Meaningful Use, Stage 3, Providers & Technology

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Meaningful Use StageThe Centers for Medicare and Medicaid Services (CMS) released the proposed rules for stage 3 of meaningful use. The entire document is over 300 pages, and reads like a legal contract or legislative bill – not something you would read for fun. Stage 3 is the final stage of meaningful use, beginning in 2017, and required by all providers and hospitals by 2018.

Stage 3 meaningful use focuses on provider flexibility, simplifying the program, interoperability of electronic records, and patient outcomes. “The steps we are taking today will help to create more transparency on cost and quality information, bring electronic health information to inform care and decision making, and support population health,” said HHS Secretary Sylvia M. Burwell in a press statement.

Stage 3 “does three things: It helps simplify the meaningful use program, advances the use of health IT toward our vision for improving health delivery, and further aligns the program with other quality and value programs,” said Patrick Conway, MD, acting principal deputy administrator and chief medical officer at CMS, in a statement.

With regard to patient engagement and interoperability, providers will have to report on the following three measures, and meet two of the three thresholds.

  1. 25% (up from 5% in stage 2) of patients must view, download, and transmit their health data
  2. 35% of all patients seen must have received a secure electronic message from the providers
  3. 15% of patients must submit/upload patient generated, non-clinical health data

All three of these measures are sure to cause concern among providers, while creating huge opportunity for IT vendors – both established and startups.

Allowing patients to view their data online was also part of stage 2 meaningful use, so the software required to do this is already available and part of most HER systems. Meeting this measure will be more of a procedural and communication burden for many providers than technical. Most large providers already have some form of portal allowing patient access. Now, they need to ensure 20% of their patients actually use the portal.

Exchanging secure massages with patients is a different story. EHR vendors are just beginning to incorporate this ability. Some are building the functionality into their products, while others are partnering with secure e-mail and text vendors. Once the software is in place, deciding what information to send and encouraging patients to sign-up will be a big hurdle for providers. For technology vendors, this will create a bunch of new opportunities. In addition to the obvious messaging needs, providers will continue investing in analytics. Combining the analysis of medical data with secure messaging, providers can push alerts and other information to high-risk patients.

Of these measures, I find the third to be most interesting and perhaps hardest to implement. Under this new measure, providers are required to collect non-clinical data from patients (i.e. weight, exercise, diet, mood, etc.). Recently, there has been an explosion of mobile apps on the scene that collect health data, and meaningful use stage 3 will further fuel this trend. Even Apple has jumped into the market with Apple Health. Collecting data won’t be a problem. The challenge will be deciding what data to collect, how to get it into the providers’ EHR, and what to do with it.

The downstream opportunities of meaningful use stage 3 are huge, for providers and software vendors. Over the next few years we will continue to see new mobile health applications, and soon providers will begin encouraging their use. It is an exciting time to be in technology and healthcare.