The meaningful use workgroup of the HIT Policy Committee recently released a late-stage list of recommendations for Stage 3 of the electronic health records meaningful use program, which includes seven proposed new objectives that are not required in Stage 2.

The workgroup is accepting feedback before finalizing the recommendations and sending them to the Policy Committee in March. A list of workgroup members is here. The HIT Policy Committee and accompanying HIT Standards Committee both comprise industry stakeholders who advise federal officials on health information technology issues, particularly the meaningful use program. The committees wield significant influence in development of meaningful use criteria, although agencies within the Department of Health and Human Services have the final say.

The meaningful use workgroup is continuing to work on final recommendations that it expects to present to the Policy Committee on March 11. The current schedule for Stage 3 anticipates the Policy Committee approving recommendations during March, with a proposed rule in the fall of 2014 and final rule during the first half of 2015. Stage 3, focusing on supporting higher levels of outcomes-oriented coordinated care and population health management, starts in 2017.

For your consideration: Providers Get Help with Stage 2 Public Health/Registries Criteria

Many of the objectives of Stage 3 are updates of objectives currently required in Stage 2, with the objectives generally being enhanced or remaining the same. Following are the new objectives in the latest draft recommendations for Stage 3 for Eligible Professionals and/or Eligible Hospitals. Paul Tang, M.D., chief innovation and technology officer at Palo Alto Medical Center and chair of the meaningful use workgroup, cautions that there “could be quite a bit of change” in these recommendations because all feedback is being taken very seriously.

Order Tracking for EP (Menu item): The EHR assists with follow-up on orders to improve management of results, and results of specialty consult requests are returned to the ordering provider.

Unique Device Identifier for EP and EH (Menu item): Record the FDA UDI when patients have devices implanted, for each newly implanted device.

Medication Adherence (Certification Criteria): Certified Electronic Health Record Technology (CEHRT) can access medication fill information from a pharmacy benefit manager and access PDMP data (Prescription Drug Monitoring Program) in a streamlined way (e.g., sign-in to PDMP system).

Amendments (Certification Criteria): Provide patients with an easy way to request an amendment to their record online, such as offer corrections, additions or updates.

Patient Generated Health Data for EP and EH (Menu item): EPs and EHs receive provider-requested, electronically submitted patient-generated health information through structured or semi-structured questionnaires (e.g., screen questionnaires, medication adherence surveys intake forms, risk assessment, functional status); or through secure messaging. While not part of certification criteria, an EHR accepting patient-generated information using interfaces to remote devices is acceptable.

Notification for EHs and Critical Access Hospitals (Menu item): Send electronic notifications of significant health care events in a timely manner to known members of a patient’s care team, with the patient’s consent if required. Significant events include arrival at ED, hospital admission, discharge from ED or hospital, or death. Note: Modular certification is encouraged but this does not need to be an EHR function.

Case Reports (Certification Criteria): CEHRT is capable of using external knowledge (i.e., CDC/CSTE Reportable Conditions Knowledge Management System) to promote an end-user when criteria are met for case reporting. When case reporting criteria are met, CEHRT is capable of recording and maintaining an audit for the date and time of prompt. CEHRT is capable of using external knowledge to collect standardized case reports (e.g., structured data capture) and preparing a standardized case report (e.g., consolidated CDA) that may be submitted to the state/local jurisdiction, and the data/time of submission is available for audit.

The complete list of draft meaningful use recommendations, as of Feb. 4, is here.

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