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The words "meaningful use" have been making providers cringe for more than 2 years now. Those clinicians who worked hard to demonstrate meaningful use under the stage 1 requirements now must go on to demonstrate meaningful use under the stage 2 requirements. We recently heard one of our colleagues describe stage 2 of meaningful use as reminiscent of the 1978 movie "Jaws 2," the ads for which ran with the tagline: "Just when you thought it was safe to go back in the water..."
As you may be aware, on August 29th the Department of Health and Human Services published a final rule allowing certain eligible providers the flexibility to continue using the Stage 1 criteria for the 2014 attestation year, even if they were due to start Stage 2. This only applies to those who have been unable to obtain the 2014-certified software in time due to vendor delays. Unfortunately, this flexibility does not extend to those who can’t meet Stage 2 due to measure difficulty or procrastination in purchasing software or adopting new workflows (we recommend speaking with a meaningful use expert or consultant before attempting to take advantage of this flexibility). Regardless of stage or year, everyone is on a 90-day reporting period for 2014, but remember that 2015 will require a full year of reporting (January through December). So even if you qualify for the flexibility and opt to stick with the Stage 1 measures, you’ll need to be ready to hit the ground running with Stage 2 as soon as the ball drops on January 1st, 2015.
The government’s intent with the EHR incentive program is to ensure that practitioners use an EHR to do more than what could otherwise be done on a paper note. As we review the criteria that must be met for stage 2 of meaningful use, we will see the inclusion of menu items and quality measures that are aimed at enhancing actionable decision support to improve the quality of medical care, population management (even for patients who might not come in to the office), and physician-patient communication. By articulating these goals we can see that they are very different from what most practitioners perceive to be the main outcome of the meaningful use rules: the creation of a lot of unnecessary busywork in the office that yields very little benefit for practitioners or patients.
The EHR incentive program consists of three stages.
• Stage 1, which many practitioners have already accomplished and received incentive dollars for completing, focused on basic data capture.
• Stage 2, which focuses on more advanced processes including additional requirements for e-prescribing, incorporating lab results into the record, electronic transmission of patient summaries across systems, and increased patient engagement.
• Stage 3, which will utilize the processes put in place in the first two stages and focus on improved patient outcomes.
For stage 2 of meaningful use, clinicians must meet or exceed the thresholds for the 17 core objectives and 3 menu objectives, as well as report on defined Clinical Quality Measures (CQMs). Many of the objectives in stage 2 are the same as those from stage 1. Some objectives that were in the set of choices in stage 1 are now part of the mandatory core set for stage 2, required for all providers. Some objectives that were in the core set in stage 1 now have higher thresholds or percentages of patients that must meet the criteria in order to qualify for meaningful use in stage 2. The data reported to the Centers for Medicare & Medicaid Services for CQMs must originate from an EHR that has been certified for 2014 standards. This rule requires that clinicians upgrade their EHR to current technology standards, a rule that is good for EHR vendors, makes sense when we look at the system as a whole, but may be very expensive for many practitioners.
In addition to the 17 core objectives, and 3 out of 6 menu objectives, clinicians will need to report on nine CQMs. We will review the details of reporting on CQMs in next month in part 2 of our overview of Meaningful Use Stage 2.
Dr. Notte is a family physician and clinical informaticist for Abington (Pa.) Memorial Hospital. He is a partner in EHR Practice Consultants, a firm that aids physicians in adopting electronic health records. Dr. Skolnik is associate director of the family medicine residency program at Abington Memorial Hospital and professor of family and community medicine at Temple University in Philadelphia.
The words "meaningful use" have been making providers cringe for more than 2 years now. Those clinicians who worked hard to demonstrate meaningful use under the stage 1 requirements now must go on to demonstrate meaningful use under the stage 2 requirements. We recently heard one of our colleagues describe stage 2 of meaningful use as reminiscent of the 1978 movie "Jaws 2," the ads for which ran with the tagline: "Just when you thought it was safe to go back in the water..."
As you may be aware, on August 29th the Department of Health and Human Services published a final rule allowing certain eligible providers the flexibility to continue using the Stage 1 criteria for the 2014 attestation year, even if they were due to start Stage 2. This only applies to those who have been unable to obtain the 2014-certified software in time due to vendor delays. Unfortunately, this flexibility does not extend to those who can’t meet Stage 2 due to measure difficulty or procrastination in purchasing software or adopting new workflows (we recommend speaking with a meaningful use expert or consultant before attempting to take advantage of this flexibility). Regardless of stage or year, everyone is on a 90-day reporting period for 2014, but remember that 2015 will require a full year of reporting (January through December). So even if you qualify for the flexibility and opt to stick with the Stage 1 measures, you’ll need to be ready to hit the ground running with Stage 2 as soon as the ball drops on January 1st, 2015.
The government’s intent with the EHR incentive program is to ensure that practitioners use an EHR to do more than what could otherwise be done on a paper note. As we review the criteria that must be met for stage 2 of meaningful use, we will see the inclusion of menu items and quality measures that are aimed at enhancing actionable decision support to improve the quality of medical care, population management (even for patients who might not come in to the office), and physician-patient communication. By articulating these goals we can see that they are very different from what most practitioners perceive to be the main outcome of the meaningful use rules: the creation of a lot of unnecessary busywork in the office that yields very little benefit for practitioners or patients.
