No doubt that the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) stole the show with their announcement of the proposed requirements for Stage 2 Meaningful Use and 2014 certification of electronic health records at the Healthcare Information and Management Systems Society's annual conference in Las Vegas.
Following a 60-day comment period, the final rule is scheduled for release this summer.
The proposed rules and standards largely reflect the recommendations made last year by the Health IT Policy Committee and the Health IT Standards Committee, National Coordinator for Health IT Farzad Mostashari, M.D., told an overflow crowd.
The proposed regulations, he said, emphasize the need for greater interoperability among systems and health information exchange. "We can't wait five years to get standards-based exchange," he said. On the Meaningful Use side, this means that organizations will have to exchange data across organizational boundaries and disparate EHRs. Read more.
CMS officials were chatty at the conference, talking about Meaningful Use Stage 2 in several different sessions, briefings and events.
Mostashari clarified some aspects of the proposed Meaningful Use Stage 2 and EHR certification rules at a press conference following his keynote speech on Thursday. He described several ways in which the proposed regulations are more flexible than the current rules. For example, he said, specialist physicians will be required to meet only the Meaningful Use requirements that pertain to their specialties and can select menu items that are relevant to them. Read more.
One of the greatest challenges in Meaningful Use Stage 2 will be the health information exchange and related transitions-of-care requirements. So many organizations have had trouble with the Stage 1 requirement that they test their ability to trade key clinical data with other providers that CMS dropped it as a criteria. But in Stage 2, providers will have to go beyond testing and actually exchange the information, CMS officials in one HIMSS session. Read more.
With public health measures receiving a higher profile in Meaningful Use Stage 2, government agencies are struggling to connect healthcare providers online to public health agencies at the state and local levels. To some extent, this connectivity may depend on the nascent health information exchanges (HIEs) evolving across the country, officials from CMS and the Centers for Disease Control and Prevention (CDC) said. Read more.
Clinical quality measures for Meaningful Use Stage 2 are still in flux, FierceHealthIT reported from the show. Although quality measures are a major focus in Meaningful Use stage 2 and the 2014 EHR certification criteria, government officials told attendees that the Notice of Proposed Rule Making (NPRM) asks for input and guidance in this area.
The proposed rules require eligible professionals (EP) to report on 12 clinical quality measures (CQMs) in Stage 2. Hospitals must report on 24 CQMs. They must choose one or more of the CQMs from each of the domains adopted by CMS from the National Quality Strategy. The uncertainty comes in deciding which of the optional measures EPs must use. Read more.
No doubt Meaningful Use will continue to dominate conversation (and generate plenty of FierceHealthIT stories and commentaries) post-HIMSS.