Tips to avoid potential Stage 2 Meaningful Use problems

Stage 2 Meaningful Use does two things: ups the ante on thresholds from Stage 1 Meaningful Use and adds requirements which eligible providers must complete for the first time. The ability of an eligible hospital (EH) or professional (EP) to go through a successful meaningful use attestation in this upcoming phase of the EHR Incentive Programs will largely come down to doing due diligence about what has changed between Stage 1 and Stage 2 Meaningful Use.

Earlier this year, Catholic Health Partners CMIO Stephen Beck, MD, FACP, FHIMSS, shared insight into how his healthcare organization was going about preparing for its transition from Stage 1, where it achieved significantly high levels of meaningful use success, to Stage 2, where it hopes to sustain its meaningful use participation successfully.

So where does this preparation start? And what does it entail?

Awareness of Stage 2 Meaningful Use should begin with a review of the revised calendar for the EHR Incentive Programs for Medicare. As you can see, early adopters are the greatest beneficiaries of the decision on the part of the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) to delay the beginning of Stage 2 until 2014.

For all other participants, they will want to chart their two-year periods in each stage of the EHR Incentive Programs going forward, planning appropriately so as to give clinicians and health IT staff the opportunity to prepare and succeed in subsequent stages without interruption.

Concomitant with this calendar is the timeline for participating and reporting during Stage 2 Meaningful Use. As has always been the case, the meaningful use work of EHs occurs during the fiscal year. This means that October 2013 is the beginning of Stage 2 for them. Conversely, EPs have always had to abide by the calendar year, making January 2013 the kickoff date for the next phase of meaningful use.

What both groups of providers need to appreciate is the timeliness of reporting periods. Although a 90-day reporting period in Stage 2 Meaningful Use has the look and feel of  eporting in Stage 1, that is not the case. Eligible providers must report during one of four eporting periods based on FY for EHs and CY for EPs. It may not seem like much, but this approach offers much less wiggle room than in the inaugural phase of meaningful use where providers could pick and choose whatever 90-day period they wanted.

Generally speaking, Stage 2 Meaningful Use basically increases the thresholds that eligible providers must exceed. This includes increased requirements for information exchange impacting electronic prescribing (e-prescribing, eRx), laboratory results, and patient care summaries, especially during transitions of care. For example, requirements for demographics move from 50 percent to 80 percent in Stage 2.

That being said, Stage 2 also rejiggers elements of Stage 1 and puts them into different categories. The most salient example of this is the re-categorization of optional Stage 1 objectives into required measures for eligible providers. For instance, the problem list has lost its status as a unique measure and now comprises part of the requirements for summary of care documents.

Above all, Stage 2 Meaningful Use places a greater emphasis on the reporting of clinical quality measures (CQMs). Here is an area of the EHR Incentive Programs where eligible providers will need to do their homework and choose which CQMs and domains they will report on. It’s an important decision because it will necessitate changes to the certified EHR technology and thus require providers to work closely with their EHR vendors to ensure that they build a system capable of reporting these measures accurately.

Lastly, eligible providers need to be cognizant of the emerging role of health information exchange (HIE) in Stage 2 Meaningful Use. As early meaningful use participants, Dr. Beck and Catholic Health Partners took the requirements for exchanging health information as a sign to prepare to connect to the eHealth Exchange, to implement directed exchange that pushes information with the continuity of care document to outside providers with referrals, and to implement integrated data exchange with external groups.

The biggest lesson to be learned about Stage 2 Meaningful Use is this: These news requirements must lead to changes in your schedules, clinical workflows, and certified EHR systems before the transition to this next phase is complete. Source