Stage 3 Meaningful Use to focus on better coordination, more clinical decision support

Doctors and hospitals will have to better coordinate care and incorporate more clinical decision support to meet Meaningful Use Stage 3 requirements, according to a Government Health IT report of this week's meeting of the Health IT Policy Committee.

The new measures will call for electronic health record systems to integrate with external medication lists to flag drug interactions and to catch "never" combinations.Though the Stage 2 regulations have yet to be finalized, the HIT Policy Committee wanted to provide a heads-up on Stage 3, which isn't expected for at least another three years. The committee's work group in July said it would release a draft of Stage 3 in August in order to set up a request for comment by November. That draft is still in the works and some recommendations remain just concepts, according to Government Health IT.

One problem with flagging drug interactions is that EHR systems send up so many alerts that doctors tune them out after a while. The challenge lies in sending alerts so that physicians will pay attention.

One proposed measure on improving priority health conditions would establish 15 clinical decision support interventions related to five or more clinical quality measures. The system, for example, would determine whether lab or radiology orders were appropriate to avoid duplication.

Another proposal calls for gathering more structured demographic data in addition to language, ethnicity and date of birth, such as occupation, disability status and gender identity.

Other recommendations deal with EHR functions, such as the ability to maintain a current problem list. Recording advance directives likely will be part of Stage 3 if it's not included in the Stage 2 final rule, according to Government Health IT.

Stage 2 rules are expected to be out by the November comment period for Stage 3. The committee is expected to send the Stage 3 recommendations to the Office of the National Coordinator by May 2013.

With measures such as sharing care summaries and care plans relying so heavily on health information exchange as proposed in Stage 2, the committee proposed a hearing this fall dedicated to systems interoperability and overcoming other barriers to exchange.

To learn more:
- download materials from the meeting
- read the Government Health IT article