Meaningful Use Stage 3: First Look
Meaningful Use of electronic health records (EHR) began as a goal of the 2009 Hitech Act. Healthcare providers were instructed to not simply adopt EHR, but to leverage EHR as a tool for improved efficiency and, ultimately, superior patient care. A total of $30 billion in incentives is to be paid out to providers who meet the government’s requirements for Meaningful Use. The requirements were divided into three stages. Stage 1 was implemented in 2011-2012 and focused on capturing and sharing patient data. Stage 2, started in 2014, focused on advancing clinical processes. On March 20, 2015, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule for Stage 3.
The primary goal of Stage 3 criteria is for healthcare providers to achieve improved patient outcomes through EHR use. Below is a summary of the proposed rule’s requirements by category: patient engagement, system interoperability, and computerization of processes.
One major issue healthcare providers have faced, both historically and in the contemporary care setting, is a lack of patient engagement. Patients don’t participate in their own care to the extent that they could. They are passive, in many cases unaware of their own health patterns, the cause/effect links of their conditions, and even how to effectively follow their treatment plans. The proposed Stage 3 Meaningful Use criteria includes several measures that aim to more fully engage patients, such as:
- More than 25% of a healthcare provider’s patients must actively engage with their electronic health records. ‘Actively engaging’ can consist of either viewing, downloading or transmitting data from their records. This is a 20% jump from Stage 2 requirements, where only 5% of patients had to engage with EHR. Under Stage 3, however, providers are permitted to use an application programming interface (API) allowing third-party developers to access data for patients.
- After visiting a healthcare provider or hospital, more than 25% of patients must receive a message via the EHR’s secure messaging Messages must be clinically relevant, that is, they must relate directly to the patient’s visit. Responses from healthcare providers to messages initiated by patients also count towards fulfilling this requirement. Stage 2 required only 5% of patients to exchange messages with providers, making for another significant increase in this area.
- For more than 15% of patients, patient-generated data from a non-clinical setting must be collected and incorporated into the EHR. This data could come from health-related apps on mobile phones or wearable devices such as Fitbits. Information about daily exercise, diet, sleep, and other habits can give physicians tremendous insight into patient health patterns, and can help physicians pre-emptively recommend lifestyle changes for improved patient health. This is a new requirement in Stage 3, as Stage 2 did not include any criteria around patient-generated health data.
Along with increasing patient engagement, the proposed Stage 3 requirements also aim to make it easier for physicians using different EHR systems to exchange patient information with one another. After all, what purpose would advanced EHR use serve if, after going to one healthcare provider, patients had to start all over again with the next provider they see? Time can be saved and unnecessary repetitions avoided if physicians using different systems are able to clearly and seamlessly communicate information to one another. With this goal in mind, proposed Stage 3 rules require that:
- For more than 50% of transitions of care and referrals, providers must use their EHR to create a summary of care to exchange electronically with other providers.
- In more than 40% of these transitions of care, providers must incorporate a summary of care from an EHR used by a different provider.
- For more than 80% of transitions of care, providers must perform a clinical information reconciliation. The reconciliation should include information about a patient’s medications and allergies, as well as problem lists.
A third point of emphasis of the Stage 3 requirements is continued computerization of routine processes performed by physicians. With dozens of prescriptions being written every day, lab tests constantly being sent and received, and other fundamental information needing to be captured and stored, it’s in everyone’s best interest to get these processes flowing electronically rather than on paper. To that end, Stage 3 rules call for:
- 80% of prescriptions to be sent electronically. This is a 20% increase from Stage 2, which required physicians to send 60% of prescriptions electronically.
- 60% of lab and imaging orders to be sent electronically. This requirement doubles the existing percentage requirements, which was 30% under Stage 2.
In addition to the above, Stage 3 also changes the Meaningful Use reporting period. According to the proposed rule, all providers will be required to report under a full calendar year cycle beginning in 2017. An exception will be made for providers attesting to the Medicaid meaningful use program for the first time.
See below for a comparison of Stage 2 and Stage 3 Meaningful Use requirements.
|Requirement||Stage 2||Stage 3|
|Secure patient messages||5%||25%|
|Patients engaging with EHR||5%||25%|
|Electronic lab & imaging orders||30%||60%|
The Meaningful Use Stage 3 objectives are intended to support nationwide efforts to improve healthcare quality. The proposed rule is open for comments through May 29, 2015.
