The final requirements that hospitals and other providers must meet to receive funding under the second phase of the federal electronic health record incentive program were issued Thursday.
The Stage 2 meaningful-use
requirements that providers must satisfy to receive payments under the program that provides incentive payments to Medicare and Medicaid providers that adopt qualifying EHRs will go into effect in early 2014, according to a final rule (PDF)
issued by the CMS and the Office of the National Coordinator for Health Information Technology. The program had previously planned
for providers to satisfy Stage 2 requirements in 2013.
The rule outlined the certification criteria that electronic health-record makers must satisfy for their products to meet the program's standards. The new rules modified the certification program to “cut red tape and make the certification process more efficient,” according to an agency news release.
“The changes we're announcing today will lead to more coordination of patient care, reduced medical errors, elimination of duplicate screenings and tests and greater patient engagement in their own care,” HHS Secretary Kathleen Sebelius said in a news release
The final rule adds two new "core objectives" to the Stage 2 reporting requirements for physicians and hospitals. The first requirement, for physicians, is to use secure electronic messaging to communicate relevant health information with patients. The second requirement, for hospitals, is to automatically track medications from order to administration using "assistive technologies in conjunction with an electronic medication administration record (eMAR)."
The final rule also adds "outpatient lab reporting" to the program's menu objectives for hospitals and "recording clinical notes" as a menu objective for both physicians and hospitals.
The rule lowered the requirement that providers submit summaries of care from 65% of “transitions of care and referrals” to just 50%. Additionally, it eliminated the organizational and vendor limitations in the requirement that providers electronically transmit a summary of care for more than 10% of transitions of care and referrals to another provider with no organizational or vendor affiliations.
Also, the final rule modifies the definition of "hospital-based" physicians to create an application process for physicians to demonstrate that they alone fund their EHR systems and are eligible to receive the incentive payments, directly.
Since the program began in January 2011, more than 120,000 eligible healthcare professionals and more than 3,300 hospitals have qualified to participate and receive incentive payments, according to the CMS. The rates of participation include more than half of all eligible hospitals and about 20% of eligible healthcare professionals.
The Stage 3 phase will add another layer of health data collection and reporting requirements for the participating providers. Medicare providers that do not successfully participate by 2015 will begin to face cuts in their overall payments from the program.
An earlier version of the story implied that the final rule dropped information-sharing requirements. They remain in place, with some adjustments.