What’s in Store for Meaningful Use Stage 2? – Meaningful Use Monday

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

A few weeks ago, the HIT Policy Committee forwarded its Stage 2 meaningful use recommendations to CMS. CMS is expected to issue a Proposed Rule in early 2012 and the Final Rule in mid-2012. 

The first recommendation—intensely debated, but overwhelmingly supported in the end—is to delay the start of Stage 2 until 2014, recognizing the unrealistic time pressure that vendors and providers would face if required to upgrade, implement, and train for the new set of requirements by 2013. 

Most of the proposed changes to the measures themselves are not dramatic in scope. Some measures did not change at all, (e.g., problem list, medication list, etc.) Others, (e.g., ePrescribing, smoking status), would have higher thresholds to meet—not a major obstacle if the higher-than-required performance trend reported among early attesters continues—and some would have a slightly broader scope, (e.g., CPOE would include radiology). 

All menu measures would become core measures, which means that they would be required of all providers. If CMS adopts this recommendation, it will be important to identify exclusion criteria to accommodate physicians for whom particular measures may not be relevant, as they did for specific core measures in Stage 1. 

The changes that are more controversial are those that hold physicians responsible for factors beyond their control, such as requiring that a given percent of patients actually view their electronic health information (Stage 1 only requires that the information be made available), or requiring that a given number of patients send a secure message to the physician/practice. Also interesting is that some of the new measures recommended for Stage 2 are measures that were specifically removed by CMS during the Stage 1 rule-making process, such as advance directives and progress notes.

If you are interested in the specifics associated with the recommendations summarized above, Computer Sciences Corporation’s Update on Stage 2 (PDF) presents a nice review.

About the author

Lynn Scheps

Lynn Scheps

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

10 Comments

  • The delay for Stage 2 is only for those “early adopters” who attest to Stage 1 in FFY 2011. For all others the timeline has not changed. I realize the market has essentially interpreted it as a delay for all, but it’s really only for a small number of providers (100 hospitals as of July).

  • If you check out the numbers listed in the ONC presentations: https://www.healthcareittoday.com/2011/08/05/preliminary-meaningful-use-details-out/ It has 4677 providers that have been paid (hospital and ambulatory). Plus, I expect that we’ll see a flood of doctors attesting at the end of the year. So, while still not a majority of doctors (although, we’ll see the numbers at the end of the year), the delay of MU stage 2 will impact quite a few people. Plus, it would have set an earlier precedent (good or bad) for the providers that follow.

  • Good point on the earlier precedent. I just worry that the market interpretation of a “delay” for all based on the small % of early adopters impacted, 100/~6,000 hospitals and 4,500/~600,000 EPs? (as of July), will contribute to EHs and EPs waiting when they probably shouldn’t. I’m sure more will have started the 90-day clock as of July 1, but even a tsunami of attesters will be a small %.

  • Heath,
    You do make a fine point. We should definitely consider how many providers are attesting compared to the number of providers that could attest. I think that would be a smaller percentage than we realize.

  • Dr. West,
    It will actually make it even more interesting if republicans take over the presidency and the senate. I’m still not sure the EHR stimulus money will go away though. However, it’s politics.

  • In response to Dr. West #5 – the original federal impetus for universal adoption of electronic medical records was originally a Republican initiative – President Bush began the whole process with a series of Executive Orders in 2001. It would be very interesting for the Republicans to cancel the very programs they created…

  • I wonder how many single providers, who attested early are aware that there was a problem in the system that didn’t allow payments to be released to them because of a software error? This error, as explained to myself, was due to the requirement of single providers to use their SSN # instead of their TIN. This created a problem as the physician would complete the process, be confirmed eligilbe and be locked in for payment and the payor would not be able to release the check. At this time, a “fix” is still in the making so those physician are still awaiting payment.

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