Meaningful Use Stage 2

CMS Final Rule on Stage 2 of Meaningful Use

The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) have released its final rule concerning the Core and Menu sets for Stage 2 of Meaningful Use. The Stage 2 Meaningful Use (MU) Measures are structured as Core and Menu sets, just as they were in Stage 1. In Stage 2 of Meaningful Use, there are a total of 17 Core objectives that are required for ambulatory Eligible Professionals (EPs) and 6 Menu measures. EPs must report on 3 of 6 Menu set objectives. In addition, EPs must report 12 ambulatory clinical quality measures. Many of the Menu measures that were optional in Stage 1 of Meaningful Use are now incorporated into the Core objectives of Stage 2.

HealthFusion® submitted our commentary on the Meaningful Use Stage 2 proposed measures to CMS during the open comment period. Also learn why the recent Republican Congressmen’s Letter on Meaningful Use Incentives won’t change the course of the program — It’s just not accurate!

Healthfusion has laid out the CMS final rule for Meaningful Use Stage 2 in the table below:

CORE
Health Outcomes Policy Priority Stage 2 Objectives Stage 2 Measures
Eligible Professionals Eligible Hospitals and CAHs
Improving quality, safety, efficiency, and reducing health disparities Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per State, local and professional guidelines to create the first record of the order. Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per State, local and professional guidelines to create the first record of the order. More than 60 percent of medication, 30 percent of laboratory, and 30 percent of radiology orders created by the EP during the EHR reporting period are recorded using CPOE
Generate and transmit permissible prescriptions electronically (eRx) More than 50 percent of all permissible prescriptions written by the EP are compared to at least one drug formulary and transmitted electronically using Certified EHR Technology
Record the following demographics
  • Preferred language
  • Gender
  • Race
  • Ethnicity
  • Date of birth
 Record the following demographics
  • Preferred language
  • Gender
  • Race
  • Ethnicity
  • Date of birth
  • Date and preliminary cause of death in the event of mortality in the eligible hospital or CAH
 More than 80 percent of all unique patients seen by the EP have demographics recorded as structured data
Record and chart changes in vital signs:
  • Height/length
  • Weight
  • Blood pressure (age 3 and over)
  • Calculate and display BMI
  • Plot and display growth charts for patients 0-20 years, including BMI
 Record and chart changes in vital signs:
  • Height/length
  • Weight
  • Blood pressure (age 3 and over)
  • Calculate and display BMI
  • Plot and display growth charts for patients 0-20 years, including BMI
 More than 80 percent of all unique patients seen by the EP have blood pressure (for patients age 3 and over only) and height and weight (for all ages) recorded as structured data
Record smoking status for patients 13 years old or older Record smoking status for patients 13 years old or older More than 80 percent of all unique patients 13 years old or older seen by the EP or admitted to the eligible hospital's or CAH's inpatient or emergency department have smoking status recorded as structured data
Use clinical decision support to improve performance on high-priority health conditions Use clinical decision support to improve performance on high-priority health conditions
  1. Implement 5 clinical decision support interventions related to 4 or more clinical quality measures, if applicable, at a relevant point in patient care for the entire EHR reporting period.
  2. The EP, eligible hospital, or CAH has enabled the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period.
Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP, eligible hospital, or CAH
  1. More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timely (available to the patient within 4 business days after the information is available to the EP) online access to their health information
  2. More than 5 percent of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download, or transmit to a third party their health information
Provide clinical summaries for patients for each office visit Provide clinical summaries for patients for each office, hospital, or CAH visit Clinical summaries provided to patients within one business day for more than 50 percent of office visits
Ensure adequate privacy and security protections for personal health information Protect electronic health information created or maintained by the Certified EHR Technology through the implementation of appropriate technical capabilities Protect electronic health information created or maintained by the Certified EHR Technology through the implementation of appropriate technical capabilities. Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1), including addressing the encryption/security of data at rest and implement security updates as necessary and correct identified security deficiencies as part of its risk management process
Incorporate clinical lab-test results into Certified EHR Technology as structured data Incorporate clinical lab-test results into Certified EHR Technology as structured data More than 55 percent of all clinical lab tests results ordered by the EP or by authorized providers of the eligible hospital or CAH for patients admitted to its inpatient or emergency department during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in Certified EHR Technology as structured data
Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach Generate at least one report listing patients of the EP, eligible hospital or CAH with a specific condition.
Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care Use EHR to identify and provide reminders for preventive/follow-up care for more than 10 percent of patients with two or more office visits in the last 2 years
Use Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient Use Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient if appropriate Patient-specific education resources identified by CEHRT are provided to patients for more than 10 percent of all unique patients with office visits seen by the EP during the EHR reporting period
Improve care coordination The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation. The eligible hospital or CAH who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation The EP, eligible hospital or CAH performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP, eligible hospital or CAH
The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral. The eligible hospital or CAH who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral.
  1. The EP, eligible hospital, or CAH that transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals.
  2. The EP, eligible hospital, or CAH that transitions or refers their patient to another setting of care or provider of care provides a summary of care record either a) electronically transmitted to a recipient using CEHRT or b) where the recipient receives the summary of care record via exchange facilitated by an organization that is a NwHIN Exchange participant or is validated through an ONC-established governance mechanism to facilitate exchange for 10 percentof transitions and referrals
  3. The EP, eligible hospital, or CAH that transitions or refers their patient to another setting of care or provider of care must either a) conduct one or more successful electronic exchanges of a summary of care record with a recipient using technology that was designed by a different EHR developer than the sender's, or b) conduct one or more successful tests with the CMS-designated test EHR during the EHR reporting period
Improve population and public health Capability to submit electronic data to immunization registries or immunization information systems except where prohibited, and in accordance with applicable law and practice Capability to submit electronic data to immunization registries or immunization information systems except where prohibited, and in accordance with applicable law and practice Successful ongoing submission of electronic immunization data from Certified EHR Technology to an immunization registry or immunization information system for the entire EHR reporting period
Use secure electronic messaging to communicate with patients on relevant health information A secure message was sent using the electronic communicate with patients on relevant health information messaging function of Certified EHR Technology by more than 5 percent of unique patients seen during the EHR reporting period

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