Meaningful Use Stage 3 – Sneak Peek

With jury still out on the final rule for meaningful use (MU) stage 2, an advisory committee has already started planning for the next and the final stage of the federal incentive program. The committee co-chaired by Dr. Paul Tang from Palo Alto Medical Foundation and Dr. George Hripcsak from Columbia University will be working together to provide recommendations for the stage 3 rules. As before, the final stage is set to build on the requirements of the preceding stage. Several of the stage 2 menu objectives are expected to become the core objectives for MU stage 3.

However, the key focus of the final stage of MU will be on improved clinical decision support, machine readable data and medicine reconciliation. The last stage will also look to increase patient involvement through patient portals (read more) and EMRs. Industry experts believe that this will prompt widespread commercialization of health IT products. Tony Keller, a Meaningful Use consultant at CureMD, a leading EMR vendor adds, “The final stage for MU would be a fair reflection of the end goal, ‘the coordinated care structure’. Getting there requires significant changes, but meaningful use intelligently builds on its foundation, using a step by step approach. This has allowed the market to become more responsive, so when the time comes, I am sure that technology will support the transition.”

Among the newly added requirements, physicians would be required to enable nearly 10% of their patients to receive health readings, submit their medical history and modify or update their health information in the electronic medical records.

Working the spirit of coordinated care, physicians would be required to provide electronic care plans to referred providers and care sites in case the patient is moved. Whereas, referred providers would be responsible for updating the original patient care site with a percentile of the patient health information.

Shifting back to clinical decision support (CDS), the preliminary plan for stage 3 is calling for a minimum of 15 CDS rules. That is 3 times the amount set for stage 2. Tony Keller believes that this shows the intent of the government, “Patient safety and quality of care are the two most important factors deriving the technological change in healthcare. The end goal is better health and a happier life for every American.”

The advisory panel also recommended an increase in minimum requirement for electronic hospital medication discharge orders to insurance drug formulates, from 10% in the proposed Stage 2 rules to 30%. Providers are also expected to be required to record additional demographic information while some prior requirements such as smoking status may be eliminated, having met the state requirements.

Stage 3 would also require physicians to contribute towards population health using electronic medical records to generate lists of patients with specific conditions while maintaining a real time view using KPI dashboards to ensure improvement in quality of care, clinical research, practice outreach and reduction in care disparity.

According to the advisory board’s agenda, they would be able to release the final recommendation for meaningful use stage 3 to the HHS by May 2013. With the final rule for stage 2 expected to be released any day now, 2013 should effectively complete the picture for the healthcare reform.


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