EHR Technology – Preview of Proposed Rules for Stage 2 Meaningful Use

There is a tremendous amount of anticipation among providers and health IT vendors for the official release of the proposed rules for the electronic health records (EHR) Stage 2 of Meaningful Use. It is expected that the proposed rules for Stage 2 Meaningful Use will be published later this month.

According to a CSC report, Meaningful Use Stage 2 will focus on health record sharing and patient engagement. The report strongly encourages that providers and practices should double their efforts on securing capabilities to coordinate care, engage with their patients, and electronically capture the data needed for quality reporting. Providers and practices choosing the right health IT services vendor is a key step towards securing these capabilities as they are very likely to be included in the menu set of the proposed rules for Stage 2 Meaningful Use.

The content and insights found in the CSC report, along with others that have been published in recent months, are very consistent with recommendations developed by the Health IT Policy Committee back in August 5, 2011. The Health IT Policy Committee advises the Office of the National Coordinator for Health IT on all health IT related matters and policy including Meaningful Use.

The Health IT Policy Committee recommendation cites their construct of core plus menu options of clinical measures is aligned with the U.S. Department of Health and Human Services (HHS) National Quality Strategy (NQS), intended to promote better care, healthy people and communities, and reduce the cost of quality care. The NQS is focused on six core objectives: safer care, patient and family engagement, care coordination, effective prevention and treatment for leading causes starting with cardiovascular health, community health promotion, and affordable care.

The NQS core objectives do correspond closely to the recommended six domains for the menu set of the proposed rules for Stage 2 Meaningful Use. The recommended six domains for Stage 2 Meaningful Use are:

1) Patient and Family Engagement: Measures that reflect potential impact to improve patient-centered care and quality of care delivered to patients, the importance of collecting patient-reported data, and measures with the ability to impact at the individual patient level as well as the population level.

2) Efficiency Measures: Measures that significantly improve outcomes and reduce errors and /or to impact and benefit a large number of patients with an emphasis on utilization, overuse and appropriate use of care.

3) Patient Safety: Measures that reflect patient safety in both hospital and ambulatory settings and processes that would reduce harm to patients and reduce burden of illness; ability to enable longitudinal assessment of condition-specific, patient-focused episodes of care, and unmet needs of both population and public health.

4) Population and Public Health: Measures that are outcome focused, and delta-focused with the ability to achieve longitudinal measurement that will demonstrate improvement or lack of improvement of the health of the U.S. population.

5) Care Coordination: Measures that reflect aspects of care coordination and can improve appropriate and timely patient and care team communication.

6) Clinical Processes: Measures that reflect clinical care processes closely linked to outcomes, based on evidence and practice guidelines.

The entire United States healthcare landscape should expect that the official proposed rules for Stage 2 Meaningful Use will support a framework for quality improvement, safer patient centered care, and a more efficient healthcare delivery system.