Healthcare News & Insights

What providers need to know about Stage 2 meaningful use requirements

The Centers for Medicare and Medicaid Services recently released its proposal for the next stage of meaningful use requirements for EHR incentives. Here’s what the 450-page proposal will mean for providers. 

One key element in the proposal: a change in deadlines. The rules would push back implementation of the Stage 2 requirements to 2014, rather than 2013 as initially planned. Under the proposed rules, providers can continue using EHRs certified under Stage 1 requirements until the end of 2013.

Other changes are focused on the goals of capturing more health information electronically, increasing information sharing between providers and enabling more electronic interaction with patients. For example, the proposed rules would require providers to set up online portals where patients can access their health information.

The rules are structured similar to those in Stage 1. Providers must meet every item in a set of core objectives (17 for doctors, 16 for hospitals), and choose from a list of menu objectives (doctors must meet three out of five, hospitals must meet two out of four).

For the most part, the meaningful use requirements in Stage 1 are carried over to the proposed Stage 2 rules. In some cases, the requirements have been made more strict, and some menu set objectives have been changed to core objectives.

The proposal also contains two significant changes to the Stage 1 requirements:

  1. A Stage 1 objective requiring doctors to give patients electronic copies of their health information is replaced with a requirement that doctors give patients “electronic/online access” to that data, and
  2. A Stage 1 objective requiring the ability to exchange health information is replaced with a requirement that doctors provide summary of care records for patients that are sent to other providers.

Here is the full list of core and menu objectives in the proposed Stage 2 meaningful use requirements:

Core objectives for eligible professionals (EPs) and hospitals:

  1. Use computerized physician order entry (CPOE) for more than 60% of medication, lab and radiology orders (an increase from 30% in Stage 1)
  2. Record demographic data including preferred language, gender, race, ethnicity and date of birth for more than 80% of patients (an increase from 50% in Stage 1)
  3. Record and chart changes in height, weight, blood pressure and BMI for more than 80% of patients (an increase from 50% in Stage 1)
  4. Record smoking status for more than 80% of patients 13 and older (an increase from 50% in Stage 1)
  5. Implement five clinical decision support interventions related to five or more clinical quality measures (an increase from one support intervention in Stage 1)
  6. Incorporate more than 55% of clinical lab test results into an EHR system as structured data (an increase from 40% in a Stage 1 menu set objective)
  7. Generate at least one report listing patients with a specific condition to use for quality improvement, reduction of disparities, research or outreach (was a menu set objective in Stage 1)
  8. Use an EHR system to identify patient-specific education resources and provide those resources to the patient after more than 10% of office visits or patient admissions (was a menu set objective in Stage 1)
  9. Perform medication reconciliation for more than 65% of transitions of care when the patient is transitioned to the provider from another (an increase from 50% in a Stage 1 menu set objective)
  10. Provide a summary of care record for 65% of referrals and transitions of care when the provider transitions the patient to another (replaces a Stage 1 objective requiring the ability to exchange health information)
  11. Submit electronic immunization data from an EHR system to an immunization registry or immunization information system (replaces a Stage 1 menu set objective requiring the capability to send immunization data)
  12. Keep electronic health information secure and private (no change)

Core objectives for hospitals:

  1. Automatically track more than 10% of medication orders (new objective)
  2. Allow more than 50% of patients to access information about a hospital visit online (replaces a Stage 1 requirement to give patients an electronic copy of their health information)
  3. Submit electronic reportable laboratory results to public health agencies (replaces a Stage 1 menu set objective requiring the capability to send lab results)
  4. Submit electronic syndromic surveillance data to public health agencies (replaces a Stage 1 menu set objective requiring the capability to send surveillance data)

Core objectives for EPs:

  1. Generate more than 65% of prescriptions electronically (an increase from 40% in Stage 1)
  2. Use clinically relevant information to identify patients who should receive reminders for preventive or follow-up care and send reminders to more than 10% of patients (replaces a menu set objective in Stage 1)
  3. Give more than 50% of patients online access to their health data within four days after the data is available (replaces a Stage 1 requirement to give patients an electronic copy of their data)
  4. Provide clinical summaries to patients for more than 50% of office visits (no change)
  5. Use secure electronic messaging to communicate with more than 10% of patients on relevant health information (new objective)

Menu set objectives for EPs and hospitals:

  1. Make more than 40% of scans and tests whose result is an image accessible through an EHR system (new objective)
  2. Record patient family health history for more than 20% of patients as structured data (new objective)

Menu set objectives for hospitals:

  1. Record whether more than 50% of patients 65 years old or older have an advance directive (no change)
  2. Generate more than 10% of hospital discharge medication orders electronically (new objective)

Menu set objectives for EPs:

  1. Submit electronic syndromic surveillance data to public health agencies (no change)
  2. Identify and report cancer cases to a state cancer registry (new objective)
  3. Identify and report specific cases to a specialized registry (new objective)

To read more, download the Stage 2 meaningful use proposal.

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