February 22, 2012 — Attendees at the HIMSS 2012 meeting in Las Vegas were given a preview of what will be in the expected proposed rules for Stage 2 meaningful use, certification and standards from officials at the Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare and Medicaid Services (CMS). In a recap featured on its website, HIMSS reported that Farzad Mostashari, National Coordinator for Health Information Technology, told attendees, “We stayed the course.” He also noted that image viewing will be an option for meaningful use (MU).
The proposed rules, which are expected to be released Feb. 23, signal several themes. Among these will be a big push towards standardized exchange starting in 2014, a similar focus on patient engagement as recommended by the HIMSS Policy Committee and increased focus on patient safety, continuous quality improvement and quality measures. Mostashari said serious consideration was given to increasing the level of flexibility while reducing the regulatory burden, and this will be seen in many areas of the proposed rule.
Additionally, there will be a push toward standardization in certification criteria. For example, for the first time there will be a single standard for the consolidated clinical document architecture (CDA); standards for transport; optional use of simple object access protocol (SOAP) and a single standard for lab results. Systematized momenclature of medicine (SNOMED) becomes the vocabulary standard for problem lists. Mostashari said the rules will propose an ambitious target, that of actual data exchange across organizational and vendor boundaries. And, for the first time, there will be new requirements around usability and safety reporting.
According to the HIMSS report, the announcement that image viewing will now be an MU option received a positive reaction from attendees, as did an announcement that the concept of physician group quality reporting will be introduced.
Also supporting the theme of increased flexibility is a “base electronic health record (EHR)” which contains a common set of functions that can be built upon as needed to meet meaningful use, and a scope of specialty practice exclusions, clarity on what constitutes an encounter, and reporting to specialty registries.
While there are changes, none of them are “dramatic” according to Mostashari. “It’s still the basic framework.”