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The federal advisory HIT Policy Committee has developed preliminary recommendations for Stage 3 criteria under the electronic health records meaningful use incentive program, and has released its 44-page document for public comment.

"The Stage 3 vision includes a collaborative model of care with shared responsibility and accountability, building upon the previous MU objectives,” the committee explains. “While the committee appreciates and recognizes today’s challenges in setting up data exchanges, it is the committee’s recommendation that Stage 3 is the time to begin to transition from a setting-specific focus to a collaborative, patient- and family-centric approach.”

Translation: Get ready by 2016 for substantially enhanced requirements to exchange data among all stakeholders with a focus on team-based models of care that support population management and outcomes.

Stage 3 criteria that currently are under consideration include:

* Require eligible professionals to conduct secure messaging with 10 percent of patients, but assess the readiness to raise it to 30 percent based on Stage 2 experiences.

* Require EPs to make information available to patients within 24 hours if generated during the course of a visit, and within four business days for labs and other information not generated during the visit, with the potential to raise both thresholds based on Stage 2 experiences.

* A menu measure would require EPs and hospitals to provide 10 percent of patients with the ability to submit patient-generated information. An example could be medical device data collected at home if appropriate standards are ready.

* Hospitals within two hours of a significant health event would notify at least one key member of the patient’s care team, such as the primary or referring physician.

* EHRs must be able to query another entity, such as an EHR or health information exchange, for outside records, and respond to such queries from other entities.

* EHRs should be able to accept two-factor (or higher) authentication for providers to remotely access protected health information. The committee also seeks comments on logical next steps for increasing privacy and security requirements.

The HIT Policy Committee’s request for comments is available here. The comment period will be open for 45 days following publication in the Federal Register in coming days.