A little over a month ago, CMS released the proposed rules for Stage 3 of Meaningful Use criteria. Stage 3 is intended to be the final stage of Meaningful Use and plans to incorporate portions of Stage 1 and 2 into its requirements. Set to begin in 2017, Stage 3 is focused on 8 objectives:
- Protecting patient health information
- Electronic prescribing
- Clinical decision support (CDS)
- Computerized provider order entry (CPOE)
- Patient electronic access to health information
- Coordination of care through patient engagement
- Health information exchange (HIE)
- Public health and clinical data registry reporting
If you're interested in diving into all 301 pages of the proposal, you can, but if not, keep reading for a summarized look at the requirements that Stage 3 could bring.
Meaningful Use Criteria Proposed for Stage 3
This is a requirement that isn't too much of a drastic change, but more of an increase of what you're already doing. EPs will need to increase their ePrescribing to 80 percent.
This requirement comes with two measures:
- Implement 5 clinical decision support interventions tied to 4 quality measures.
- Turn on drug-drug and drug-allergy alerts for the entire EHR reporting period.
During Stage 3 you'll be required to use computerized provider order entry on:
- 80 percent of medication orders
- 60 percent of lab order
- 60 percent of diagnostic imaging orders
Patient Access to Information
This requirement focuses on the availability of information to patients, it consists of 2 measures:
- Allow 80 percent of patients access to their records through the View/Download/Transmit function or through an ONC-Certified Application-Program Interface (API).
- Provide 80 percent of patients access to patient-specific educational resources.
Active Patient Engagement
This requirement differs from the patient access requirement because it does require your patients to take action. There are 3 areas in which your patients are required to engage:
- 25 percent of your patients must access their records through the View/Download/Transmit function or through an ONC-certified API (this might require some heavy encouragement to your patients on your part).
- 35 percent of your patients must receive a clinically-relevant secure message.
- Provider must incorporate information from patients or "non-clinical" settings for 15 percent of patients.
While performing health information exchanges, you'll be required to:
- Send electronic summaries for 50 percent of TOCs and referrals.
- Receive electronic summaries for 40 percent of TOCs and referrals.
- Perform medication/allergy/problem reconciliation for 80 percent of your TOCs and referrals.
Public Health and Clinical Data Registry Reporting
Active engagement (which is broadly defined by CMS as including either registering, testing, or transacting) is required for:
- Syndromic surveillance
- Reportable conditions case reporting
- Public health registries
- Non-public health registries
- Electronic lab reporting
EPs are required to choose 3 options from items 1-5 while EHs must choose 4 options from items 1-6.
The CMS's goal for Stage 3 is to simplify the complex process and offer flexibility to providers in how they choose to meet the criteria. While this stage is designed to be harder than previous stages, it should make reporting periods easier to understand while allowing for higher data quality. Remember that your opinion as an EP matters! You have the option to post your opinions on the proposed rule at regulations.gov. Comments will be accepted until May 29th at which point the rule will begin to be finalized.
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