Dissecting Stage 2 of EHR Adoption

The CMS and ONC final rules for stage 2 set forth the new timeline for attesting to meaningful use. The first possible year of attesting to stage 2 will be 2014. But the rules also outline changes that will effect those attesting to stage 1 meaningful use from 2013 and beyond.

CPOE Objective
Currently in stage 1 meaningful use, a core objective is to use computerized provider order entry (CPOE) for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. The Denominator= Unique patient with at least one medication in their medication list. The new 2012 final rule changes the Denominator to = Number of orders during the EHR Reporting Period. This change for the denominator is optional in stage 1 starting in 2013 and beyond.

Vital Signs Objective
Currently in stage 1 meaningful use, Age Limits = Age 2 for Blood Pressure, Height, and Weight. The exclusion is all three elements not relevant to scope of practice. The new 2012 final rule changes the age limit to age 3 for blood pressure and no age limit for height or weight. The exclusion is for blood pressure to be separated from height and weight. The vital signs changes are optional in 2013, but will be required starting in 2014.

Testing Health Information Exchange
Currently in stage 1 meaningful use, a test of electronic transmission of key clinical information is required. Effective in 2013 this objective will be removed.

Providing e-Copy of health information
Currently in stage 1 meaningful use, you must provide patients with e-copy of health information upon request and provide electronic access to health information. In the 2012 final rule the objective changes to providing patients the ability to view online, download and transmit their health information. The measure of the new objective is 50% of patients have access to their information; there is no requirement that 5% of patients do access their information for Stage 1. The objective change is effective and will be required in 2014.

Public Health Objectives
Currently in stage 1 meaningful use, there are objectives for reporting immunizations, reportable labs, and syndromic surveillance. The 2012 final rule clarifies that this is required “except where prohibited” to all three objectives.

Read all of the Dissecting Stage 2 posts.