OMB reviews stage 3 meaningful use requirements

The Centers for Medicare & Medicaid Services has recently confirmed that stage 3 meaningful use is currently in the process of being examined and reviewed by the Office of Management and Budget. The agency also noted that the proposed rule will be on display soon, according to FierceEMR. 

Stage 3 set to enhance incentive program and reduce confusion
The OMB received the rule on Dec. 31, 2014, and has been reviewing it since. The primary benefit of the rule is that it is expected to provide significant savings to Medicare in the form of payment adjustments. The U.S. Department of Health and Human Services has stated that these savings will probably end up reducing the cost of care. However, it is still too early on to quantify the exact qualitative benefits of health outcomes and the improved quality of care.

In its statement to the OMB, the HHS explained that it is proposing the stage 3 criteria that eligible hospitals, providers and critical access hospitals will be required to adhere to under the Medicare and Medicaid EHR Incentive Programs. The criteria will focus on the use of electronic health record technology, hoping to advance users' understanding of the system to promote enhanced outcomes for patients. 

Stage 3 is also supposed to propose solutions to problems that providers have faced with the past two meaningful use stages. For example, it is expected to work for changes to the reporting periods and the overall structure of the incentive program, providing one clear definition of meaningful use to make the concept easier for providers to grasp.

After these changes are made, the framework of the program will become much more flexible and clearer, ensuring that there is future sustainability for the EHR program. One of the biggest issues providers have faced in the past is confusion from the multiple stage requirements. This is something that stage 3 meaningful use is aiming to reduce as well. 

When stage 3 is implemented at some point before the start of 2017, the CMS is expected to coordinate with the Office of the National Coordinator for Health Information Technology to make sure that the EHR certification process and criteria, as well as certified EHR technology, will be set in place.

New recommendations for stage 3
The Meaningful Use Workgroup suggested a list of 19 objectives for stage 3 meaningful use during a Health IT Policy Committee meeting held last March. The group reviewed the proposed objectives and voted to approve the list. Those recommendations fall into four categories of care improvements.

The first category is improving quality of care and safety and has seven subparts that are targeted for improvement. These include clinical decision support, order tracking, demographics/patient information, care planning – advance directive, electronic notes, hospital labs and unique device identifiers.

The second category is engaging patients and families in their care. The aim is to enhance patient-generated health data, secure messaging, patient education, visit and clinical summaries, and the process of viewing, downloading and transmitting data. 

Improving care coordination is the third category, which includes improved summaries of care during transitions, notifications and medication reconciliation.

Finally, improving population and public health is the fourth category, which involves immunization history, registries, electronic lab reporting and syndromic surveillance.

However, before any of the proposed rule's requirements for stage 3 meaningful use go into effect, the notice of proposed rule making has to be made available for public comment, which has the potential to influence the requirements that end up in the final rule. The CMS is most likely going to receive requests for more flexibility and timing from health care organizations and industry groups, especially after the resistance it has faced as a result of stage 2 meaningful use.