Modified Stage 2 for EHR Incentive Program

All the providers will need to take into account the new Final Rule released by CMS in October. Here’s all what you need to know about the Modified Stage 2 for EHR Incentive Program in 2015 through 2017.

Goals for the Modification:

1. Align with Stage 3 to achieve overall goals of programs
2. Synchronize reporting period objectives and measures to reduce burden
3. Continue to support advanced use of health IT to improve outcomes for patients

Final Rule:

• Changes EHR reporting period in 2015 to 90-day period to accommodate modifications, Aligns EHR reporting period with full calendar year
• Streamlines program by removing redundant, duplicative and topped out measures and introducing objectives
• Modifies patient action measures related to patient engagement
• Modifies public health reporting requirements
• No changes to CQM selection or reporting scheme from CQM requirements in Stage 2 rule

Reporting Period

• 2015: All providers will attest for any continuous 90-day reporting period for the calendar year. However, EHs and CAHs have a 15 month period from October 1, 2014 to December 31, 2015
• 2016: All providers attest for full calendar year, first time participants may attest for any continuous 90-day period for the calendar year
• 2017: All providers attest for full calendar year, first time participants and Stage 3 may attest for any continuous 90-day period for the calendar year.
• 2018: All providers attest for full calendar year, first-time Medicaid participants may use 90-day EHR reporting period.

Attestation and Reporting objectives

• All providers are required to attest to a single set of objectives and measures. This replaces the core and menu structure of previous stages.
• All providers are now in Stage 2 of Meaningful Use — with a “Modified Stage 2” for providers that were previously in Stage 1.
• Attestation will not be available to providers until January 4, 2016. The current attestation deadline is February 29, 2016.

EPs:

EHs/CAHs

Patient Action Measure change: The following changes are effective for providers for EHR reporting period beginning in 2015:

• Changing threshold from Stage 2 objective for Patient Electronic Access measure #2 from 5% to equal to or greater than 1 patient seen by provider or discharged from hospital
• Changing threshold from Stage 2 objective Secure Electronic Messaging from percent to functionality fully enabled (yes/no)

Modified Stage 2 Objectives:

This covers what are the main objectives that providers will need to meet

1. Protect Patient Health Information
   Protect electronic health information created or maintained by the CEHRT through the implementation of appropriate technical capabilities
2. Clinical Decision Support
   Use clinical decision support to improve performance on high-priority health conditions.
3. CPOE
   Use 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.
4. Electronic Prescribing (eRx)
   EP: Generate and transmit permissible prescriptions electronically (eRx).
   EH and CAH: Generate and transmit permissible discharge prescriptions electronically (eRx).
5. Health Information Exchange
   The EP, 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 provides a summary care record for each transition of care or referral.
6. Patient Specific Education
   Use clinically relevant information from CEHRT to identify patient-specific education resources and provide those resources to the patient.
7. Medication Reconciliation
   The EP, eligible hospital, or CAH who receives a patient from another setting of care or provider of care or believes an encounter is relevant performs medication reconciliation.
8. Patient Electronic Access (VDT)
   EP: Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP.
   EH and CAH: Provide patients the ability to view online, download, and transmit their health information within 36 hours of hospital discharge
9. Secure Messaging (EPs only)
   Use secure electronic messaging to communicate with patients on relevant health information.
10. Public Health and Clinical Data Registry Reporting
    The EP, eligible hospital or CAH is in active engagement with a public health agency to submit electronic public health data from CEHRT except where prohibited and in accordance with applicable law and practice. Includes Immunization Registry, Syndromic Surveillance, Specialized Registry and – Electronic Reportable Laboratory Result(for EH and CAH only)  Reporting

Measures which are no longer an objective

Core:

• Patient Demographics
• Vital Signs
• Smoking Status
• Clinical Summaries
• Clinical Lab Test Results
• Patient Lists
• Preventative Care

Menu:

• Electronic Notes
• Imaging Results
• Family Health History

Certification:

• No changes to the certification requirements for objectives and measures of meaningful use for EHR reporting periods in 2015 through 2017.
• Providers continue to use technology certified to the 2014 Edition for EHR reporting period in 2015 and subsequent years until they transition to health information technology certified to the 2015 Edition that is required for EHR reporting period in 2018.
• Note: Providers may upgrade early to technology certified to the 2015 Edition for EHR reporting period prior to 2018 as outlined in final rule.