We’re a ways into this now. And meaningful use of electronic health records is continuing to evolve. While Meaningful use Stage 1 is still relevant, Meaningful Use Stage 2 Measures need to be integrated in the not so distant future. So now seems to be a perfect time to compare Stage 1 to Stage 2.
Meaningful Use Stage 2 Measures, as predicted, are more demanding
The Meaningful Use Stage 2 Measures raise the bar in two dimensions. In the vertical dimension, performance measures are increased. For instance,
- Use of computerized provider order entry must increase from 30% of medication to 60% of medication orders.
- Vital signs must be recorded for 80% of patients over age 2, up from 50% of patients.
- Providers must implement five clinical decision support rules, up from 1 under the Stage 1 rules.
- Recording of clinical lab tests with numerical or positive/negative results must increase from 40% of all such clinical lab tests to 55% of all such clinical lab tests.
The bar is changed horizontally as well, by increasing the number of Objectives and Measures, and by extending the breadth of some of the Stage 1 Measures. For instance,
- Use of computerized provider order entry is extended to laboratory and radiology orders, requiring 30% of such orders to be created in the EHR.
- Providing timely electronic access to health information has been broadened to specify providing the ability to view online, download and transmit health information within 4 business days of the information being available to the EP.
- Several Meaningful Use Stage 1 Menu measures have become Meaningful Use Stage 2 Core Measures. These include generating lists of patients for quality improvement activities and sending clinically relevant reminders to patients.
- New measures include using secure electronic message to communicate with patients, accessing imaging results electronically and recording family history as structured data.
Stage 1 vs. Stage 2 … a Unique Meaningful Use Matrix for Eligible Professionals
The Fox Group has developed a new Stage 1 vs. Stage 2 Meaningful Use Matrix. This unique matrix puts the Meaningful Use Stage 2 measures in context by giving you a side by side comparison of the Meaningful Use Objectives and Measures contained in Stage 1 vs. Stage 2. Of course, this is a summary document, and more documentation of denominators and numerators, of patients to be included, etc., will be forthcoming from CMS over the next few months.
In the meantime, don’t forget about Core Measure 15, protecting electronic health information. Providers continuously tell us their EHR vendor says the software is HIPAA compliant. They are then unpleasantly surprised to learn the measure includes conducting a security risk analysis in accordance with the HIPAA Security Rule. The Office of Civil Rights, which enforces HIPAA regulations, recently issued an audit tool for its auditors who conduct investigations of breaches involving electronic Protected Health Information. The tool contains 79 specifications regarding the Security Rule alone! Your EHR software vendor cannot conduct such an audit for you, and indeed, many of the provisions of the Security Rule are independent of EHR software in general.
Meaningful Use Stage 2 Measures Compared to Those in Stage 1 … Download Now
The Meaningful Use Stage 2 Objectives and Measures are clearly pointing us to a future of electronic health records, sharable with patients and other providers, and increasing the interconnectedness among providers. The incentives and pitfalls are there. Make sure you are keeping up!