December 8, 2015

Even though many organizations are still working on Stage 2 requirements for Meaningful Use, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) released final rules for the third stage in October 2015.

Stage 3 requires another round of adaptations by EHR vendors and internal IT departments alike to improve electronic processes, and increase electronic data sharing and data-driven decision-making. The end goal is to deliver more efficient and effective patient care. The final deadline has been extended until January 2018 for compliance by healthcare providers seeking to avoid Medicare penalties.

The third stage covers eight objectives across four major capabilities: security, electronic prescriptions, clinical decision support, and data sharing with other providers and patients. Integrating systems and data is the underpinning here; more than 60 percent of the proposed measures require interoperability, up from 33 percent in Stage 2.

While vendors will enable many of these integration points, CIOs must take an active hand in understanding the integrations required as well as working with the various healthcare IT vendors to ensure implementation plans are aligned. Patient engagement is another looming requirement of the third stage.

Functionality and Interoperability Requirements

Some specific examples of the increased level of functionality and interoperability mandated in Meaningful Use Phase 3 include:

  • ePrescribing: The thresholds have increased to 80 percent for EPs (eligible professionals) and 25 percent for EHs (eligible hospitals).
  • Clinical decision support (CDS): This includes five CDS interventions tied to four quality measures and enabling drug-drug and drug-allergy interaction alerts for the entire EHR reporting period.
  • Computerized physician order entry (CPOE): Providers must use physician order entry on at least 80 percent of medication orders, 60 percent of lab orders and 60 percent of diagnostic imaging orders.
  • Patient access to information: Eighty percent of patients must be able to access their records through one of two specific methods and providers must give 35 percent of patients access to patient-specific educational resources.
  • Active patient engagement: This includes a requirement that providers must incorporate information from “non-clinical” settings, such as a wearable or personal health record, for 15 percent of patients.
  • Public health and clinical data registry reporting: Data sources include immunizations, public health registries, non-public health registries and electronic lab reporting among others. EPs must choose three measures while EHs choose four.

emids explores the upcoming health IT challenges of MU3 requirements and provides a roadmap to success in our latest white paper, http://go.emids.com/mu3.

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