"If we mess up Meaningful Use as an organization, just pick any organization out there, that hurts," Branzell says. "You [don't] get your reimbursement from the government. You mess up ICD-10, you don't get paid. If you don't get paid for a few months, with today's cash flows in a lot of these smaller organizations, [your] viability's at risk."
In the wording of its Friday announcement, CMS may have been trying to make it appear that it was trying to satisfy the needs of the provider community without really doing so, says Laura Kreofsky, principal advisor at Impact Advisors, a healthcare IT consulting firm.
Kreofsky referred back to HHS Secretary Kathleen Sebelius' December 2011 announcement delaying the start of Stage 2. "It was, in my opinion, a more clearly worded press release," she says.
"Whether it was intentional or not, the initial ripple was very easy to have misconstrued," Kreofsky says. "The message has got to be in the provider community: Nothing's changed around Stage 2, and that everybody needs to stay the course under their Stage 2 or Stage 1 work.
"CMS purported to do this to basically make sure we're all ready for Stage 3. It was more defensive on the part of CMS than responsive to the needs of the provider organizations and vendor community."
Friday's announcement also introduced another potential complication which could make the job of healthcare system CIOs even more complicated, Kreofsky said, referring to CMS's call for frequent updating of criteria under its HIT Certification Program.