On May 12, 2015, four Health IT Policy Committee work groups shared feedback on CMS’ proposed rule for Stage 3 of the meaningful use program, Health Data Management reports (Slabodkin, Health Data Management, 5/13).
Background
Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.
In March, CMS released a proposed rule for meaningful use Stage 3 that aims to offer eligible professionals and eligible hospitals more flexibility. Among other things, the proposed rule would:
- Eliminate the current 90-day reporting period for eligible professionals, eligible hospitals and critical access hospitals attesting to meaningful use for the first time;
- Mandate that all providers submit clinical quality measure data electronically in 2018; and
- Require all eligible professionals in 2018 to report on Stage 3 of the meaningful use program regardless of their previous participation.
In addition, the proposed rule would raise the threshold for several program requirements. For example, under the proposed Stage 3 rule:
- 80% of prescriptions would be required to be sent electronically, up from 60% under Stage 2;
- 60% of lab and imaging orders would be required to be sent electronically, compared with 30% under Stage 2;
- 25% of patients would have to have engaged in secure messaging with a provider, compared with 5% under Stage 2; and
- 25% of patients would have to view, download or transmit data from their records, compared with 5% under Stage 2 (iHealthBeat, 3/20).
Advanced Health Models and Meaningful Use Workgroup Feedback
Overall, the Advanced Health Models and Meaningful Use Workgroup said that it agreed with the proposed rule’s aims to simplify the program, reduce the burden of participation and increase flexibility.
However, the work group suggested several changes, such as:
- Adjusting public health reporting requirements; and
- Requiring every participant to use the same shortened reporting period to facilitate interoperability (Durben Hirsch, FierceEMR, 5/12).
Consumer Workgroup Feedback
Meanwhile, the Consumer Workgroup proposed changing the percentage of patients who view, download or transmit their own records to 10% by 2018.
The work group also recommended that the federal government make use of both traditional Web-based portals that connect patients to their providers’ EHRs and application programming interfaces, or APIs, which they say could be used to give patients access to their information on their smartphones and other mobile devices.
Work group Chair Christine Bechtel, who is president of Bechtel Health Advisory Group, said that using both portals and APIs “will give the marketplace time to figure things out” (Conn, Modern Healthcare, 5/12).
Interoperability and Health Information Exchange Workgroup Feedback
The Interoperability and Health Information Exchange Workgroup Chair and Massachusetts eHealth Collaborative President and CEO Micky Tripathi said the work group generally agrees with the direction and goals of the proposed HIE measures, but expressed concerns about thresholds set under Stage 3’s objective seven (Health Data Management, 5/13).
The work group recommended that the threshold for:
- Sending an electronic summary of care record should be 40%, down from the proposed 50%; and
- Receiving and incorporating electronic summary of care records should be 25%, down from the proposed 40% (FierceEMR, 5/12).
Tripathi said the lower thresholds are “not because we’re opposed to higher thresholds — we very much support higher thresholds — but we don’t want to have to backtrack on the thresholds as has happened with view, download or transmit requirement” (Health Data Management, 5/13).
He added that if thresholds remain high, they should be balanced by making more exclusions for participants, including an exclusion for records sent from providers that do not use certified EHR technology (FierceEMR, 5/12).
Privacy and Security Workgroup Feedback
Meanwhile, the Privacy and Security Workgroup said that it supports the proposals to increase patients’ access to health data through the view, download or transmit requirement and APIs.
However, the work group raised concerns about the potential privacy and security risks related to increasing patient access to electronic health data (Health Data Management, 5/13).