Meaningful Use Stage 2 – Are you Ready to Attest?

Meaningful Use Stage 2 – Are you Ready to Attest?

Attention: open in a new window. PDF | Print | E-mail

In order to encourage medical professionals and hospitals to use electronic health records (EHRs), with the goal of increasing interoperability and improving patient engagement, the Centers for Medicare and Medicaid Services (CMS) have created incentive programs that provide payments to eligible providers who adopt and demonstrate meaningful use of EHR technology. Stage 1 of Meaningful Use began in 2011, with objectives related to data capture and sharing of patient data. The stage 2 of the EHR incentive program began in 2014 and involves more advanced clinical processes, emphasizing better care coordination and information exchange between providers.

As health care organizations currently look to attest to Stage 2 of Meaningful Use, they likely face two major challenges: improving the use of electronic clinical and discharge summaries, and encouraging patients to access to their health information and resources online. In this article, we’ll discuss the details of both of these Stage 2 measures, review obstacles to achieving some of these objectives, and outline strategies for successful attestation.

Stage 2 Objective: Giving Patients Access

One of the fundamental goals of Stage 2 is to use EHR technology to better engage patients and families in their own healthcare. For eligible hospitals and critical access hospitals, this means giving more than 50 percent of patients access to view, download and transmit hospital admission and discharge information online within 36 hours after discharge. Accompanying this measure, more than five percent of patients must also view, download or transmit this information to a third party during the reporting period. In the case of routine office visits, eligible providers must submit clinical summaries to at least 50 percent of patients within one business day of the date of care. They must also provide a summary of care document to at least 50 percent of patients undergoing a transition of care to another setting or provider.

Benefits of Clinical Care Summaries:

Aside from the benefits of achieving Meaningful Use objectives, clinical care summaries offer many benefits to the healthcare setting. These include:

  • Providing instant and critical patient information at the point of care, when it is needed most
  • Reducing paperwork and hassle associated with updating and processing manual and paper-based patient forms and records
  • Offers patients an accurate, updated record of a visit or clinical event, along with relevant instructions or procedures

Traditionally (pre-EHR), hospitals typically prepared a report with an admitted patient’s diagnosis, condition and treatment summary, which was later transcribed and mailed to the patient’s primary care physician via U.S. Mail. This delay puts patients at greater risk of readmission and other complications. Even with the use of EHRs, discharge summaries tend to focus on billing processing, and often leave out critical information about care management that can help a patient’s recovery and self-care. In order to meet the Meaningful Use Stage 2 measure, eligible hospitals and professionals may find it beneficial to use a health information exchange (HIE) that tracks patient views, downloads and transmissions. Additionally, patient web portals should integrate with the organization’s EHR for easier interoperability and care coordination. In terms of future interoperability within the entire health network, providers should focus on internal workflow policies as well as standardizing the coding and semantics within clinical summaries for better exchange and care coordination down the road.

Stage 2 Criteria: Exchanging Information and Engaging with Patients

Beyond sending clinical summaries and relevant patient information online, another policy priority in Meaningful Use Stage 2 is to encourage patients and caregivers to actively participate in their own health care management, now that they have access to their own personal health records. For eligible professionals, Meaningful Use requirements specify that eligible providers must communicate via secure electronic messaging with at least five percent of patients during the reporting period, or conduct one or more successful test messages through the certified EHR technology.

The online patient portal is one of the most common ways that providers are achieving this objective today. According to Healthcare Informatics, hospitals that were early adopters of MU Stage 2 report that an average of 15 percent of patients are currently downloading, viewing and transmitting their health information, with those numbers increasing over time. One of the key challenges of achieving the five percent number is coming up with a strategy for getting the patients to login to the online portal. Some of the obstacles to meeting this requirement include:

  • Assisting patients without access to computers or Internet
  • Helping patients without email addresses (a requirement for login)
  • Aiding those who are technology-challenged to use the system
  • Encouraging patients to use the system regularly and for their benefit

Encouraging Use of Online Portals:

Despite these challenges, there are a variety of approaches to take in order to help eligible professionals reach the five percent number of patients accessing the online portal. These include:

  • Offering a sign-up sheet with directions on registering for the portal at the point-of care
  • Installing a self-service kiosk for accessing the system onsite
  • Forcing use of the system to schedule follow-up appointments or review summaries of care
  • Improving interfaces for more intuitive use
  • Developing secure online mobile applications for gaining access to the patient portal
  • Training staff to encourage patients to use the system while in the office or on the phone
  • Investing in appropriate marketing efforts (direct mail, billboards, videos and online ads) to encourage logins
  • Offer incentives for patients to register and use the system, where appropriate

While it’s true that Meaningful Use policies are compelling providers to provide online access to patients, these providers should instead view these objectives as an opportunity for a competitive advantage -- to position themselves as industry leaders in health care technology. With online access to health information, patients will receive better quality care in a more timely fashion, and likely reap the benefits of reduced health care costs in the future. Once eligible professionals overcome the technology hurdles of implementation, they too will begin to enjoy the benefits of an improved patient experience, better care coordination and widespread interoperability and the efficiencies it brings.