News Corner: Meaningful Use Stage 3 and Transitions of Care: Asking too Much?

The Center for Medicare and Medicaid recently released its proposed rule for Meaningful Use (MU) Stage 3. Designed to give providers additional flexibility and simplify the MU program, Stage 3 focuses on driving interoperability between different electronic health records and improving patient outcomes.

Despite the honorable goals of the program, many in the industry believe that the requirements placed on providers in the next few years are too stringent, particularly when it comes to transitions of care, either to a different setting or to another clinician. These transition periods are notoriously susceptible to errors, as information gets “lost.”  While technology is moving toward creating a full continuum of care between different institutions, Meaningful Use Stage 3 takes this mission to a legislative level.

Health Data Management detailed the differences between MU Stage 2 and MU Stage 3 requirements as they relate to care transitions. The main changes between the two stages are threefold:

  • Each requires healthcare providers to give a summary of care for at least 50% of transitions and referrals, but Stage 3 calls for the summaries to be created using a certified EHR system and be electronically exchanged.
  • In Stage 2, providers have to transmit a summary of care to the recipient provider using a certified EHR or e-Health Exchange organization. Stage 3 calls for the new provider, in at least 40% of transitions or referrals, to incorporate an electronic summary of care document from a source other than that provider’s EHR system.
  • Stage 3 requires providers to perform “clinical information reconciliation” for 80% of new patients, including a review of all medications, allergies, and current diagnoses. Stage 2 has providers conducting at least one successful electronic exchange of a summary of care using an EHR from a different vendor or a CMS-designated test EHR.

The burden being placed on healthcare providers to drive information exchange, which is a heavy lift, isn’t what’s being questioned. The majority of the controversy exists around whether this initial burden is truly necessary to push interoperability forward.

As the Stage 3 ruling is expected to be the final stage of the Federal EHR Incentive Program, with all providers being required to attest by 2018 regardless of their current stage, some suggest that now isn’t the most appropriate time to push.

While there are certain hardships involved with setting up the program, particularly in care transitions, the Stage 3 ruling also brings with it a number of benefits, including:

  • Extended reporting periods
  • Reduced reporting burdens due to elimination of “topped out” measures
  • The establishment of an industry standard for interoperability.

The real question then becomes, are the heavy requirements now worth the reporting efficiencies later? Should providers get on board with MU Stage 3?   Please share your thoughts by commenting below.

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