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Meaningful use stage 2 final rule issued by federal government


The Centers for Medicare and Medicaid Services and Office of the National Coordinator for Health Information Technology have released the final requirements for your exchanging health information with colleagues and increasing patient online access through your electronic health record system to receive federal incentive payments.

The Centers for Medicare and Medicaid Services and the Office of the National Coordinator (ONC) for Health Information Technology (HIT), both part of the U.S. Department of Health and Human Services (HHS), have released the final requirements for stage 2 of meaningful use.


• clarify that stage 2 of the program will begin as early as 2014. No providers will be required to follow the final stage 2 requirements before 2014;

• outline the certification criteria for the certification of electronic health record (EHR) technology, so eligible professionals and hospitals may be assured that the systems they use will work, helping them meaningfully use HIT and qualify for incentive payments;

• modify the certification program in an attempt to cut red tape and make the certification process more efficient; and

• allow current “2011 Edition Certified EHR Technology” to be used until 2014.

The CMS final rule also provides a flexible reporting period for 2014 to give providers sufficient time to adopt or upgrade to the latest EHR technology certified for 2014.

“The changes we’re announcing today will lead to more coordination of patient care, reduced medical errors, elimination of duplicate screenings, and tests and greater patient engagement in their own care,” says HHS Secretary Kathleen Sebelius.

Steven J. Stack, MD, chairman of the board of the American Medical Association, says, “We will carefully review the final rule and hope to see the changes we advocated for to promote widespread adoption and meaningful use of EHRs by physicians.” The organization was one of several offering comments in May.

Since January 2011, more than 120,000 eligible healthcare professionals have qualified to participate in the program under which they can receive Medicare and Medicaid incentive payments when they adopt and meaningfully use certified EHR technology. That number exceeds a goal of 100,000 set by the government earlier this year and includes one out of every five eligible healthcare professionals, according to HHS.

The program is divided into three stages:

Stage 1 sets the basic functionalities EHRs must include, such as capturing data electronically and providing patients with electronic copies of health information.

Stage 2 (which will begin as early as 2014) is designed to increase health information exchange between providers and promote patient engagement by giving patients secure online access to their health information.

Stage 3 will continue to expand meaningful use objectives with the goal of improving healthcare outcomes.

During stage 2, healthcare providers must meet the requirements to qualify for incentives. The stage 2 requirements also state the criteria that EHR systems must meet to be certified.

"Extending the start for stage 2 until 2014 was a necessary step to permit medical groups sufficient time to implement new software," says Susan Turney, MD, MS, FACP, FACMPE, president and chief executive officer of the Medical Group Management Association–American College of Medical Practice Executives. "Permitting group reporting will reduce administrative burden, as will lowering the thresholds for achieving certain measures such as mandatory online access and electronic exchange of summary of care documents. MGMA supports the rule’s expanded list of exclusions and believes it will allow physicians to achieve meaningful use with fewer hurdles."

Allison Viola, MBA, RHIA, senior director of federal relations at the American Health Information Management Association, says, “We are pleased to see that CMS has heard our calls for increased alignment of quality reporting programs and acknowledgement of making an effort to reduce the reporting burden and duplication of reporting."

The final rule is available online. CMS also has prepared a fact sheet on the final rule and a fact sheet on the ONC standards and certification final rule.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health