A First Look at Meaningful Use Stage 2

The Meaningful Use Stage 2 Notice of Proposed Rulemaking was released today at 4:15pm.  It represents the work of hundreds of people from every healthcare stakeholder group.   I'll summarize all 455 pages this weekend and give two webinars next week (Greater New York Hospital Association and a special session for the Harvard School of Public Health).  

For now, I recommend you read this summary on pages 156-163 to understand that EPs must meet or qualify for an exclusion to 17 core objectives and 3 of 5 menu objectives.   Also that eligible hospitals and Critical Access Hospitals must meet or qualify for an exclusion to 16 core objectives and 2 of 4 menu objectives.

Other key points from the executive summary:

*For EPs, we propose a set of clinical quality measures beginning in 2014 that align with existing quality programs such as measures used for the Physician Quality Reporting System (PQRS), CMS Shared Savings Program, and National Council for Quality Assurance (NCQA) for medical home accreditation, as well as those proposed under Children's Health Insurance Program Reauthorization Act CMS-0044-P 18 (CHIPRA) and under ACA Section 2701.

*For eligible hospitals and CAHs, the set of CQMs we propose beginning in 2014 would align with the Hospital Inpatient Quality Reporting (HIQR) and the Joint Commission's hospital quality measures.

*This proposed rule also outlines a process by which EPs, eligible hospitals, and CAHs would submit CQM data electronically, reducing the associated burden of reporting on quality measures for providers. We are soliciting public feedback on several mechanisms for electronic CQM reporting, including aggregate-level electronic reporting group reporting options; and through existing quality reporting systems. Within these mechanisms of reporting, we outline different approaches to CQM reporting that would require EPs to report 12 CQMs and eligible hospitals and CAHs to report 24 CQMs in total.

*Stage 2 meaningful use requirements include rigorous expectations for health information exchange including: more demanding requirements for e-prescribing; incorporating structured laboratory results; and the expectation that providers will electronically transmit patient care summaries to support transitions in care across unaffiliated providers, settings and EHR systems.

To understand the themes underlying Meaningful Use Stage 2, here's a great blog post from Health Affairs.

Finally, here's a powerpoint summary you can reuse for your own presentations - no attribution needed.  I've compared each criteria to its Stage 1 equivalent.