Meaningful Use Stage 3 and 2015 Certification final rules released

After much anticipation, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) released the final rules for the third stage of the Meaningful Use incentive program and the corresponding certification requirements for EHR vendors.

The timeline for implementation remains unchanged from the proposed rules. Despite a public outcry from the Healthcare community, Stage 3 is set to begin as an optional requirement for physicians and hospitals in 2017 and required in 2018. The new requirements for certification and subsequent participation in the program are significant and will be challenging for some EHR vendors to deliver in the aggressive timelines proposed. Practice Fusion is committed to meeting the certification requirements for Meaningful Use, and will help all providers achieve Meaningful Use Stage 3.

What should I expect for Stage 3 of Meaningful Use in 2018?

To simplify Meaningful Use reporting in Stage 3, CMS proposes to require eight overall objectives with one or multiple measures per objective instead of the core and menu measure structure currently in place.

Objective Associated Measures (Attestation or threshold)
Protected Patient Health Information EPs must attest YES to conducting the security risk analysis upon installation or update to the new Edition of certified EHR Technology.
Electronic Prescribing (eRx) More than 80% of all permissible prescriptions written by the EP are queried for a drug formulary and transmitted electronically using CEHRT.
Clinical Decision Support (CDS) EPs must satisfy both measures in order to meet the objective:</p>
  • Measure 1</span> – Implement five clinical decision support interventions related to four or more CQMs at a relevant point in patient care for the entire EHR reporting period.
  • Measure 2 – The EP has enabled and implemented the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period.
Computerized Provider Order Entry (CPOE) An EP must meet all three measures in order to meet this objective:</p>
  • Measure 1More than 80% of medication orders created by the EP during the EHR reporting period are recorded using CPOE;
  • Measure 2More than 60% of laboratory orders created by the EP during the EHR reporting period are recorded using CPOE; and
  • Measure 3More than 60% of diagnostic imaging orders created by the EP during the EHR reporting period are recorded using CPOE.
Patient Electronic Access to Health Information EPs must satisfy both measures in order to meet the objective:</p>
  • Measure 1More than 80% of all unique patients seen by the EP (i) The patient (or patient-authorized representative) is provided access to view online, download, and transmit their health information within 24 hours of its availability to the provider; OR (ii) The patient (or patient-authorized representative) is provided access to an ONC-certified API that can be used by third-party applications or devices to provide patients (or patient-authorized representatives) access to their health information, within 24 hours of its availability to the provider.
  • Measure 2 – The EP must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide electronic access to those materials to more than 35% of unique patients seen by the EP during the EHR reporting period.
Coordination of Care through Patient Engagement EPs must attest to the numerator and denominator for all three measures, but would only be required to successfully meet the threshold for two of the three proposed measures to meet the objective:</p>
  • Measure 1 – For more than 25% of all unique patients seen by the EP actively engage with the electronic health record made accessible by the provider. An EP may meet the measure by either: (i) patient view, downloads, or transmits to a 3rd party their health information; or, (ii) patient access their health information through the use of an ONC-certified API that can be used by third-party applications.
  • Measure 2 – For more than 35% of all unique patients seen by the EP during the EHR reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient, or in response to a secure message sent by the patient.
  • Measure 3 – Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for more than 15% of all unique patients seen by the EP.
Health Information Exchange (HIE) EPs must attest to the numerator and denominator for all 3 measures, but would only be required to successfully meet the threshold for 2 of the 3 proposed measures to meet the objective:</p>
  • Measure 1 – For more than 50% of transitions of care and referrals, the EP that transitions or refers their patient to another setting of care or provider of care: (1) creates a summary of care record using CEHRT; and (2) electronically exchanges the summary of care record.
  • Measure 2 – For more than 40% of transitions or referrals received and patient encounters in which the provider has never before encountered the patient, the EP incorporates into the patient’s EHR an electronic summary of care document from a source other than the provider’s EHR system.
  • Measure 3 – For more than 80% of transitions or referrals received and patient encounters in which the provider has never before encountered the patient, the EP, performs a clinical information reconciliation. The provider must implement clinical information reconciliation for the following three clinical information sets: Medication, Medication allergy, and Current Problem list.
Public Health and Clinical Data Registry Reporting Providers must attest YES to three of the following five measures:</p>
  1. Immunization Registry Reporting – The EP is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS).
  2. Syndromic Surveillance Reporting – The EP is in active engagement with a public health agency to submit syndromic surveillance data from a non-urgent care ambulatory setting for EPs.
  3. Case Reporting – The EP is in active engagement with a public health agency to submit case reporting of reportable conditions.
  4. Public Health Registry Reporting – The EP is in active engagement with a public health agency to submit data to public health registries.
  5. Clinical Data Registry Reporting – The EP is in active engagement to submit data to a clinical data registry.