The Centers for Medicare and Medicaid Services is reminding stakeholders that the public comment period for the proposed rule setting criteria for Stage 2 of the electronic health records meaningful use program ends on May 7.

The proposed rule is available here and a rule to make corrections to the proposed rule, published on April 18, is here.

A story in the April issue of Health Data Management focused on the “Ah-Hah!” moments when stakeholders reading the proposed rule came across a surprising paragraph or a new objective immediately recognized as problematic. Here are two examples:

* The rule calls for eligible professionals to provide more than 50 percent of patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP; and within 36 hours of discharge for hospitals. But that's only half the battle, as more than 10 percent of patients actually have to view, download or transmit. How is that supposed to happen?

* Under Stage 1, the licensed professional whose judgment creates the order (the physician) must personally use the CPOE function. But physicians want to be caregivers and not documenters, says Shefali Mookencherry, principal consultant at Hayes Management Consulting in Newton Center, Mass. So, CMS in proposed Stage 2 is asking for comment on whether other licensed professionals can actually enter an order and be the first-time generator of the order after receiving a verbal, written or electronic communication from the physician. Some states, Mookencherry notes, permit the pharmacist to be the first generator of an order if the pharmacist has an agreement with the physician. But other states may not permit someone besides the physician to generate the first order, regardless of what meaningful use says.

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