The Office of the National Coordinator for Health IT and the Centers of Medicare and Medicaid Services have revised aspects of their measures in the meaningful use Stage 2 final rule.

The interim final rule allows for public comment and makes several changes that primarily affect hospitals. The changes offer more clarity for providers and better align standards to the timeframe.

ONC has updated the version of the data element catalog in its 2014 Edition EHR certification criteria final rule to better support the technical descriptions and capability for capturing data for the clinical quality measures that CMS released Oct. 25, according to an interim final rule with comment released Dec. 4 in the Federal Register.

The rule will take effect 30 days after it is officially published Dec. 7. Comments will be accepted for 60 days.

To be certified, EHRs will need to be able to electronically record all of the data identified in the data element catalog (DEC) that would be necessary to calculate each clinical quality measure and to use the latest quality reporting document standard, QRDA III from Health Level 7, to create a data file for transmission of clinical quality measurement data.

ONC acted now to enable vendors and providers to update the DEC ahead of the start of EHR testing and certification in January 2013 instead of having to re-certify later.

Other major changes include:

  • Revising the regulation text for the hospital measures for the objective of making patient information available online. The measure will now base the denominator not on all patients, but all unique patients.
  • Expanding the denominator options for the objective of sending electronic lab results to ambulatory providers. It now allows hospitals to choose between a denominator of all lab orders received from office providers or all lab orders received electronically from office providers.
  • Moving the clinical quality measure minimum denominator threshold effective date from 2014 to 2013, so hospitals can begin taking advantage of this flexibility right away.


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