Stage 2 ready for primetime

By Bernie Monegain
03:56 PM

Stage 1 meaningful use will be extended to 2014, and Stage 2 proposed rules – soon to be published on the ONC site and in the Federal Register – get bullish on interoperability.

Those two messages from ONC chief Farzad Mostashari, MD, drew applause from an overflow crowd at a HIMSS12 session on meaningful use Wednesday, The session had been billed as a ‘sneak peak’ of the proposed rules for Stage 2. Mostashari promised a “deeper dive,” at Thursday sessions.

The crowd – a couple hundred people – had gathered early outside the meeting room, moving in even as the previous session came to a close. Once the doors closed, a few outside knocked, and then pounded to be let in. The last to walk in was Mostashari, who strode to the stage amid a rousing round of applause – a rock star with a power team and a Power Point presentation.

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Mostashari announced the proposed rules for Stage 2 had been submitted to the Federal Register earlier Wednesday morning. They would not be posted on the ONC website until Thursday, he said, and perhaps a few days later on the Federal Register, which would start the clock ticking for the 60-day comment period. Final rules are expected next summer.

The Stage 2 rules would “stay the course,” Mostashari said. They would reflect the recommendations of the federal advisory committees on policy and standards.

They would emphasize standards and interoperability.

“We are pushing for the first time a single standard for lab results, public health,” he said. “There’s a lot of interoperability being added into the 2014 certification. There is a very ambitious push for actual exchange across organizations and vendor boundaries.

Mostashari employed the word “push” time and time again.

“There’s going to be a push on patient engagement,” he said. “There’s going to be a push on patient quality improvement in hospitals. There’s going to be a push on patient quality measures.”

“We’re pushing on decision support…and population public health is not just a test, it’s actual.”

“We listened, and we learned from what you have been telling us,” Mostashari said. “We take seriously the need for flexibility. We have done whatever we can to increase flexibility and to reduce the burden.”

Some other items highlighted:
• The definition for certified EHR will no longer be based on certain defined criteria. It will be more flexible and more dynamic
• Quality measures will be aligned with other requirements for quality reporting
• Proposed is a batch reporting technology for eligible providers. The announcement received applause.
• Electronic exchange of summary care documents (Stage 1 change proposes eliminating tests for electronic exchange in favor of doing it; “Stage 2, you’ve got to be doing that a lot,” Mostashari said)
• Actual electronic information exchange
• Submissions to public health registries

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