CMS lays out vision for Stage 3 meaningful use

'The goal was to become simpler; to get to something that was sustainable for future achievement'
By Mike Miliard
06:47 PM
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If Robert Anthony had his choice, "it wouldn't be called the Stage 3 meaningful use regulation," he said at HIMSS15 on Monday. "It would be called the 'meaningful use for everyone' regulation.”

"Even though we're talking about Stage 3," said Anthony, deputy director of the quality measurement and health assessment group at the Centers for Medicare & Medicaid Services, "what we're really talking about is what everybody will be doing – or we're proposing that everyone will do – in 2018 and beyond."

To a packed auditorium on Monday, Anthony – together with Elisabeth Myers, policy and outreach lead in CMS's division of health IT – laid out Stage 3 requirements for eligible providers and hospitals, explaining what proposed rules (which, when finalized, will take effect starting in 2017) will mean for them.

The hope is that some lessons were learned from earlier stages of the process.

"We heard loud and clear that the framework for meaningful use as we'd devised it in Stage 1 and Stage 2 had become something that was fairly complex," said Anthony. "It had become somewhat burdensome."

Some of that was related to workflow issues, he said. "Some of it was the sheer amount of what we were talking about measuring and reporting on."

With Stage 3, said Anthony, "the goal was to become simpler; to get to something that was sustainable for future achievement. To focus in areas that were priorities for us as an agency, but also for us as healthcare providers and consumers: promoting health information exchange and focusing on improved outcomes."

Part of that is streamlining – eventually synchronizing on a single stage, "whether you're a new physician or one who has been doing this for five years," with a single reporting period, aligned to the calendar year.

Part of that is simplification, he said, moving from more than 20 objectives to a core of "eight that everyone should do, with some internal flexibility," he said.

The goal, in other words, is to reduce the ‘hoop jumping’, to enable hospitals and providers "to focus on objectives of advanced use."

Health organizations will have option to report in Stage 3 criteria in 2017. They'll be required to do so beginning in 2018, regardless of prior participation/stage of meaningful use.

Myers spent some time explaining the measures for Stage 3's eight advanced use objectives:

1.  Protect electronic health information

2.  e-Prescribing

3.  Clinical decision support

4.  Computerized provider order entry

5.  Patient electronic access to their data

6.  Coordination of care through patient engagement

7.  Health information exchange

8.  Public health reporting

Some of those are retained Stage 2 objectives with small modifications, she said. Some are objectives with more expanded scope. All of them are about the "movement of information to support the improvement of healthcare," said Myers

In most cases, "we deliberately put in some flexibility," in order to better fit with how patients and providers do things, she said.

For example, for the patient access objective, CMS will now allow providers to use APIs to help meet the criteria, said Myers – suggesting that the wearable devices and wellness apps that have become so popular could be one way to meet the criteria.

The aim, she said, is "allowing for different types of technology for different types of use cases for different types of providers and patient populations."

Meanwhile, for those with questions on Stage 3, Anthony suggested they drop by booth #6039, where CMS will be holding "office hours daily" to discuss meaningful use, electronic clinical quality measures and more.