Healthcare Technology Featured Article

December 15, 2015

Diving into Meaningful Use Stage 3


Government requirements are continuing to wash over private practices and the next wave will be Meaningful Use Stage 3, which focuses on the advanced use of EHRs. Changes are expected to reduce the complexity of the program and shift to a single set of sustainable objectives and measures by 2018.

There are 10 objectives to be carried out by Eligible Professionals (EPs) – those held accountable through CMS to demonstrate meaningful use of EHR technology. Here are the objectives to successfully demonstrate Meaningful Use for 2015 through 2017 reporting years:

1. Protect Patient Health Information: The healthcare industry has been the target of cybercriminals in 2015 with a myriad of attacks on healthcare organizations such as Anthem, Premier and Blue Cross and Blue Shield, who suffered the largest data breaches. In light of these occurrences, it is more important than ever to protect electronic health information created or maintained by the CEHRT through the implementation of appropriate technical capabilities. It is recommended to complete a full risk analysis and maintain a signed and dated copy in your office.

2. Clinical Decision Support (CDS): Use clinical decision support to improve performance on high priority health conditions. In order for EPs to meet this objective, they must implement five clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period. The clinical decision support interventions must be related to high priority health conditions.

The EP must also enable the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period. However, any EP who writes fewer than 100 medication orders during the EHR reporting period is excluded from this requirement. It is a good idea to set up a warning for drug-drug and drug-allergy interactions to ensure these measures are met.

3. Computerized Provider Order Entry (CPOE): Use computerized provider order entry for medication, laboratory, and radiology orders directly entered by any licensed healthcare professional. Any EP who writes fewer than 100 medication orders during the EHR reporting period is excluded from this rule.

4. Electronic Prescribing: Generate and transmit permissible prescriptions electronically. More than 50 percent of permissible prescriptions written by the EP are queried for a drug formulary and transmitted electronically using CEHRT. Again, for any EP who writes fewer than 100 permissible prescriptions during the EHR reporting period or does not have a pharmacy within his or her organization and there are no pharmacies that accept electronic prescriptions within 10 miles of the EP’s practice location does not have to adhere to this measure.

5. Health Information Exchange: The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care must provide a summary care record for each transition of care or referral. The EP who provides a referral must use CEHRT to create a summary of care record and can electronically transmit it to a receiving provider for more than 10 percent of transitions of care and referrals. EPs who transfer a patient to another setting or refers a patient to another provider less than 100 times during the EHR reporting period is not required to meet this measure.

6. Patient-Specific Education: Use clinically relevant information from CEHRT to identify patient specific education resources and provide those resources to the patient. The patient portal is a good option to ensure those resources are available to patients on an ongoing basis. EPs that do not have office visits are not required to do this.

7. Medication Reconciliation: The EP, who receives a referral for a new patient from another setting of care or provider, must perform medication reconciliation. The only exclusion applies to EPs who was not the recipient of any transitions of care during the EHR reporting period.

8. Patient Electronic Access: Provide patients the ability to view online, download, and transmit their health information within four business days of the information being available to the EP. More than 50 percent of all unique patients seen by the EP must be provided timely access to view online, download, and transmit to a third party their health information subject to the EP’s discretion to withhold certain information. The second part of the measure states that for an EHR reporting period in 2015 and 2016, at least one patient seen by the EP during the EHR reporting period (or patient-authorized representative) must be able to view, download or transmit to a third party his or her health information during that reporting period.

For an EHR reporting in 2017, more than 5 percent of unique patients seen by the EP must be able to view, download or transmit to a third party their health information. The one exclusion that applies is for any EP who neither orders, nor creates any of the information listed for inclusion as part of the measures; or conducts 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 4Mbps broadband availability according to the latest information available from the FCC.

9. Secure Electronic Messaging: Use secure electronic messaging only to communicate with patients on relevant health information. For 2015, the capability for patients to send and receive a secure electronic message with the EP was fully enabled. In 2016, at least one patient seen by the EP must be sent a secure message using the electronic messaging function of CEHRT to the patient, or in response to a secure message sent by the patient. For 2017, a secure message can be sent using the electronic messaging function of CEHRT to the patient or in response to a secure message sent by the patient, will be required for more than 5 percent of unique patients. EPs will be excluded from this rule if they have no office visits during the EHR reporting period, or any EP who conducts 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 4Mbps broadband availability according to the latest information available from the FCC.

10. Public Health Reporting: The EP must be in active engagement with a public health agency to submit electronic public health data from CEHRT, except where prohibited.

In Stage 2 of Meaningful Use in 2015 EPs are required to participate in Immunization Registry Reporting with a public health agency to submit immunization data and syndromic surveillance data. This measure also covered those EPs who are required to submit data to a specialized registry.

Some EPs are excluded from this measure because they do not administer any immunizations to any of the populations for which data is collected by its jurisdiction’s immunization registry or for those who operated within a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required to meet the CEHRT definition. The same holds true for those EPs submitting syndromic surveillance data.

Mastering Meaningful Use: For those navigating the meaningful use waters, the best advice is to work with your vendor to automate these measures and embed them in your work flow. In this way, private practices will be able to track their progress and map their way to successfully meeting Meaningful Use requirements while providing the highest quality care to patients.

About the Author: Debra Harris is a senior product manager for AdvancedMD with more than 25 years experience in the healthcare software industry. Debra’s regulatory experience helped to drive MU success since 2010 for AdvancedMD and their customers. She also led the ONC EHR Technology certification for AdvancedMD, and played an integral role in planning for coordination of product deployment of regulatory requirements.




Edited by Maurice Nagle
By Special Guest
Debra Harris, AdvancedMD Clinical Product Manager ,





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