Proposed Stage 2 requirements raise the bar for providers

The proposed Stage 2 meaningful-use requirements raise the bar for hospitals and eligible professionals on the use of computerized physician order entry, electronic prescribing and electronic recording of several patient-health measures, according to CMS officials.

Four health information technology and policy officials with the CMS previewed the Stage 2 measures in a presentation at the Healthcare Information and Management Systems Society's 2012 Conference and Exhibition in Las Vegas on Thursday morning. On Thursday afternoon, the proposed requirements were published on the Office of the Federal Register's website (PDF). They are slated to be published in the Federal Register on March 7.

Under the proposed Stage 2 standards, hospitals as well as eligible professionals—the latter category includes physicians not employed by hospitals—would have to use CPOE for more than 60% of medication, laboratory and radiology orders, double the share required under the Stage 1 standards.

The CPOE requirement is one of more than a dozen core objectives that hospitals and EPs would have to meet as part of demonstrating their meaningful use of electronic health-record systems, which would make them eligible to receive federal health IT incentive payments.

Other core objectives for both hospitals and EPs include the use of electronic prescribing for more than 50% of prescriptions issued, the recording of demographic data for more than 50% of patients, recording of vital signs in more than 80% of patient encounters and recording smoking status for more than 80% of patients.

In an effort to promote electronic engagement with patients, Stage 2 would require that more than 50% of patients be provided online access to their health information and demonstrate that more than 10% had actually accessed that information.

Among the proposed menu objectives for EPs are electronic recording of family health history for more than 20% of patients, successful ongoing transmission of syndromic surveillance data, successful ongoing transmission of cancer case information and successful ongoing transmission of data to a specialized cancer registry. For hospitals, menu objectives include electronic recording of advance directives for more than 50% of patients and the use of electronic prescribing for more than 50% of discharge prescriptions.

Also late Thursday, the CMS released a fact sheet on the proposed Stage 2 requirements.