Stage 3 | The Gap Group

This information is based on the October 16, 2015 final rule titled “Medicare and Medicaid Programs; Electronic Health Record Incentive Programs – Stage 3 and Modifications to Meaningful Use in 2015 through 2017” and corrections and correcting amendment released on June 1, 2016.

Meaningful Use Stage 3 objectives and measures align with other quality improvement programs, promote interoperability and focus on the triple aim components of cost, access and quality. EPs must attest to all objectives and measures to meet requirements for Stage 3, unless an exclusion or flexible option applies.

Stage 3 will be optional for EPs in 2017. For EPs opting to demonstrate in 2017, there is an optional 90-day reporting period. For 2017, EPs can use a combination of 2014 or 2015 CEHRT for reporting.

Stage 3 will be mandatory for EPs beginning in 2018. Reporting will be for a calendar year and 2015 CEHRT must be used for reporting.

Proposed Objectives and Measures for 2017 & 2018

1. Protect Patient Health Information

Measure: Conduct or review a security risk analysis including addressing the (including encryption) of ePHI data created or maintained by CEHRT and implement security updates as necessary and correct identified security deficiencies as part of the provider’s risk management process.

2. Electronic Prescribing (eRx)

Measure: More than 60% of all permissible prescriptions written by the EP are queried for a drug formulary and transmitted electronically using CEHRT.

3. Clinical Decision Support (CDS)

Measure 1: EP must implement 5 clinical decision support interventions related to 4 or more CQMs.
Measure 2: EP has enabled and implemented the functionality for drug-drug and drug-allergy interaction checks.

4. Computerized Provider Order Entry (CPOE)

Measure 1: More than 60% of medication orders created by the EP are recorded using CPOE.
Measure 2: More than 60% of laboratory orders created by the EP are recorded using CPOE.
Measure 3: More than 60% of diagnostic imaging orders created are recorded using CPOE.

5. Patient Electronic Access to Health Information

Measure 1: For more than 80% of all unique patients seen by the EP:

Measure 2: EP must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide electronic access to those materials to more than 35% of unique patients seen by the EP.

6. Coordination of Care through Patient Engagement
Requires attestation to all measures but are only required to meet thresholds for two.

Measure 1: More than 5% (in 2017) and 10% (in 2018) of all unique patients seen by the EP actively engage with the EHR made accessible by the provider. An EP may meet the measure by either:

A. View, download or transmit to a third party their health information; or
B. Access their health information through the use of an API that can be used by applications chosen by the patient and configured to the API in the provider’s CEHRT; or
C. A combination of option A and option B

Measure 2: More than 5% (in 2017) and 25% (in 2018) of all unique patients seen by the EP, a secure message was sent using the electronic messaging function of CEHRT to the patient, or in response to a secure message sent by the patient.
Measure 3: Patient generated health data or data from a non-clinical setting is incorporated into the CEHRT for more than 5% of all unique patients seen by the EP.

7. Health Information Exchange (HIE)
Requires attestation to all measures but EPs are only required to meet thresholds for two.

Measure 1: For more than 50% of transitions of care and referrals, the EP that transitions or refers the patient to another setting of care or provider of care:

A. Creates a summary of care record using CEHRT; and
B. Electronically exchanges the summary of care record.

Measure 2: For more than 40% of transitions or referrals received and patient encounters in which the EP has never before encountered the patient, the EP receives or retrieves and incorporates into the patient’s record an electronic summary of care document.
Measure 3: For more than 80% of transitions or referrals received and patient encounters in which the EP has never before encountered the patient, the EP performs clinical information reconciliation.

8. Public Health and Clinical Data Registry Reporting
Requires attestation to three measures.

Measure 1: Immunization Registry Reporting
Measure 2: Syndromic Surveillance Reporting
Measure 3: Electronic Case Reporting
Measure 4: Public Health Registry Reporting
Measure 5: Clinical Data Registry Reporting

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Meaningful Use Stage 3 Objectives