Connecting America for Better Health

Did you notice? "Connecting America for Better Health" is the new tagline on the CMS EHR Incentive Program logo. Significant! Indeed, it's now all about connected care.


The proposed Stage 2 Meaningful Use requirements are out now for public comment, through May 7. As always, HITECHAnswers does a great job of staying on the front lines, announcing the news and rallying the experts. (I recommend that you follow HITECHAnswers for news and developments across healthcare in general but come to EMRlogic Live for the eyecare perspective.)


As we would expect, Stage 2 is about building on the Stage 1 platform. What does that mean? 


First, the approach of core and menu set measures with exceptions remains intact. There are some changes, of course, to the measures but you're now used to the overall format. 


Second, as indicated in the program's new tagline, there's a change of focus from using EHRs to communicating, using EHRs. Significantly, "Connecting America" is not just about communications between providers. Patients are being brought into the picture as well. And for you as an Eye Care Provider, that means not just hospital patients but your patients too. For example, you'll no longer give patients an electronic copy of their exam summary, you'll have to provide them electronic access to the same. That, in turn, means a patient portal. The measures will include a requirement that a given percentage of patients use the portal and also send a secure message back to the provider.


Third, we can expect to see an increased level of audits. Some auditing is already taking place but more is forthcoming. It's not yet clear to what degree more audits will be tied to stage 2 versus year 2. If year 2, the increase starts now. Timing aside, we know that the change process began with attestation, will slowly migrate to electronic reporting (auditing) and culminate in pay-for-peformance reimbursement.


Fourth, we'll see advances in the reporting of Clinical Quality Measures. In stage 1, you were able to report zeros. That will cease in stage 2. We'll see consolidation of the current reporting mechanisms. PQRS, for example, is now essentially an insurance billing function. Whereas to date it has been disconnected from the doctor's exam, a pilot program is in the works to integrate it into EHRs along with the reportable CQMs.


Fifth, ONC Direct, also known as the Direct Project, has as its goal "to replace the fax machine as the point-to-point communications tool for healthcare". Every Health Information Exchange (HIE) in the country will use ONC Direct. That means also that every Eligible Professional (you!) will use ONC Direct to send and receive the Continuity of Care Record (CCR) and Document (CCD). Your certified EHR already has this capability; it was required for the initial certification. In Stage 1, you had to send a test (which could even fail!) but in Stage 2, you'll have to actually use it and use it successfully.


Successful use of ONC Direct means that the HIE requirement goes from merely performing the CCD test to actually connecting with at least three external providers in your primary referral network, or establishing an ongoing bidirectional connection with at least one health information exchange organization.


Stay tuned for more on what's happening in eye care with ONC Direct and one statewide health information exchange.


Alistair Jackson, M.Ed.