The Centers for Medicare and Medicaid Services has sent the final rule for Stage 2 of the electronic health records meaningful use program to the Office of Management and Budget for review, one of the last steps before publication.

The rule will finalize criteria for providers to demonstrate they are using previous and newly mandated functionalities in EHRs in a “meaningful” manner. A proposed rule published in February substantially raised the bar--some say unrealistically--for meaningful use compliance in Stage 2, particularly in the area of health information exchange. But that rule, and a companion proposed rule covering certification of EHRs, also showed more flexibility for meeting certain requirements.

For instance, the proposal for "gap certification" meant EHR vendors only need to get new capabilities certified under Stage 2--they do not have to recertify continuing capabilities already certified under Stage 1. Another popular provision was that providers don't have to buy a new certified EHR that includes functions not covered under meaningful use. They can meet meaningful use by using a certified Complete EHR, a modular EHR or a combination of Modular EHRs.

A feature story in the April issue of Health Data Management, “Meaningful Use Stage 2 Brings Cheers, Fears,” examined the popular and worrisome provisions of the proposed rule.

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