Meaningful Use Objectives For Stage 2 Electronic Health Records
Sharing electronic health records is always a matter of security. It’s all about making sure someone’s medical history is protected as it’s transferred and stored in the digital space. Christensen Law shares this article of a few things that go into securing your electronic health records.
Written By: S.Sandy Sanbar, MD, PhD, JD, Blake Christensen, DO, D. Wade Christensen, JD, J.Clay Christensen, JD, L. Nazette Zuhdi, JD, LLM, Adam W. Christensen, JD, MBA, Oklahoma City
On Jan 1, 2014, Meaningful Use Stage 2 began for eligible professionals (EPs). Physicians must develop strategies for meeting each of the following five Meaningful Use Objectives, and talk to their vendors about plans and timelines for getting their electronic health record (EHRs) certified and upgraded.
(1) Develop Web Portals for Patients. Physicians should sign up their patients to participate in a web portal linked to EHR’s that give more than 50% of patients seen during the reporting period timely online access (within 4 business days of a visit) to their health records and allows them to message the physician securely. And, more than 5% of patients seen in that party their health information. EPs will also have to demonstrate Meaningful Use for the entire calendar year, not just for the 90-day period required in Stage 1. Secure messaging might be built into the EHR. One may use an external messaging service like RelayHealth, which offers a certified EHR that includes patient-messaging features. Kryptiq is another external messaging service. Patients may also set up their own personal health record (PHR) on an external “platform” such as Microsoft Health Vault, which allows users of some EHRs to upload clinical data to patients’ PHRs with their permission.
(2) Exchanging Clinical Summaries. EHRs should be capable of generating a summary in a specific and mandatory format known as the Consolidated CDA, which can be shared with other physicians who use EHRs when exchanging clinical summaries with other providers during transitions of care, such as referrals and consultations. Some EHRs can currently create a similar summary known as the Continuity of Care Document (CCD). In Stage 2, EPs must provide a summary-of-care record for more than 50% of transitions of care and referrals. In 10% of those transitions, the summary must be transmitted electronically using certified EHRs. EPs have to exchange a summary at least once with a recipient who uses a different EHR from that of the sender, or conduct a successful exchange with one of the Centers for Medicare & Medicaid Services-designed test EHR. Some healthcare organizations and physician groups are acquiring internal health information exchanges (HIEs) that allow providers to send clinical messages and document attachments to one another. Other organizations may allow independent practices to join their HIEs. Alternatively, a private practice could join a community or regional HIE if one is available. Direct Secure Messaging (DSM) protocol, created by a public-private consortium, specifies how a clinical message can be transmitted from one trusted party to another. Companies known as health information service providers (HISP) route the messages, maintain provider directories, and guarantee the authenticity of senders and receivers of information. DSM could provide independent physicians a cost-effective way to exchange summaries.
(3) Laboratory Orders. Physicians should place laboratory orders themselves. More than 30% of laboratory and imaging test orders must be done electronically in Stage 2. Laboratories are expected to offer a two-way interface before 2014 in order to keep its customers. Physician groups should analyze workflow and figure out how best to pace lab orders electronically, e.g. customizing template orders for annual exams that might include a blood panel, ECG, and bone density test.
(4) Medication Reconciliation. More than 60% of medication orders must be done electronically in Stage 2, compared with just 30% or prescription drug orders in Stage 1. When a patient is transferred to the care of an EP, the physician must use his EHR to reconcile the patient’s medications in 50% of these care transitions. Vendors must build in the capability. Staffers will have to ask patients about their medications and capture that data in structured fields, and Surescripts medication histories can help as well.
(5) Preventive Care reminders. An EHR must have some kind of registry function that can identify patients who are due for preventative/follow-up care for more than 10% of patients with two or more office visits in the previous 2 years. The EHR must have a method of automating those alerts to patients; the office staff does not have to call or mail reminders. Third-party solutions do exist that help solve this problem if an EHR cannot do it.
Electronic health records make the transfer of important patient information easier to do between doctors and other health professionals, but its convenience can be abused if not properly secured. Christensen Law hopes that this has been informative for readers and if you have any questions regarding medical law, don’t hesitate to give our professional lawyers in OKC a call!