Meaningful Use Stage 3: a detailed timeline

By now, most providers are well acquainted with the Meaningful Use Stage 1 or Stage 2 criteria and implementation timeline. Just as stage 1 and 2 were becoming a newly acquired comfort zone for the healthcare industry Stage 3 Meaningful Use has entered the picture.

The proposed meaningful use Stage 3 rule issued on 03/30/15 by Centers for Medicare and Medicaid Services (CMS) attempts to streamline standards and offer providers more flexibility concerning regulatory compliance. With the impending implementation of Stage 3 what can providers expect concerning changes from Stage 2 regulations and timeline.

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Stage 3 Meaningful Use Timeline

2017: The EHR reporting period (regardless of MU status) will be a full 365 days.

2017: The reporting period for quality reporting will shift to 365 days.

2017: Hospitals and EPs in their first year of MU, will no longer be required to use the 90-day reporting option, instead shifting to the 365-day reporting period.

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2017: Any hospital or EP will have the option of attesting to Stage 3 in 2017.

2017: Providers have the choice of attesting to the same MU stage that they attested to in 2016. A provider attesting to Stage 2 in 2016 will be limited to Stage 2 and Stage 3 in 2017.

2018: All hospitals and EPs will be required to adopt Stage 3 regardless of prior participation or where they currently are in the program. Stage 1 and Stage 2 would become obsolete in 2018.

2018: 2015 Edition CEHRT would be required.

2018: CQMs should be reported electronically “where feasible.”

Stage 3 Meaningful Use Changes

CPOE: Under Stage 2, 60% of prescription orders, 30% of lab orders, and 30% of radiology orders were required to be CPOE. Under Stage 3 80% of prescription orders, 60% of lab orders, and 60% of diagnostic imaging orders in Stage 3.

Patient Engagement: Under Stage 3 meaningful use, providers are required to engage 25% of unique patients with the information in their EHR.

Summary of Care Record: Departing from Stage 2, Stage 3 enacts a new transitions of care measure requiring a summary of care record to be electronically transmitted to 50% of transitions of care this departs from the 40% threshold of Stage 2.

Clinical Decision Support: Under Stage 3, providers must implement five clinical decision support interventions related to 4 or more clinical quality measures at a relevant point inpatient care for the entire EHR reporting period. In the absence of four clinical quality measures related to a provider’s scope of practice or patient population, the clinical decision support interventions must be linked to high-priority health conditions. Further a provider must have enabled and implemented the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period.

Given these changes, one is struck with the impression that this may very well be a difficult transition. The government has taken steps to simplify the regulations related to Meaningful Use.

However, it is apparent that there is a strong expectation that providers will need to be well on their way to using advanced EHR technology by 2018. The next few years will likely be a fluid period in the healthcare industry and the EHR technology industry as this shift towards stage 3 meaningful use occurs.