Surprise, Surprise … Stage 2 of Meaningful Use Recommended for Delayed Start

By Sanin Rahman

It may come as a small surprise that the Centers for Medicare & Medicaid Services (CMS) HIT Policy Committee has recommended that the Office of the National Coordinator (ONC) delay the start of Stage 2 of Meaningful Use requirements until 2014 – there has been much written in the two weeks since the recommendation.There are, however, several questions that remain unanswered. For example:

• What will happen to the incentive payments for Meaningful Users of Health IT during this “extra” year, and will these providers have to attest to Meaningful Use for that year as well in order to qualify for the incentives in the following year (the first of Stage 2)?
• Also, what will this mean for Stage 3 of Meaningful Use? Will the same thing happen again in 2015?While some organizations are breathing collective sighs of relief over the delay, others are concerned because it might throw a wrench into their multi-year plans. How are you reacting to it?

One thing to keep in mind through all of this is that spreading Meaningful Use of Health IT throughout your organization is most definitely an exercise in change management, as opposed to an activity in technology implementation. Change management challenges that are addressed properly (which, unfortunately, very few are) lead to long-term and sustained changes in the culture and practices within an organization. Likewise, truly achieving Meaningful Use will not only lead to Health IT being used by your providers and their teams in the short-term, but will also create a culture in which the care provided is based on data, decisions are driven by data, and in which your leaders will look to the data to continuously improve the organization. Hence, depending on how you approach the challenge of instituting Meaningful Use of Health IT, you have a high probability of ensuring that these new practices are “sticky,” i.e., Meaningful Use of Health IT becomes an inherent part of the way the organization functions.Once that happens, you and your providers will have reduced one major variable in being able to comply with any data-related benchmarks and requirements that may be imposed or mandated by any governance body.

You’re probably thinking, “Easier said than done buddy,” and you would be right — changing behaviors and maintaining those changes for the long-term has always been an incredible challenge.However, in his book “Leading Change,” John Kotter has developed some important steps that organizations can take to move in the right direction:

• Create Urgency: If this change you’re trying to go through isn’t urgent, your stakeholders and adopters won’t care — really.So figure out why it is so urgent, and infuse that urgency throughout your organization.
• Form a Powerful Coalition: This point might come across as warm and fuzzy, but it is crucial to make sure that every part of the organization that is impacted by Meaningful Use is represented in your Meaningful Use Steering Committee or Task Force (or whatever you call it). Otherwise you run the risk of failure down the road.It really is as simple as that.
• Create a Vision for Change: Don’t just look at your Meaningful Use initiative as a set of activities that need to be completed. Work with your coalition to create the vision of what your organization can accomplish once Meaningful Use is achieved.
• Communicate the Vision: Have a vision already?Then shout it out loud!Don’t just tell your stakeholders what will be done to achieve Meaningful Use, show them what can be achieved when Meaningful Use is done right.Why?Because this will get your stakeholders bought into the program, and you will have champions for the program working toward this common goal instead of a lonely program manager trying to get others to comply.

My reason for going into all of this is that HIMSS released a study that showed that ineffective change management is one of the primary reasons EHR implementations fail.And with that, I’d like to cede the proverbial floor. What are your thoughts?