Preparing Hospitals for Stages 2 and 3 of Meaningful Use: 7 Recommendations

Even though the final requirements for stage 2 and 3 of meaningful use are yet to be released, the preliminary recommendations made by the Health Information Technology Policy Committee's meaningful use workgroup give a strong hint to what those later stages may require, according to a white paper released by CSC.

The meaningful use workgroup's preliminary recommendations include an increased scope or threshold for most stage 1 "core set" measures. For example, one stage 1 core set measure requires more than 30 percent of unique patients with a medication in their medication list to have at least one medication order entered using CPOE. The meaningful use workgroup's recommendations propose that CPOE be used for at least one medication and one lab or radiology order for 60 percent of patients in stage 2.

Under the preliminary recommendations, most stage 1 "menu set" items would be moved to the "core set," meaning healthcare providers can no longer defer them.

In addition to building off of current stage 1 requirements, the preliminary recommendations also propose six entirely new stage 2 measures for eligible hospitals and four entirely new stage 2 measures for eligible professionals. To see the meaningful use workgroup's full list of recommendations, summarized by CSC, click here.

To help healthcare providers reach their goals for meaningful use, CSC has published seven recommendations:

1. "Re-evaluate — and if necessary update — your plan for Stage 1." In order to build upon successful achievement of stage 1, it will become more and more important for healthcare providers to re-think their strategies for preparation in later stages of meaningful use.

2. "Do not ignore stage 1 menu set items you have chosen to defer." CMS has hinted that all menu set items will eventually be required, most likely in stage 2 of meaningful use. Ignoring the menu items you chose to defer in stage 1 will make it more difficult to tackle those menu set items later.

3. "Implement CPOE the right way from the start." Even though CPOE under stage 1 is limited to medication orders, preparing to implement CPOE for all types of orders from the beginning will better serve providers' efforts to achieve meaningful use in the long run.

4. "Ensure you have a plan for a robust patient portal." Involving and engaging patients in the management of their own health and health records will continue to be an integral part of meaningful use. Providers should start planning for a robust patient portal now.

5. "Make sure your system is certified against stage 2 in 2013, regardless of when you are planning to meet stage 1." Since stage 2 will likely require new capabilities like physician documentation and eMAR, healthcare providers should re-evaluate their individual systems to ensure they will be able to be certified against any new certification criteria adopted under stage 2.

6. "Actively participate in a health information exchange." Being an active participant in health information exchange will eventually become an integral part of meaningful use. Under the preliminary recommendations from the meaningful use workgroup, bidirectional connection to an HIE would satisfy the objective in both stage 2 and 3.

7. "Keep an eye out for more details on stage 2 requirements related to quality reporting and privacy and security." Since the meaningful use workgroup's preliminary recommendations do not discuss potential stage 2 requirements for quality reporting and privacy and security, healthcare providers should watch for future recommendations from the HIT Policy Committee's quality measure workgroup and privacy and security tiger team.

Learn more about CSC.

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