ONC seeks input on meaningful use stage 3 criteria

Although the government has yet to finalize stage 2 rules for demonstrating meaningful use (MU) of electronic health record (EHR) systems, committees already are working to develop rules for stage 3-and they want your input.

Earlier this month, the Health Information Technology Policy and Standards advisory committee of the Office of the National Coordinator for Health Information Technology (ONC) held two hearings in Washington, DC, on proposed aspects of stage 3. The first was “to identify ways in which MU stage 3 may advance the consistent delivery of high-quality care in diverse care settings,” according to a blog posting from Kevin Larsen, MD, medical director of meaningful use for the ONC.

"The committees are looking for as much input as they can get," an ONC spokesman told Medical Economics. "The views of doctors and other healthcare professionals will be very useful as the committees begin structuring rules for stage 3." No deadline has been set yet for submitting comments.

Questions for which you can provide input:

• How can the ONC best leverage EHRs to support quality improvement (QI) and accelerate the QI work of providers and organizations under the MU program?

• How can the ONC improve the availability of “small data”-the data that providers and patients can use in real time to improve their decision-making and improve quality?

• How can the ONC build and deploy “plug-and-play” clinical quality and decision support functionality in EHRs and data systems?

• What types of measures foster accountability for care outcomes and concurrently support tactical QI at the provider and organizational level?

• How can the ONC use the MU program to promote data liquidity and transparency across care settings and payers?

• How can the ONC best leverage patient-reported data to improve care?

To submit responses to the questions on quality of care, visit: http://healthit.hhs.gov/blog/faca/index.php/2012/06/19/joint-hearing-to-conceptualize-clinical-quality-for-meaningful-use-stage-3/#more-504

The second day of hearings looked at ways in which patient-generated health data (PGHD), such as information from a patient’s personal health record, could be incorporated into the stage 3 rules.

Questions for which you can provide input:

• How can the ONC ensure that patients’ reports of symptoms and their knowledge of their own contraindications make their way into EHRs?

• Although a clear need exists to have a structure for PGHD, does all PGHD for care management need to be in a structured form?

• To manage the legal, policy, and operational issues associated with provider collection of PGHD, what should individual providers do to ensure that they have a plan for managing those data?

• Patients-particularly those living with chronic conditions-have an ongoing stream of information, for which clinical encounters with the delivery system are infrequent data points. What is the relationship between that data stream and the EHR?

• Although PGHD has some specific needs, identification and sourcing of all data sources are important; how can addressing PGHD management issues help clarify how data sources are tagged more generally in the EHR?

• For which health issues is it clear that patients and families are the authoritative sources?

• How should the ONC balance the need to build in the capability for providers to incorporate structured PGHD into the EHR without being overly prescriptive?

• How should the ONC balance the concern about being overly prescriptive with ensuring a certain degree of interoperability, usability, and understandability of PGHD?

• What important implications does PGHD have for the robustness of clinical decision support, quality measurement, and care coordination?

• How can collection of PGHD address health disparities, and what cautions exist to ensure that disparities are not widened?

To submit responses to the questions pertaining to PGHD, visit:
http://healthit.hhs.gov/blog/faca/index.php/2012/06/18/federal-advisory-committees-seeking-input-on-incorporation-of-patient-generated-data-for-stage-3-meaningful-use/

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