How Does Stage 2 Meaningful Use Relate to Stage 1?
Ron Sterling
Sterling Solutions
Author: Keys to EMR/EHR Success
Your Meaningful Use (MU) Strategy will have a significant impact on your ability to avoid extra work and disruption to your operation. One of the most important issues to consider in your EHR and MU strategy is the Proposed Stage 2 Meaningful Use Measures. The proposed Stage 2 Measures provide important insights into what you should choose as your Stage 1 Menu Items and even your EHR product and implementation plan.
The following table presents the Stage 1 and 2 Measures in a way that will help you analyze the effect of Stage 2 on meaningful use and focus your strategy to avoid problems:
| MU Measure | Stage 1 Requirement | Proposed Stage 2 Effect | Proposed Stage 2 Requirement |
| Computerized Provider Order Entry (C-1) | CORE – Medication Orders for 30% of Unique Patients. | Increase Percentage. Added Radiology and Lab Orders. | CORE – 60% of Medication, Lab, and Radiology Orders. |
| Drug-Drug and Drug Allergy Interaction Checks (C-2) | CORE – Enabled for Reporting Period. | Not a Separate Measure. | Â |
| Up to Date Problem List (C-3) | CORE – 80% of all Unique Patients | Not a Separate Measure. |  |
| Transmit eRx (C-4) | CORE | Increased Percentage. Added Stage 1 Menu Item on Formularies. | CORE – Transmit 65% of Rx Electronically. Use at Least One Formulary. |
| Active Medication List (C-5) | CORE – 80% of all Unique Patients. | Not a Separate Measure. |  |
| Active Medication Allergy List          (C-6) | CORE – 80% of all Unique Patients. | Not a Separate Measure. |  |
| Record Demographics   (C-7) | CORE – 50% of all Unique Patients. | Increased Percentage. | CORE – 80% of all Unique Patients. |
| Record Vital Signs (C-8) | CORE – 50% of all Unique Patients. | Increase Percentage. | CORE – 80% of all Unique Patients |
| Record Smoking Status (C-9) | CORE – 50% of all Unique Patients > 13. | Increased Percentage. | CORE – 80% of all Unique Patients > 13. |
| Report Clinical Quality Measures (C-10) | CORE | Not a Separate Measure. | Â |
| Clinical Decision Support Rule  (C-11) | CORE – Implement One Rule. | Increase Number of Rules. | CORE – Implement Five Rules. |
| Electronic Copy of Health Information (C-12) | CORE – Provide Information to 50% of Patients Who Request Within 3 Days. | Consolidated With Stage 1 Menu Item on Patient Electronic Access. | See Patient Electronic Access. |
| Clinical Summaries (C-13) | CORE – Provide Clinical Summary for 50% of Office Visits within 3 Days. | Shorter Timeframe. | CORE – Provide Clinical Summary for 50% of Office Visits within 24 Hours. |
| Electronic Exchange of Clinical Information (C-14) | Core – Perform a Test. | NO LONGER REQUIRED. | N/A |
| Protect Electronic Health Information (C-15) | CORE – Perform a Security Risk Analysis. | No Change. | CORE – Perform a Security Risk Analysis. |
| Drug Formulary Check (M-1) | MENU – Implement at Least 1 Drug Formulary. | Added to Stage 1 Core Item to Transmit Rx. | N/A. |
| Clinical Lab Test Results (M-2) | MENU – 40% of Lab Test Results In EHR as Structured Data. | Increased Percentage. Moved to Stage 2 Core. | CORE – 55% of Lab Test Results In EHR as Structured Data. |
| Patient Lists (M-3) | MENU – Generate a List of Patients Using Condition Criteria. | Moved to Stage 2 Core. | CORE – Generate a List of Patients Using Condition Criteria. |
| Patient Reminders (M-4) | MENU – Send Reminders to at Least 20% of Patients > 65 or < 5 | Moved to Stage 2 Core. | CORE – Send Reminders to at Least 10% of Patients with an Office Visit Within 24 Months Prior to Start of Reporting Period. |
| Patient Electronic Access (M-5) | MENU – 10% of All Patients Provided Access within 4 Business Days of Receipt of Information. | Consolidated with Stage 1 Core Item for Electronic Copy of Health Information. Moved to Stage 2 Core. | CORE – 50% of All Patients Provided Access within 4 Business Days of Receipt of Information. 10% of All Patients View, Download or Transmit Information. |
| Patient-Specific Education Resources (M-6) | MENU – 10% of Unique Patients Provided Resources Using EHR to Identify Appropriate Resources. | Moved to Stage 2 Core. Change Measure. | CORE – 10% of Office Visits Result in Providing Patients Education Resources Using EHR to Identify Appropriate Resources. |
| Medication Reconciliation    (M-7) | MENU – Performed for 50% of Incoming Transition of Care Patients. | Increased Percentage. Moved to Stage 2 Core. | CORE – Performed for 65% of Incoming Transition of Care Patients. |
| Transition of Care Summary (M-8) | MENU – 50% of Transitions of Care Supported with a Care Summary. | Increased Percentage. Moved to Stage 2 Core. | CORE – 65% of Transitions of Care Supported with a Care Summary. 10% of Transitions Are Electronically Transmitted. |
| Immunization Registry (M-9) | MENU – Test Successful Submission. | Moved to Stage 2 Core. Change Measure. | CORE – Ongoing Transmission. |
| Syndromic Surveillance Data Submission (M-10) | MENU – Test Successful Submission. | Change Measure. | MENU – Ongoing Transmission. |
| Secured Messaging | N/A | New Stage 2 Core. | CORE – For More than 10% of Patients Seen, a Secure Message was Sent. |
| Imaging | N/A | New Stage 2 Menu Item. | MENU – 40% of Scans and Tests Resulting in an Image Are Accessible from EHR. |
| Structured Family Health Data | N/A | New Stage 2 Menu Item. | MENU – 20% of Unique Patients have Structured Family Health Information. |
| Cancer Case Reporting | N/A | New Stage 2 Menu Item. | MENU – Ongoing Transmission. |
| Cases Other Than Cancer Reporting | N/A | New Stage 2 Menu Item. | MENU – Ongoing Transmission. |
Analyze this table to develop your MU strategy and simplify the challenge of attaining MU and implementing your EHR.
This article was originally published on Avoid EHR Disasters and is used here with permission. Ron Sterling is author of the HIMSS Book of the Year Keys to EMR/EHR Success. He is a nationally recognized EHR expert with the information that you need to improve patient service and performance. For questions or if you are looking to engage him as a speaker, he can be contacted at rbsterling@sterling-solutions.com.