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HIMSS12: Proposed Stage 2 meaningful use rule announced

by Diana Bradley, Staff Writer | February 24, 2012
The Centers for Medicare and Medicaid Services Thursday announced its long-awaited Notice of Proposed Rulemaking for Stage 2 requirements for the Medicare and Medicaid Electronic Health Record Incentive Programs.

Substantially adopted from the Health IT Policy Committee's recommendations, CMS' proposed Stage 2 criteria for meaningful use focus on increasing the electronic capturing of health information in a structured format, and increasing the exchange of clinically relevant information between providers of care at so-called "care transitions."

Physicians are specifically encouraged to communicate with patients online, with the new rules requiring that more than 10 percent of their patients be able to correspond with them via "secure messages" or an encrypted form of email. Furthermore, patients must receive timely electronic access to their health care information from their physicians.

Speaking with DOTmed News not even an hour after the rule was announced, Mark Segal, GE Healthcare IT's vice president of government and industry affairs and health care information technology, noted that he was not particularly surprised by anything in the 455-page document, after a quick scan.

"The rule seems to include more flexibility for specialists, but also more precision," said Segal."[CMS] is trying to eliminate ambiguity in wording that then requires clarifications to be written and then clarifications on the clarifications. So I think in general they have learned from what they did before."

In July 2010, CMS initiated a separate set of core objectives and menu objectives for eligible providers, eligible hospitals and critical access hospitals for Stage 1. All but one of the 10 elective objectives in Stage 1 will become mandatory, with many of them also being combined or unified for Stage 2.

Diagnostic imaging is involved in one of the new elective objectives for Stage 2, with the proposal stating that physicians can choose to demonstrate that more than 40 percent of all tests and scans resulting in an image are EHR-assessable. In cases where there are situations that make it impossible for an eligible provider or eligible hospital to meet the measure, an exclusion was defined.

A subsequent rise in the measure threshold that providers must achieve for each objective that has been retained from Stage 1 also eliminates unnecessary accounting and reporting stresses for providers by recognizing that, for providers who have been long-time Stage 1 meaningful users, recording these data in structured form has become routine in their delivery of care. Up from 40 percent, more than 65 percent of prescriptions must be e-prescribed by meaningful users, for example.

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