Calling the Shots: Nursing News and Notes

Meaningful Use: Proposed Rule for Stage 3 Released

Meaningful Use: Proposed Rule for Stage 3 Released

Thursday, April 9, 2015
With much anticipation, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule to Stage 3 of the meaningful use program on March 20, 2015.

The overarching goals with meaningful use are to use certified electronic health record (EHR) technology to engage patients and maintain the security and privacy of their health info; to improve care coordination, safety, efficiency, and quality; and to reduce health disparities. The hope is that meaningful use will lead to better clinical and population health outcomes and more empowered patients, as well as stronger data on health systems.

 To help incentivize meaningful users of certified EHR technology, eligible professionals, hospitals, and critical access hospitals can receive payments under the EHR Incentive Program. On the other hand, a reduction in reimbursement may be the penalty for non-meaningful users.

CMS has broken the meaningful use goals into three stages—stage 1: data capture and sharing; stage 2: advance clinical processes; and stage 3: improved outcomes. By doing this, CMS hopes the goals will be more easily achievable. (CMS had delayed implementation of parts of the program after facing criticism from health information technology companies and physicians.)

 What Is Stage 3 of Meaningful Use?

To also assist with meeting the goals, CMS simplified the requirements in stage 3, proposing the following eight objectives:

  • Objective 1: Protect patient health information
  • Objective 2: Electronic prescribing
  • Objective 3: Clinical decision support
  • Objective 4: Computerized provider order entry
  • Objective 5: Patient electronic access to health information
  • Objective 6: Coordination of care through patient engagement
  • Objective 7: Health information exchange
  • Objective 8: Public health and clinical data registry reporting.

In addition, CMS’ proposed rule offers some flexibility with the timing. Originally, providers needed to be compliant with stage 3 in 2017; now stage 3 is optional until 2018.

“These changes together support our broader efforts to increase simplicity and flexibility in the program while driving interoperability and a focus on patient outcomes in the meaningful use program,” CMS stated in the proposed rule.

Praise and Criticism

Some experts have applauded CMS for this step in a more simplified, coherent, and relatively easy-to-understand direction, including the inclusion of the eight core objectives.

However, not everyone shared that same opinion of the proposed rule. One chief information officer wondered if the proposed thresholds are not possible in today’s world, such as the goal where more than 25% of patients discharged from a hospital or emergency room or seen by an eligible professional must “actively engage” with their electronic records. Many physicians agreed. A Healthcare Informatics survey found that more than half of respondents believed the patient engagement objective would be the most difficult one to satisfy.

To read the proposed meaningful use rule in its entirety and to offer your own comments, visit https://www.federalregister.gov/articles/2015/03/30/2015-06685/medicare-and-medicaid-programs-electronic-health-record-incentive-program-stage-3. Comments will be accepted until May 29, 2015.

 

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