Changes Seen in Stage 3 Meaningful Use in Upcoming Rules

Two proposed rules implementing Stage 3 of the electronic health record (EHR) incentive program have been submitted to the Office of Management and Budget (OMB) for review. These two rules could make substantial changes to the program based on the short descriptive narratives posted on the OMB website including the use of EHR to improve patient outcomes, a new definition of EHR, and the application of the National Coordinator for Health Information Technology (ONC) Health IT Certification Program in more health care settings and programs.

Patient Outcomes

The Proposed rule submitted by HHS implements Stage 3 of the meaningful use of EHR under the Medicare and Medicaid EHR Incentive Program. HHS notes on the OMB’s website that “Stage 3 will focus on improving health care outcomes and further advance interoperability.” Changes to the reporting periods, timelines and structure of the program will be included in this Proposed rule. Finally this Proposed rule will have a new single definition of meaningful use. “These changes will provide flexible, yet, clearer framework to ensure future sustainability of the EHR program and reduce confusion stemming from multiple stage requirements,” according to HHS.

EHR Definition

The second Proposed rule submitted by the ONC would have a new definition of EHR, according to an additional OMB’s website posting. The ONC Health IT Certification program will also be modified, according to the posting so that it will be applicable to other types of health information technology and other health care settings that interact with the ONC Health IT Certification Program. This Proposed rule will also include technical capabilities, implication specifications, and related standards for use by Certified Electronic Health Record Technology. These changes will ensure that eligible professionals, hospitals, and critical access hospitals will be able to participate in the incentive program.

The two Proposed rules are expected to be published in early 2015 and Stage 3 is expected to be implemented sometime in 2017. The submission to OMB of the proposals is the beginning of the process of Stage 3 implementation; changes to parts of the rule discussed in the short descriptions posted on OMB’s website are possible.