The following is a guest post by Eric Zerneke. You can learn more about Eric at the end of the post.
The latest announcement from the Department of Health and Human Services solidified Stage 2 Meaningful Use requirements, many of which physicians and clinicians were already anticipating. The announcement also stated that deadlines for the implementation of Stage 2 would be pushed back to 2014. With Stage 2 comes an increase in patient rights to their own data and pushes for greater information sharing and exchange amongst patients and their physicians. Additionally, with the latest technology upgrades, mobilized technology, and “bring your own devices,” there is a strong emphasis on implementing the most progressive security measures.
While the entire ruling is quite lengthy and detailed, LuAnn Kimker, Principle Consultant, Arcadia Solutions has highlighted the top five points that should be understood and addressed about this landmark announcement:
Structured Lab Results
Requirements in MU Stage 2 have increased the use of structured data for all lab results from 40 to 55 percent and elevated this measure from a menu to a core objective. This measure, while it comes at a cost to practices, provides incentives for them to implement lab interfaces that enforce and maintain actionable, structured data to better manage high-risk patient populations. Without a lab interface, data entry is a labor-intensive manual task with a high risk for entry inaccuracies in structured fields.
Patient Access to Health Information
This MU Stage 2 measure for online access to health information has a significant increase to its requirements, jumping from 10 to 50 percent, with 10 percent of patients having actually accessed their health information. This measure involves a larger paradigm shift with how providers engage patients in shared care and collaboration. An important factor of this measure requires all practices to have a portal for patient access, which many don’t. Additionally, patient participation is required for this measure to be fully realized and providers have minimal influence over whether or not a patient makes use of the portal. In some instances, patients have received and understood their health information directly from their physician. In other instances, they are affected by the cultural and financial impact associated with having internet access. This is even more apparent when senior-aged patients on Medicare or low-income patients on Medicaid are considered. In Stage 2, providers are held responsible for encouraging patient-centered care by educating and encouraging patients to utilize a patient portal.
Ongoing Submission to Registries
While MU Stage 1 required only a test of this measure’s existing capabilities, Stage 2 addresses the challenges of fully implemented health information exchange and the ongoing submission for the entire reporting period. This measure, a menu objective for submitting information to immunization registries in Stage 1, is now a core objective in Stage 2. Additionally, three of the four menu objectives proposed for Stage 2 also measure ongoing submission to various registries. While there is much benefit to this measure for the epidemiology and the safety of the population, the technology needed to support this measure must grow rapidly at the state and EHR capability level, for it to be successful.
Computerized Physician Order Entry (CPOE)
This measure was a primary focus during Stage 1 and continues to be a core objective as we enter Stage 2. Its requirement has doubled from 30 to 60 percent and now includes prescriptions, lab results, and diagnostic imaging. This measure will prove to be a challenge during Stage 2 because without a bi-directional lab/diagnostic image interface in place to manage a patient’s EHR, the risk of duplicate workflows and data field incompatibility between a provider and a laboratory, for example, still exists. Further, measuring all three components, this may be at various stages of implementation, as one measure for CPOE adds to the task.
Summary of Care Referrals
As this unpopular measure enters MU Stage 2 and becomes a core objective, it consolidates Stage 1 measures that govern accurate medication lists, allergy lists, and problem lists. Additionally, its requirement has increased from 50 to 65 percent, with 10 percent of information transmitted electronically. The challenge and the reason for this measure’s unpopularity, is the difficulty in establishing the secure transfer of patient information, a key factor both providers and vendors must address in order to effectively support future health information exchange and properly coordinate care.
The ruling on Meaningful Use Stage 2 will surely affect all patients, physicians, and vendors. The good news is that this announcement works in favor of both the patient and the physicians by creating increased benefits to treating patients more holistically and efficiently. While there is still a considerable education and implementation curve, once the growing pains have calmed and more successes are being published, it will be a beneficial opportunity for all parties.
Eric Zerneke is the Vice President of Marketing and Business Development for Arcadia Solutions, a nationally recognized healthcare consulting firm.