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Stage Two EHR Meaningful Use” Rules Now Released “


What will EHR Meaningful Use Stage 2 rules mean for your practice?


Last week federal officials released the final regulations of the Health Information Technology for Economic and Clinical Health, or HITECH, for Stage 2 rules for Meaningful Use.  These rules dictate the terms which medical providers must meet in order to continue to qualify for incentive payouts for the adoption and use of EHRs. The new regulations will be entered into the Federal Register on September 4.  


Notably, the new rules state that Meaningful Use Stage 2 for EHRs will not start until 2014, a full year later than was previously suggested.  This means that medical providers will now have an extra year to comply with these standards. 


To demonstrate Stage 2 Meaningful Use providers must meet 17 core objectives and 3 menu objectives that they select from a total list of 6, for a total of 20 core objectives.  Hospitals and clinics must meet 16 core objectives and 3 menu objectives that they select from a list of 6, for a total of 19 core objectives.  


In a conference call with journalists last week, National Health IT coordinator Dr. Farzad Mostashari explained the Stage 2 menu items are “potentially more relevant to specialists” than the Stage 1 items, which had been criticized for being overly orientated towards primary care providers. 


Other highlights from the 672 page ruling include specific requirements for how hospitals and physicians conduct their risk assessments, notably with regards to security and encryption of stored medical data.  The ruling specifically lays out guidelines for information considered “at rest,” referring to data that is stored on end-user devices. The new rules also state that providers must also implement security updates as often as necessary in order to correct deficiencies in the risk management process. 


Stage 2 rules also require that providers must enter electronic data for at least 60% of their patients, up from 30% in Stage 1.  Some thresholds have been scaled back; providers must provide online access and engagement to health information and messaging for 5% of patients, as opposed to the 10% originally proposed. 


Other concessions made to providers in Stage 2 have to do with reporting timelines.  These regulations allow for a 90-day reporting period for the year 2014, as opposed to a 365-day reporting period as originally proposed.  This means that providers would only have to prove Stage 2 Meaningful Use adherence for 3 months in 2014.  After 2014 all reporting will move to a standard 365-day cycle.  Also starting in 2014, providers will have to submit their Meaningful Use achievements electronically.


In Summary: Stage 2 Changes

All in all, while Stage 1 Meaningful Use addressed the basic functions of EHRs, including use of electronic data and patient rights with regards to their online health information, Stage 2 lays out guidelines for increased information exchange between providers and patients by promoting secure data storage and online patient engagement. 


Finally, as before, providers can start earning Stage 1 incentives as late as 2017, though Medicare will begin imposing penalties for not achieving basic Meaningful Use in 2015.  Stage 3 Meaningful Use is slated to begin in 2016. 


More Resources: FAQs on Meaningful Use from


Sources:, Information Week, GovInfo Security, MedCity News


[original image by: Striatic]

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