The federal HIT Policy Committee’s Meaningful Use Work Group is poised to ask the public to comment on its preliminary proposals for the definition of meaningful use in Stage 2.

To be published in the next week or two, the Request for Comment will give the public 30 days to provide feedback.
(For Stage 1, the committee fielded more than 800 comments.)

For some functions, the proposals bump up percentages required in Stage 1. For instance, computerized provider order entry (CPOE) would increase from 30 percent of medication orders to “CPOE (by licensed professional) for at least one medication, and one lab or radiology order for 60 percent of unique patients who have at least one such order (order does not have to be transmitted electronically).” For eligible providers, the percent of orders e-prescribed would jump from 40 to 60.

The work group suggests that 80 percent of hospital patients be offered the ability to view and download information via a secure portal; and providers would be required to demonstrate that online secure patient messaging is in use.
Another proposal would require 30 percent of hospital medication orders to be automatically tracked via electronic medication administration recording.

Other new requirements seek to improve care coordination. Ten percent of patients would have to have a list of their care team members recorded in the electronic health record. Providers would be asked to record a longitudinal care plan for 20 percent of patients with high-priority health conditions.

Besides raising the bar from Stage 1, the Request for Comment also reaches out to ask the health IT community some direct questions about a few options for changing the way meaningful use is considered. For instance:

• For future stages of meaningful use assessment, should CMS provide an alternative way to achieve meaningful use based on demonstration of high performance on clinical quality measures (e.g., can either satisfy utilization measures for recording allergies, conducting CPOE, drug-drug interaction checking, etc, or demonstrate low rates of adverse drug events)?
• Should Stage 2 allow for a group reporting option to allow group practices to demonstrate meaningful use at the group level for all eligible providers in that group?

After analyzing the comments, the policy committee plans to revisit the recommendations in its public meetings in the spring of 2011.

Separate workgroups are developing recommendations around privacy, security and electronic reporting of clinical quality measures that will be incorporated into the meaningful use requirements.

The policy committee is scheduled to issue its final recommendations in the summer of this year, with the Centers for Medicare & Medicaid Services publishing a Notice of Proposed Rulemaking by the end of 2011 and a final rule by the middle of 2012.