Meaningful Use: Stage 2


The HITECH Act of 2009 allotted 27 billion dollars to encourage the nation’s healthcare system to adopt electronic healthcare records. Dr. Farzad Mostashari, the national Coordinator for Health Information Technology, put it best when he said “… you don’t get paid for installing an electronic healthcare record, but you get it for the meaningful use for electronic healthcare records.” His point being that the government does not want providers to just have electronic healthcare records, but wants providers to use them to their fullest capability in order to provide better patient outcomes. During the first stage of Meaningful Use, the government created certain measures and objectives with required thresholds to ensure EHRs were being utilized. This past August, CMS released the final rule for Meaningful Use Stage 2 to further the utilization of EHRs.

The final rule for Eligible Providers requires them to meet 17 core measures, and 3 out of 6 menu objectives. Some of the initial core measures have been dropped to make room for new measures. Previous menu objectives have now been upgraded to the status of core measures, meaning they are no longer a choice and must be met. Across the board all measures have seen increased thresholds for Stage 2. An example would be during Meaningful Use Stage 1 the required threshold for an eligible provider using CPOE was set at 30%. The final rule for Meaningful Use stage 2 doubles that threshold to 60%. This is a significant increase that will require increased compliance from providers. There has also been an increase in the pool of Clinical Quality Measures (CQM) to choose from for providers. This should allow for providers to find CQM that are more specific to their practice. In addition to the increased number of choices available to providers, they are now responsible for reporting on more CQM. During Stage 1 providers were required to choose six CQM, Stage 2 will require the selection of 9 CQM.

Fortunately, due to the recommendations of providers and industry experts, CMS has opted to push back the attestation period for Stage 2 of Meaningful Use to 2014 to give the industry and providers more time to prepare. The Allscripts Meaningful Use Stage 2 release is slated for Q1 of 2013, leaving nearly a full year to implement the changes necessary to meet Meaningful Use Stage 2 requirements. This will allow ample time for providers and support staff to adapt their workflows for the increasing demands and complexities of Meaningful Use Stage 2. An additional consideration for your organization would be to use this extra time to upgrade to version 11.4 of Allsripts Enterprise EHRTM which was released in September 2012. This would give providers a jumpstart on adopting the usage of ICD-10. Providers might find it easier to focus on the adoption of ICD-10 by itself, rather than trying to cope with learning ICD-10 while simultaneously meeting the new more involved requirements of Meaningful Use Stage 2.

As a result of the increased usage demanded by Meaningful Use Stage 2 EHRs will be utilized to their potential more than they ever have been before. When providers start to truly leverage this technology they will start to see improved results in patient outcomes. Although some might find adapting to this technology challenging, ultimately it will improve patient care.

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