The following two tables compare the Stage 1 and Stage 2 meaningful use criteria under the Meaningful Use proposed/interim regulations that were issued last month. These tables illustrate some of the changes to the existing criteria, and also the changes in the metrics for the measures (generally increasing the compliance rate required to continue to qualify for the incentive payments).
Table 1 – Core Criteria Under Stage 1 and Stage 2 Meaningful Use Comparison
Eligible Providers must meet all of the Core Criteria to Qualify for the Incentives. Stage 1 had 15; Stage 2 has 17. Stage 1 meaningful use Core Criteria are found in section 495.6(d) for eligible providers. Stage 2 meaningful use Core Criteria are found in section 495.6(j) for eligible providers.
| Core Criteria for EPSubsections (d), (j) | Stage 1 Metric | Stage 2 Metric |
| § 495.6(j)(1) – provider use of CPOE for medication, lab, and radiology orders | [§ 495.6(d)(1)] 30% of orders | 60% of orders |
| § 495.6(d)(2) – drug-drug and drug-allergy checking | Enabled during period | N/A |
| § 495.6(d)(3) – maintain up to date problem list | 80% of patients | N/A |
| § 495.6(j)(2) electronic prescriptions | [§ 495.6(d)(4)] 40% of Rx | 65% of Rx |
| § 495.6(d)(5) – active medication list | 80% of patients | N/A |
| § 495.6(d)(6) – active allergy list | 80% of patients | N/A |
| § 495.6 (j)(3) demographics | [§ 495.6(d)(7)]50% of patients with encounters | 80% of patients with encounters |
| § 495.6 (j)(4) vital signs | [§ 495.6(d)(8)]50% of patients with encounters | 80% of patients with encounters |
| § 495.6 (j)(5) smoking status | [§ 495.6(d)(9)]50% of patients with encounters | 80% of patients with encounters |
| § 495.6(d)(10) – reporting clinical measures to CMS or State | Successful testing | N/A |
| § 495.6 (j)(6) decision support | [§ 495.6(d)(11)] Implement 1 decision support intervention | Implement 5 decision support interventions |
| § 495.6 (j)(7) lab results as structured data | [§ 495.6(e)(2)] Was Menu in Stage 1; 40% of all lab results | 55% of all lab results |
| § 495.6 (j)(8) patient lists by specific condition for QI | [§ 495.6(e)(3)] Was Menu in Stage 1; at least 1 list | At least 1 list |
| § 495.6 (j)(9) patient reminders | [§ 495.6(e)(4)] Was Menu in Stage 1; 20% of patients sent during period | 10% of patients seen in last 2 years receive a reminder |
| § 495.6 (j)(10) patient electronic access of health information | [§ 495.6(e)(5)] Was Menu in Stage 1; 10% of patients receive timely access | 50% of patients receive timely access |
| § 495.6 (j)(11) clinical summaries at patient visit | [§ 495.6(d)(13)] 50% receive summary from office visit | 50% receive summary from office visit |
| § 495.6 (j)(12) patient education resources | [§ 495.6(e)(6)] Was Menu in Stage 1; 10% of patients receive ed. resources | 10% of all office visits |
| § 495.6 (j)(13) medication reconciliation for transition of care | [§ 495.6(e)(7)] Was Menu in Stage 1; 50% of transitions have recon | 65% of transitions of care have medication recon |
| § 495.6 (j)(14) patients transitioned to another provider’s care have care summary prepared by provider | [§ 495.6(e)(8)] Was Menu in Stage 1; 50% of transitions have recon | 65% of transitions of care have patient summary |
| § 495.6 (j)(15) capability to submit electronic data to immunization registry | [§ 495.6(e)(9)] Was Menu in Stage 1; perform 1 test to registry | Ongoing submission of data to registry during CY |
| § 495.6 (j)(16) security risk assessments under HIPAA security regulations | [§ 495.6(d)(15)] Conduct security assessment | Conduct security assessment |
| § 495.6 (j)(17) use electronic messaging to communicate with patients | N/A | 10% of patients seen during period received secure message from provider |
| [§ 495.6(d)(14)] – capability to exchange key clinical information among care providers and patients | One test of exchange | N/A |
| [§ 495.6(d)(12)] 50% of patients receive timely access | 50% in 3 days on patient request | N/A |
Table 2 – Menu Criteria Under Stage 1 and Stage 2 Meaningful Use Comparison
In Stage 1, EP had to meet 5 out of 10 Menu Criteria to qualify. In Stage 2, EP must meet 3 out of the 5 Menu Criteria to qualify. Stage 1 meaningful use Menu Criteria are found in section 495.6(e) for eligible providers. Stage 2 meaningful use Menu Criteria are found in section 495.6(k) for eligible providers.
| Menu Criteria for EPSubjections (e), (k) | Stage 1 Metric | Stage 2 Metric |
| § 495.6(k)(1) – access to imaging results in EHR | N/A | 40% of imaging results in HER |
| § 495.6(k) (2) patient family health history in structured data | N/A | 20% of all patients seen |
| § 495.6(k) (3) capability to submit syndromic surveillance data to public health agency | [§ 495.6(e)(10)] Was Menu in Stage 1; perform 1 test to registry | Successful ongoing submission of data for period |
| § 495.6(k) (4) capability to identify and report cancer cases to State cancer registry | N/A | Successful ongoing submission of data for period |
| § 495.6(k) (5) capability to report other specialized registry (other than cancer) to specialized registry | N/A | Successful ongoing submission of data for period |
| [§ 495.6(e)(1)] – implement drug formulary checking | Enable functionality | N/A |
| [§ 495.6(e)(2)] – lab results as structured data | 40% of lab results are structured data | Moved to Core |
| [§ 495.6(e)(3)] – generate lists by specific conditions | 1 reporting list | Moved to Core |
| [§ 495.6(e)(4)] – send reminders to patients for follow-up care | 20% of patients | Moved to Core |
| [§ 495.6(e)(5)] – Provide patients with timely access to health information | 10% of patients have electronic access | Moved to Core |
| [§ 495.6(e)(6)] – Use EHR for patient education | 10% of patients | Moved to Core |
| [§ 495.6(e)(7)] – Incoming transition of care to EP medication reconciliation | 50% of patients have medication recon | Moved to Core |
| [§ 495.6(e)(8)] – Outgoing transition of care from EP care record summary | 50% of patients have care summary | Moved to Core |
| [§ 495.6(e)(9)] – immunization registry | 1 certified test | Moved to Core |
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