EHR Standards Toughen Under Finalized Stage 2 Meaningful Use

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Federal officials soften some proposed requirements and officially delay the deadline to upgrade to the next electronic health record phase, but doctors wanted more leeway.

Starting as early as 2014, physician practices will be required to achieve more difficult objectives to demonstrate meaningful use of electronic health records to earn federal bonuses and prevent future penalties.

The Centers for Medicare & Medicaid Services finalized its requirements for stage 2 of the EHR incentive program in an Aug. 23 regulation. The final rule mandates that doctors meet a larger number of core objectives — and stricter guidelines for some of those objectives already in place — during the next part of the three-stage program. Physicians also must adopt and demonstrate meaningful use of EHR systems by Oct. 1, 2014, or be assessed a 1% penalty from Medicare.

Doctors who successfully adopt early enough can earn up to $44,000 over five years from Medicare, or up to $63,750 over six years from Medicaid. Demonstrating meaningful use of a paperless record will become required annually to prevent penalties that will take effect starting in 2015. CMS reports that about 55,000 physicians had earned Medicare incentives through June 2012 under the less-stringent stage 1. Slightly more than 34,000 had earned Medicaid bonuses.

Stages 1 and 2 each require meeting 20 total objectives, but stage 2 makes mandatory some EHR measures that are optional for stage 1, such as whether the electronic systems can incorporate clinical laboratory test results. Other measures stay the same but have higher thresholds, such as a requirement that EHRs send more than 50% of applicable prescriptions electronically, up from more than 40%. The number of required core set measures goes up to 17 in stage 2 from 15 in stage 1. Physicians also must choose and comply with three out of six additional “menu” set measures, as well as report at least nine clinical quality measures.

Source:; Charles Fiegl; September 3, 2012.

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