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Meaningful Use Stage 2: The Final Rule - What does it mean to you?
Posted by The HCI Group
on August 8, 2013 at 10:28 AM
Meaningful Use Stage 2 & EHR ImplementationThe push for electronic health records (EHRs) to be more widely adopted and used in ways that have greater impact on improvements in patient care continues with the release of the Meaningful Use (MU) Stage 2 rules.
In addition to building on the core objectives established in Stage 1, this stage calls on clinicians and hospitals to:
  • Further increase the interoperability of health information
  • Use more standardized data formats
  • Make their EHR systems more capable than the current Meaningful Use Stage 1.
At the same time, it offers important improvements on the rules defined in Stage 1, including:
  • More details and more reasonable timeframes
  • A phased approach that facilitates a more achievable path to compliance. 

A more defined set of rules

Stage 1 Meaningful Use defined a set of 15 objectives providers must meet as proof of their effective use of EHRs, plus another 10 criteria from which five must be demonstrated. To qualify for the stimulus payments in Stage 1 of the EHR incentive program, medical providers need to complete 20 Meaningful Use criteria. 

In Stage 2, almost all of the core objectives from Stage 1 are maintained. Hospitals and Critical Access Hospitals (CAH) have to meet or qualify for an exclusion to 16 objectives and two of four menu objectives;. For Eligible Professionals (EPs), the requirement is to meet or qualify for an exclusion to 17 core objectives and three of five menu objectives.

Among the changes in Stage 2 is a better defined set of rules, plus greater clarification of the Clinical Quality Measure (CQM), which should help ease some of the reporting burden healthcare providers must manage.

What are the major changes from Stage 1 to Stage 2?

  • The requirement to “perform at least one test of certified EHR technology’s capacity to electronically exchange key clinical information” in Stage 1 has been re-evaluated for the possible inclusion into the “transition of care” core objective or eliminated altogether.
  • Providing patients with an electronic copy of their discharge instructions at the time of discharge, upon request, has been replaced by an electronic/online access core objective.

Providers who don’t meet their core objectives and menu items are required to meet at least one of these

Final Rule exceptions: 

  1. The lack of availability of Internet access or barriers to obtaining information technology (IT) infrastructure.
  2. A time-limited exception for newly practicing EPs or new hospitals that otherwise won’t be able to avoid payment adjustments.
  3. Unforeseen circumstances such as natural disasters that will be handled on a case-by-case basis.
EP-only: Exceptions due to a combination of clinical features limiting a provider’s interaction with patients or, if the EP practices at multiple locations, lack of control over the availability of certificated EHR technology (CEHRT) at practice locations constituting 50 percent or more of their encounters.

How HCI Helps Clients Overcome the Battier to Obtianing IT Infrastructure

For clinicians and hospitals facing inadequate access to IT infrastructure, a solution that will help them meet Meaningful Use requirements involves more than simply purchasing one of the hundreds of electronic medical records systems that are on the market. Full compliance in demonstrating meaningful use may require workflow changes to accommodate EHR programs, integration of existing systems with the new programs, and ongoing support with IT complexities encountered as subsequent stages are introduced and regulations and policies continue to change.

At HCI, our clients are partnering with us for the expert healthcare IT consulting and resources they need to help them achieve Meaningful Use and overcome IT barriers. With highly skilled experts in every area of EHR implementation, HCI’s team can help hospitals and practitioners meet immediate Meaningful Use needs while positioning them for the stages and changes to come. Our clients call on us for a full range of specialized services, from taking the lead in strategy and implementation to ongoing helpdesk support and clinical adoption.


Additional resources that may be of interest:
Meaningful Use Milestones, the Road to Attestation