SAN ANTONIO — It was a busy second day at the CHIME 2011 Fall Forum. It started bright and early with 7:30 with a sunrise session on meaningful use. And wouldn't you know it, there was actually a little bit of news.

The Center for Medicare & Medicaid Services' Travis Broome told a packed conference room that the agency will issue its proposed rule on Stage 2 of meaningful use by January, with a final rule planned for June. But that's not all, Broome confirmed — well, virtually confirmed — what many IT insiders have been whispering: compliance with Stage 2 requirements will likely be delayed until 2014. Broome said that the agency agrees "with the logic" of the federal Health IT Policy Committee, which, during its meeting in July, said, "(W)e agree with the logic of delaying the start of stage two of meaningful use for a period of one year for those first attesting to meaningful use in 2011. We also agree that it makes sense to maintain the current expectations for those first attesting to meaningful use in 2012, so that all providers attesting to meaningful use in 2011 or 2012 would attest to stage two in 2014. That would give all providers adequate time to move up the escalator for a robust set of stage two meaningful use expectations."

Importantly, Broome said that if Stage 2 is delayed, hospitals that attest for Stage 1 in 2011 are eligible for bonus payments through 2013. For a while now, there's been some confusion about how payments would coincide with Stage 2 timelines. The clarification was pretty welcome news to the CIOs in attendance.

Following Broome's session, I sat through a very informative look at how three hospitals have pursued their meaningful use strategies. The CIOs from MedCentral Health System in Ohio, Atlantic Health in New Jersey and Main Line Health in Pennsylvania are each at slightly different stages of their meaningful use journeys. MedCentral, for instance, was one of the first organizations to attest back in March. Mike Mistretta, the system's CIO, said that applying for funds so early was really a no-brainer. The system had been working on many of the requirements even before meaningful use found its way into the regulatory lexicon. After the session, he told me that executives and board wanted to attest early partly because there's no telling if, given everything that's going on in D.C. these days, those funds will be there in a year or two.

Karen Thomas of Main Line Health and Linda Reed of Atlantic said they plan to attest in early 2012. Both were going through major IT upgrades and both systems had recently acquired new hospitals earlier this year, which were factors in how quickly they could get ready to apply. All three CIOs said that it is critical to make sure that meaningful use isn't just viewed as an IT initiative. They've engaged clinicians and, in some cases, ensured that there are executive sponsors of various parts of the project.

As I mentioned in yesterday's blog, one of the underlying currents at this meeting is IT staff burnout. It's being heavily discussed in hallway chatter. Reed told me that she's worried about her staff potentially leaving. She said that some haven't been able to take vacation and she's not sure when she can grant vacation time. Lynn Vogel, vice president and CIO at the University of Texas M. D. Anderson Cancer Center said that it is incumbent on executives to make sure that IT deployments are collaborative events. He told me that hospital IT departments are facing a "tsunami of activities, expectations and challenges" and tackling those requires a team effort. Vogel, who is also chair of the CHIME board, added that CIOs need to educate the board and other leaders about the long-term impact of all of the initiatives underway. Stimulus money associated with meaningful use, for instance, is a one-time deal. That money won't be there down the road, so hospital leaders need to fully understand the future impact of IT deployments.