With Stage 2 of Meaningful Use, patients and families will be able to view, access, download and transmit to various data sources, and data exchanges during transitions of care – such as when a patient transfers from one healthcare center to another. It is a requirement.
But one aberration of these final Stage 2 rules is that providers won’t have full control over whether they qualify for some of the measures. Hospitals and providers have to offer 50% of patients access to their own health records through a portal, up 10 percentage points from Stage 1. But 5% of patients actually have to use the portal as well. Does this mean that physicians should ask patients to view their personal records online? The answer isn’t quite clear.
As a physician, if you don’t get around to dictating discharge notes within 36 hours of a discharge, it’s time to start getting into the habit. In Stage 2, hospitals and providers must transmit patient data to a referring physician or portal within that time frame. In addition, physicians, hospitals and other providers must generate an electronic summary care record at least 65% of the time when transitioning a patient’s care or making a referral.
How difficult will implementing all of this be? Unlike Stage 1 in which practices had to only demonstrate they could perform tasks with electronic health medical systems, Stage 2 requires actually doing these tasks. This will require coordination and cooperation among health facilities, as well as patients, employees, and others involved in data sharing.
A major concern for Stage 2 is data security and privacy as data actually begins to flow outside the walls of physician offices. This requires careful scrutiny at every point where data is accessed, viewed and shared to determine encryption needs. Any mobile technology – laptops, cell phones, tablets – requires a risk analysis of data on these devices.
A third major piece of Stage 2 is data exchange, regional or statewide health information exchanges or private exchanges with local hospitals. Not all of these exchanges are up and running yet. Therefore physicians may need to choose from a variety of exchanges available. Experts advise comparing governance, cost, and ease of use for data exchanges in order to make the best choice.
Physicians should make a checklist:
1. Determine whether your system will offer features and capacity needed. If not, begin seeking out, or working with, vendors now, including any third-party vendors as needed.
2. Realize that meeting some of the quality reporting requirements or data exchange requirements will be out of your control.
3. Make security a priority.
4. Ask other hospitals, regional extension centers, and practices for advice and consultation.
5. Conduct a systematic survey of what needs to be upgraded and purchased as well as what changes need to be made.
6. Make small steps toward Meaningful Use to avoid being overwhelmed and to ward off last-minute complications.
With careful planning Stage 2 can be implemented without a lot of meaningful chaos in your practice.