- The Counseling Compact – Legislative NewsAug 12 , 2022
- Emergency Interventions via Telehealth How to Be Prepared for CrisisAug 10 , 2022
- July Is Bebe Moore Campbell National Minority Mental Health Awareness MonthJul 22 , 2022
- Mental Health Awareness; Let’s Practice Year-Round!Jul 13 , 2022
- Why the Reduction in Telehealth is Detrimental to Behavioral Health ProvidersJul 06 , 2022
- Oracle, Cerner and the Unified Medical RecordJul 05 , 2022
- Ignore your customers: Reid Hoffman and VC influenceJun 22 , 2022
- Mental Health: The Need For A Routine During COVID-19Apr 26 , 2021
- Mental Health Care In A PandemicApr 16 , 2021
- Part II: Is Telemedicine Here to Stay?Dec 18 , 2020
- Part I: Is Telemedicine Here to Stay?Nov 30 , 2020
- Covid-19: Ignorance is Not BlissJul 29 , 2020
- Covid-19: Why You Should Be Wearing a MaskJul 13 , 2020
- Part 2: Getting Care During a PandemicJun 15 , 2020
- Part 1: Getting Care During a PandemicJun 04 , 2020
- Data Aggregation and Its Importance: A WHOOP ExperienceMar 09 , 2020
- How WHOOP Could be a Trailblazer in Treating Population HealthFeb 13 , 2020
- How the Internet Changed HealthcareOct 18 , 2019
- Patient Histories: The Key to Quality CareOct 01 , 2019
- 3A’s (Aggregate, Analyze and Act) of Healthcare ITSep 19 , 2019
- Telemedicine – Benefits and ChallengesSep 04 , 2019
- Health Data Exchange StandardsJul 31 , 2019
- Telehealth: Technology meets HealthcareApr 11 , 2019
- Integrated Care: The Future of Behavioral HealthMar 29 , 2019
- Troubles with Getting Mental Health Help and InsuranceMar 15 , 2019
- 7 Things to do to Protect Against Ransomware AttacksAug 08 , 2018
- Oh EHR, how can we love thee?Apr 20 , 2018
- What’s in Store for Practice Fusion UsersJan 31 , 2018
- What is precision medicine? And how can EHR help?Jan 05 , 2018
- What’s the SOAPware alternative?Dec 15 , 2017
- Artificial Intelligence, EHRs and the future of health technologyNov 02 , 2017
- ACA Executive order’s impact on EMR and eHealth technologyOct 25 , 2017
- EHRs and Mental Health: What Needs to Change?Sep 29 , 2017
- American Medical Association (And Others) Unhappy With EHR ProvidersSep 22 , 2017
- A Celebration of Citizenship DaySep 18 , 2017
- Amazon’s Stealthy Foray Into the World of EHRAug 18 , 2017
- Google, the Gender Gap and Personal ResponsibilityAug 10 , 2017
- Neal Patterson and the Mission of Health ITJul 21 , 2017
- The Myth About Motivating People To PerformJul 14 , 2017
- Fragmented health data and personalized medicine: What to do?Jul 07 , 2017
- Apple’s Venture Into the World of EHR SoftwareJun 23 , 2017
- What does the U.K. health record hack mean for eHealth security?Jun 15 , 2017
- Why Doctors need an All-rounder Healthcare Solution?Mar 19 , 2016
- Are we ready for data-driven healthcare?Mar 12 , 2016
- Using Medicare And Private Sector Claims Data for Patient care QualityFeb 26 , 2016
- The Doctor must “Evolve” with the TechnologyFeb 26 , 2016
- The 2015 Practice Profitability IndexFeb 25 , 2016
- ‘Mind Your Risks’ – The NIH health campaignFeb 22 , 2016
- Middle East and Arab Health 2016Feb 03 , 2016
- Medical Billing in 2016Jan 08 , 2016
- CMS publishes 2014 National Health ExpendituresJan 02 , 2016
- Results from the Practice Profitability Index 2015Dec 16 , 2015
- This National Diabetes Month, you have a role in diabetes education and supportNov 26 , 2015
- Safe Texting in HealthCare: Do’s & Dont’sNov 18 , 2015
- Is TeleMedicine the future of healthcare ?Nov 13 , 2015
- Evaluating specific KPIs can improve business performanceNov 09 , 2015
- 50 Years of Medicare: More than 55 million Americans covered by MedicareSep 23 , 2015
- How Much Does Healthcare Cost Matter To A Patient?Sep 18 , 2015
- How does Affordable Care Act Change Your Practice?Sep 11 , 2015
- A ‘Don’t Do’ List to avoid patient no-showsAug 21 , 2015
- Add more patients and grow your medical business in 5 easy stepsAug 05 , 2015
- Medicare Trust Fund is now protected by the Fraud Prevention SystemJul 16 , 2015
- ICD-10: A Short StoryMay 19 , 2015
- Patient portals and patient engagement: Is there a link?Apr 21 , 2015
- Meaningful Use Stage 3: First LookApr 07 , 2015
- 6 Ways Physicians can Free Patient RecordsMar 17 , 2015
- Is the EHR market saturated?Dec 04 , 2014
- 5 Benefits of healthcare information exchanges for small practicesApr 22 , 2014
- New Study shows EMR Adoption Increases Patient Confidence, Loyalty and SatisfactionApr 22 , 2014
- Cloud-Based EMR Vendors and Patient Data SecurityApr 22 , 2014