Medicare Meaningful Use Stage 2

Medicare Meaningful Use Stage 2, which began in 2014, builds on the use and capabilities of EHRs introduced in Medicare Meaningful Use Stage 1. Regulations call on care providers to put more advanced processes into place, increase the interoperability of health information and adopt standardized data formats. Stage 2 also places a greater emphasis on exchanging clinical data between providers and enabling patient engagement.

Meaningful Use Stage 2 features the same nine core objectives as Stage 1, only with higher thresholds. The threshold percentages increase to ensure that EHR processes are extended to a larger population. For example, instead of ordering at least one medication for 30% of unique patient visits through Computerized Provider Order Entry (CPOE) during the reporting period (Stage 1), you must submit 60% (Stage 2).

Meaningful Use Stage 2 core objectives

  1. Use Computerized Provider Order Entry (CPOE) for medication orders: There are three measures to fulfill in this objective. Measure one requires the use of CPOE to record more than 60% of medication orders created by the eligible professional (EP) during the EHR reporting period. For the second measure, more than 30% of the EPs laboratory orders must be captured by CPOE during the reporting period. And for the third, CPOE must capture more than 30% of the radiology orders created during the EHR reporting period by the EP.
  2. Submit prescriptions electronically: More than 50% of all prescriptions written by the EP must be queried for a drug formulary and transmitted electronically using Certified EHR Technology (CEHRT).
  3. Implement clinical decision support at the point of care: This objective requires that the EP meet two measures. The first measure requires the use of five clinical decision support interventions at a relevant point in patient care during the EHR reporting period. These interventions must relate to at least four clinical quality measures. For the second measure, the EP must enable drug-drug and drug-allergy interaction check functionality during the entire 90-day reporting period —any EP who writes fewer than 100 medication orders during this time frame is excluded.
  4. Provide patients with electronic access (VDT): This objective requires that the EP meet two measures. To satisfy the first measure, more than 50% of the patients seen by the EP during the EHR reporting period must receive online access to their health information within four days of its availability. EPs can use their discretion to withhold certain information. For the second measure, a patient must view, download, or transmit their health information to a third party during the 90-day reporting period.
  5. Protect electronic health information: Protect electronic health information that has been created or maintained by the CEHRT by conducting or reviewing a security risk analysis and implementing the appropriate technical capabilities.
  6. Provide patient specific education: More than 10% of all patients seen during the 90-day reporting period must receive patient-specific education materials, as identified by the CEHRT.
  7. Perform medication reconciliation: More than 50% of the patients transitioned to the care of the EP during the reporting period must receive a medication reconciliation.
  8. Create and transmit a summary of care record: When transitioning or referring patients to another care setting or provider, the EP must use a CEHRT to create a summary of care record. This record must be submitted electronically to a receiving provider for more than 10% of referrals.
  9. Enable secure messaging: During the EHR reporting period, patients must be able to send and receive a secure electronic message with the provider.

Meaningful Use Stage 2 public health objectives

To successfully attest to Stage 2, EPs must fulfill one public health measure, with five reporting options available to choose from.

Measure options:

  1. Immunization Registry Reporting: The EP must be actively submitting and receiving immunization data and forecasts from a public health agency.
  2. Syndromic Surveillance Reporting: EPs must be actively submitting syndromic surveillance data from a non-urgent care ambulatory setting. For eligible hospitals, syndromic surveillance must be submitted from an emergency or urgent care department.
  3. Case reporting: The EP is actively engaged with a public health agency to submit case reporting of reportable conditions.
  4. Public health registry reporting: The EP is actively submitting data to public health registries on behalf of a public health agency.
  5. Clinical data registry reporting: The EP is actively engaged in submitting data to a clinical data registry.
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