHR vendors failed to become 2014 certified, than the EHR vendors themselves. However, that part of the story is not likely to be told. Plus, it doesn’t take into account how a doctor/hospital whose EHR vendor is 2014 Certified will feel having to do the substantially harder MU stage 2 while their colleagues only have to do MU stage 1. (UPDATE: This EHR Certification Tool that CMS created seems to say that even if you’re on a 2014 Certified EHR and scheduled to do MU stage 2, that you can do Stage 1 or stage 2 objectives with 2014 CQMs. The chart linked at the bottom of this post says it as well. Seems like they’re being pretty open in their interpretation of “due to delays in 2014 Edition CEHRT availability”. Clear as mud?)

I’ve captured a chart showing the EHR Certification flexibility that this final rule provides:
EHR Certification Flexibility - 2014 Certified EHR

Plus, here’s the latest chart showing the meaningful use timelines:
Updated Meaningful Use Stage 3 Timeline

Other Resources and Responses:
CMS Official Press Release
CHIME’s Response
CMS’ EHR Certification Rule Tool
CMS HITECH 2014 CEHRT Flexibility Chart

We’ll keep adding other responses and commentary on the final rule as we find them.