Stage 2 Meaningful Use Criteria

Last month the Centers for Medicare and Medicaid Services (CMS) released their proposed Stage 2 Meaningful Use rules that provide the healthcare industry with guidelines for converting to electronic health records (EHRs).  Funded by the 2009 American Recovery and Reinvestment Act (ARRA), the program offers individual Medicare providers up to $44,000 each in incentives to adopt Health IT and use it in a “meaningful way”.  The programs stated goals are to

  1. Improve health care quality, safety, efficiency and reduce health disparities
  2. Engage patients and families in their health care
  3. Improve care coordination
  4. Improve population and public health
  5. Ensure adequate privacy and security protections for personal health information

The Stage 1 Meaningful Use rules were released in 2010, and consist of 15 mandatory core items and 10 optional menu items, of which providers had to select 5. The Stage 2 rules consist of 17 compulsive core items, and 5 selective menu items, of which providers must pick 3.

While Stage 1 was focused on having providers show they had the ability to use electronic health information in a meaningful way, Stage 2 takes the next logical step to actually doing it. Providers must use their certified EHR technology for a greater percentage of their patients, provide information to patients more quickly, and must go beyond providing electronic access to patient health information by attesting that patients actually access that electronic information.

For example, in Stage 1 clinical summaries must be provided to patients for more than 50% of all office visits within 3 business days. In Stage 2, those clinical summaries must be provided within 24 hours. Further, for Stage 2, providers must attest that more than 10% of all unique patients have viewed, downloaded or transmitted their electronic health information to a third party. This is significant as it’s the start of measuring patient engagement, and will require providers to take an active role in engaging patients in their care.

Technology can help oncology providers encourage patients to view their electronic health information by alerting them when tests and labs are available to be reviewed. With our Patient Engagement Portal, clinic staff control which health information is released to individual patients and when, can see if it’s been reviewed by patients, and easily schedule email reminders to encourage patients to access their personal health information. We have years of experience building consumer web experiences and surveys show that patients find our site easy to use.

Other notable changes from Stage 1 to Stage 2 include:

  • A secure message was sent using certified EHR technology by more than 10% of unique patients. This is a new rule for Stage 2 that was not part of Stage 1. Our Patient Engagement Portal supports secure messaging between patients and their health care team with an intuitive user interface that is easy to use.
  • Summary of care record must be transmitted using certified EHR technology for more than 65% of referrals or transition of care to another provider. This increased from 50% in Stage 1, and was moved from an optional rule (menu set) to required (core set). In addition, for more than 10% of referrals or care transitions, providers must use certified EHR technology that connects with a different organization using a different certified EHR vendor. This will require that certified EHR vendors support the exchange of electronic health information with other vendors. Navigating Cancer supports the CCD format and can exchange information with other Health IT systems.
  • Patient-specific education resources identified by certified EHR technology must be provided to patients for more than 10% of all office visits. This was moved from an optional rule (menu set) to a required rule (core set) as well. Once clinic staff has released a diagnosis, our Patient Engagement Portal becomes personalized to each patient based on their condition. Diagnosis specific educational resources from trusted experts will be delivered to them automatically with no additional work required by clinic staff.

The attestation period for Stage 2 will begin in 2014, a delay of one year for providers that attested for Stage 1 in 2011. If you are planning to attest for Stage 1 in 2012, the attestation period for Stage 2 also begins in 2014. If you are attesting for the first time, you must attest for a 90-day period. If you have already attested for Stage 1 or plan to attest by the end of 2012, your attestation period for Stage 2 will be the 2014 calendar year. CMS is accepting comments until May 7, and it’s expected the rules will become final this summer.

As noted above, two of the primary goals of Meaningful Use have been to improve care coordination and engage patients and families in their care. The Stage 2 rules are starting to require that health care providers use certified technology to actually fulfill these goals, rather than just showing that they can do it. This will change how patients and providers interact, and will introduce a new era in the doctor-patient relationship. Technology such as our Patient Engagement Portal will play a critical part in this new relationship, enabling a more robust and efficient way to communicate and share important health information with patients and providers.

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