Meaningful Use Stage 2: Ready or not here it comes!!

On August 23, 2012, CMS announced a final rule to govern Stage 2 of the Medicare and Medicaid EHR Incentive Programs. The rule specifies the Meaningful Use Stage 2 (MU2) criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to continue to participate in the EHR Incentive Programs. The final rule for MU2 intends to increase health information exchange between providers and promote patient engagement by giving patients secure online access to their health information. The majority of the new measures focus around this intent.

Don’t be fooled into thinking that your organization is ready because you sailed through Meaningful Use Stage 1 (MU1) attestation.   MU2 has higher thresholds for the existing MU1 measures, such as increased and/or expanded percentages compliance for CPOE orders, recording Vitals, and electronic submission of prescriptions.

In addition, there are many new measures including direct messaging, electronic referrals, and secure health information messaging that will require getting your patients onboard and communicating with you electronically via your portal. All of this can be achieved with detailed preparation and planning, resulting in a positive financial outcome for your organization.

As we move forward into Quarter 3 of 2014, the push to get MU2 configured and rolled out to providers for attestation is being felt by many organizations. While the task may seem to be a daunting one, there are things you can do now to prepare and ease the transition for your staff and providers. It’s imperative to take a good, hard look at your present configuration, how your numbers stood up for MU1, and develop a plan of attack moving forward for MU2.

To get started, take a look at your providers MU1 numbers and begin the analysis of what has changed for those measures your organization plans to attest to again for MU2. There are a lot of good articles and checklists available on Client Connect to help get this particular step underway immediately.

Next, if you don’t have a patient portal in place, you need one immediately. The need to enroll as many patients as possible cannot be overstated. Multiple measures rely directly on the use of the portal, and many others can be tied in as well. The larger the initial pool of potential patients you have available for some of the more specific measures, the more likely your organization is to succeed with these particular pieces of MU2. With all that in mind, get the portal implemented, and aggressively market it to your patients immediately.


This is also a great opportunity to take a look at your Orderable Item Dictionary (OID) and clean that thing up! Reclassify OIDs to the appropriate parent class, if you haven’t done so already. If it’s not really a referral, don’t list it under the Referral parent class. Sorry, but there is no such thing as a “Referral for a Colonoscopy” or a “Referral for a Mammogram”. If you’ve created similar orders to meet provider’s requests along the way, now is a great opportunity to standardize that workflow, and move the staff towards a process that will allow for capturing of results data to boost your numbers.

It’s time to take a look and verify: do all the OIDs that should have resultable items attached actually have them? Do your RIDs have LOINC codes? Should there be LOINCs attached? Are you missing information from a specific vendor or compendium? Have you started analyzing your Referral parent class entries and attaching SNOMEDs that might be appropriate from the provided value set?

While we’re on the subject of clean up…the Referring Provider dictionary needs to be examined closely as well. Any providers with multiple entries need to be resolved, and your organization will need to reach out to those providers whose referrals are sent out regularly to obtain the Direct IDs for those individuals. Keep in mind, the MU2 package moves away from the Allscripts Referral Network™ and towards the use of the ACDM (Allscripts Community Direct Messaging). If you aren’t familiar with the ACDM, the video can be found here, . It is a great way to gather base line information.

What can you do now to get ahead of the game? Commit to knowing the material. Allscripts Learning Center, Client Connect, CMS website, and the Galen wiki all contain a broad array of information available to help. Really read the measures and understand how they are calculated and recorded within Touchworks. Know what workflows within your organization are going to need to be adjusted to meet the measures.

Many of the measure-specific PDFs available on Client Connect contain detailed information on set up, workflow considerations, sample test scenarios, and report validation checklists. After your organization decides which measures you will be configuring for, download and thoroughly digest all applicable PDFs. Become familiar with the Value Sets on the MU2 Clinical Quality Measure Configuration Workbook; watch all the videos already available on Client Connect and sign up for all upcoming webinars and presentations. Now is the time to educate yourself in order to make informed decisions when moving forward in the process.

Finally, be realistic about the amount of time your internal staff have available to commit to MU2 configuration moving forward. While they still have their day to day responsibilities to address, there are a myriad of measures available to configure and piles of documentation to read through. Complicated configuration choices will need to be made for each of these measures, AAP set ups will need to be completed for each provider and any other designated end-users, thorough testing needs to be designed and documented, and eReferrals have to be coordinated with other organizations. With all of the demands of busy healthcare organizations, if the light at the end of the tunnel is dim, we are here to help. Galen has the knowledge, resources, and connections to assist you with your configuration, implementation, testing, and training effort to attest to MU2.

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