The EHR incentive program consists of three stages.
• Stage 1, which many practitioners have already accomplished and received incentive dollars for completing, focused on basic data capture.
• Stage 2, which focuses on more advanced processes including additional requirements for e-prescribing, incorporating lab results into the record, electronic transmission of patient summaries across systems, and increased patient engagement.
• Stage 3, which will utilize the processes put in place in the first two stages and focus on improved patient outcomes.
For stage 2 of meaningful use, clinicians must meet or exceed the thresholds for the 17 core objectives and 3 menu objectives, as well as report on defined Clinical Quality Measures (CQMs). Many of the objectives in stage 2 are the same as those from stage 1. Some objectives that were in the set of choices in stage 1 are now part of the mandatory core set for stage 2, required for all providers. Some objectives that were in the core set in stage 1 now have higher thresholds or percentages of patients that must meet the criteria in order to qualify for meaningful use in stage 2. The data reported to the Centers for Medicare & Medicaid Services for CQMs must originate from an EHR that has been certified for 2014 standards. This rule requires that clinicians upgrade their EHR to current technology standards, a rule that is good for EHR vendors, makes sense when we look at the system as a whole, but may be very expensive for many practitioners.
In addition to the 17 core objectives, and 3 out of 6 menu objectives, clinicians will need to report on nine CQMs. We will review the details of reporting on CQMs in next month in part 2 of our overview of Meaningful Use Stage 2.
Dr. Notte is a family physician and clinical informaticist for Abington (Pa.) Memorial Hospital. He is a partner in EHR Practice Consultants, a firm that aids physicians in adopting electronic health records. Dr. Skolnik is associate director of the family medicine residency program at Abington Memorial Hospital and professor of family and community medicine at Temple University in Philadelphia.
The words "meaningful use" have been making providers cringe for more than 2 years now. Those clinicians who worked hard to demonstrate meaningful use under the stage 1 requirements now must go on to demonstrate meaningful use under the stage 2 requirements. We recently heard one of our colleagues describe stage 2 of meaningful use as reminiscent of the 1978 movie "Jaws 2," the ads for which ran with the tagline: "Just when you thought it was safe to go back in the water..."
As you may be aware, on August 29th the Department of Health and Human Services published a final rule allowing certain eligible providers the flexibility to continue using the Stage 1 criteria for the 2014 attestation year, even if they were due to start Stage 2. This only applies to those who have been unable to obtain the 2014-certified software in time due to vendor delays. Unfortunately, this flexibility does not extend to those who can’t meet Stage 2 due to measure difficulty or procrastination in purchasing software or adopting new workflows (we recommend speaking with a meaningful use expert or consultant before attempting to take advantage of this flexibility). Regardless of stage or year, everyone is on a 90-day reporting period for 2014, but remember that 2015 will require a full year of reporting (January through December). So even if you qualify for the flexibility and opt to stick with the Stage 1 measures, you’ll need to be ready to hit the ground running with Stage 2 as soon as the ball drops on January 1st, 2015.
The government’s intent with the EHR incentive program is to ensure that practitioners use an EHR to do more than what could otherwise be done on a paper note. As we review the criteria that must be met for stage 2 of meaningful use, we will see the inclusion of menu items and quality measures that are aimed at enhancing actionable decision support to improve the quality of medical care, population management (even for patients who might not come in to the office), and physician-patient communication. By articulating these goals we can see that they are very different from what most practitioners perceive to be the main outcome of the meaningful use rules: the creation of a lot of unnecessary busywork in the office that yields very little benefit for practitioners or patients.
The EHR incentive program consists of three stages.
• Stage 1, which many practitioners have already accomplished and received incentive dollars for completing, focused on basic data capture.
• Stage 2, which focuses on more advanced processes including additional requirements for e-prescribing, incorporating lab results into the record, electronic transmission of patient summaries across systems, and increased patient engagement.
• Stage 3, which will utilize the processes put in place in the first two stages and focus on improved patient outcomes.
For stage 2 of meaningful use, clinicians must meet or exceed the thresholds for the 17 core objectives and 3 menu objectives, as well as report on defined Clinical Quality Measures (CQMs). Many of the objectives in stage 2 are the same as those from stage 1. Some objectives that were in the set of choices in stage 1 are now part of the mandatory core set for stage 2, required for all providers. Some objectives that were in the core set in stage 1 now have higher thresholds or percentages of patients that must meet the criteria in order to qualify for meaningful use in stage 2. The data reported to the Centers for Medicare & Medicaid Services for CQMs must originate from an EHR that has been certified for 2014 standards. This rule requires that clinicians upgrade their EHR to current technology standards, a rule that is good for EHR vendors, makes sense when we look at the system as a whole, but may be very expensive for many practitioners.
In addition to the 17 core objectives, and 3 out of 6 menu objectives, clinicians will need to report on nine CQMs. We will review the details of reporting on CQMs in next month in part 2 of our overview of Meaningful Use Stage 2.
Dr. Notte is a family physician and clinical informaticist for Abington (Pa.) Memorial Hospital. He is a partner in EHR Practice Consultants, a firm that aids physicians in adopting electronic health records. Dr. Skolnik is associate director of the family medicine residency program at Abington Memorial Hospital and professor of family and community medicine at Temple University in Philadelphia.
