A look ahead to the proposed rule for Stage 2 meaningful use


Capabilities for coordinating care, engaging with patients and electronically capturing data for quality reporting are likely to be required in the proposed rule for Stage 2 meaningful use. The rule is expected later this month.

According to a report from IT vendor CSC, the most challenging aspects of demonstrating the next stage of meaningful use of electronic health record systems will be enabling patients to view and download their information and transmitting summary-of-care records when patients move among care settings.

“The importance of these requirements goes beyond meeting the incentives for meaningful use,” said report authors Erica Drazen, managing director, and Jane Metzger, principal researcher, CSC’s Global Institute for Emerging Healthcare Practices.

These requirements are also the path “to winning under the new Medicare payment rules and becoming accountable for the care of a population,” the authors wrote in the report.

In Stage 1, organizations could defer about half of the optional requirements for demonstrating meaningful use. Providers were most likely to defer requirements related to patient engagement and coordinating care because of the lack of operational readiness by the provider organization and vendor product readiness, CSC reported.

Providers will need to be ready to demonstrate those capabilities in Stage 2.

CSC urged that providers start now by establishing the following processes:

  • Provide patients with access electronically to their data through patient portals or directly from EHRs.
  • Electronically capture physician notes, including diagnosis and treatment, and the reason for excluding patients from treatment recommendations.
  • Exchange patient information in transitions of care.

Some of the optional measures in Stage 1 will be most likely required in Stage 2, such as reconciling patients’ medications, checking drug formulary, electronically transmitting summary care records between providers at transitions in care, and providing patients timely access to their electronic health information.

Providers who attested to Stage 1 generally exceeded the minimum thresholds for the criteria they met, according to CMS data cited in the report. For example, physicians and hospitals that used computerized physician order entry for medication orders did so for 85 percent of patients instead of just the required 30 percent.

"Once organizations adopt a capability, they use it for almost all patients, in part because maintaining two separate processes is difficult and could result in safety issues,” the authors noted.

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