Mostashari: Stage 2 Rules Offer Flexibility, Push Interoperability

National Coordinator for Health IT Farzad Mostashari said the proposed requirements for Stage 2 of the meaningful use program offer new flexibility and emphasize the importance of interoperability, Health Data Management reports (Goedert, Health Data Management, 2/22).

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

The proposed rule published on Thursday outlines the requirements for health care providers attesting to Stage 2 of the meaningful use program. Officials plan to soon release a proposed rule on the certification criteria for EHRs that support Stage 2 requirements.

Following their publication in the Federal Register, the proposed rules will undergo a 60-day public comment period. Officials hope to release the final Stage 2 rules this summer (Health Data Management, 2/22).

Overview of Proposed Rules

During a Wednesday session at the Healthcare Information and Management System's Society's conference in Las Vegas, Mostashari offered a preview of the proposed Stage 2 rules.

Mostashari said the proposed rules largely reflect recommendations from the Health IT Policy and Standards committees (Terry, FierceHealthIT, 2/22).

The proposed rules would officially extend Stage 1 until fiscal year 2014, retain the 90-day reporting requirement for the first year of Stage 1 and allow health care providers to remain in Stage 1 for two years. Stage 2 of the meaningful use program would take effect in 2014 (Walsh, CMIO, 2/22)

Proposed Stage 2 Requirements for Health Care Providers

Under the Stage 2 proposed rules, hospitals would need to meet 16 core meaningful use objectives and two objectives from a menu of four criteria. Physicians and other eligible health care professionals would need to meet 17 core objectives and three of five menu objectives (Versel, InformationWeek, 2/22).

The proposed rules also call for:

  • Aligning clinical quality measures under the meaningful use program with other programs that involve quality reporting, such as the Medicare Physician Quality Reporting System and the shared savings program for accountable care organizations;
  • Allowing eligible professionals to report data in batches;
  • Allowing physician groups to report quality data for their entire group (FierceHealthIT, 2/22);
  • Including the viewing of medical images as an optional menu objective;
  • Including the submission of data to disease registries as an optional menu objective (Health Data Management, 2/22);
  • Enabling at least 50% of patients to view, download and share their EHR data online;
  • Requiring health care providers to report on eight safety criteria related to medications (InformationWeek, 2/22); and
  • Requiring health care providers to submit data to public health agencies when possible.

Proposed Stage 2 Requirements for EHR Certification

According to FierceHealthIT, the Stage 2 proposed rules on EHR certification will call for:

  • Allowing EHR products to receive certification if they can help a health care provider achieve core meaningful use criteria, as well as the optional menu items selected by the health care provider;
  • Requiring EHRs to follow protocol from the Direct project for secure clinical messaging;
  • Requiring vendors to incorporate standard clinical terminologies into their EHR products; and
  • Requiring vendors to meet new EHR usability requirements (FierceHealthIT, 2/22).

For additional coverage and reaction to the proposed Stage 2 regulations, see today's iHealthBeat feature.


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