The Stage 2 rule for the Electronic Health Record (EHR) Incentive Programs included changes to the Stage 1 meaningful use objectives, measures, and exclusions for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs). Some of these Stage 1 changes took effect on October 1, 2012, for eligible hospitals and CAHs, or January 1, 2013, for EPs. Several are optional, but others are required, this according to the American Institute of Healthcare Compliance (AIHC).
Stage 1 Changes and Timing:
Computerized Physician Order Entry (CPOE)
Change: Addition of an alternative measure based on the total number of medication orders created during the EHR reporting period
Timing: 2013 and onward
Change: Revised the description of who can enter orders into the EHR and have it count as CPOE
Timing: 2013 and onward (regardless of what stage of meaningful use the provider is attesting to)
Electronic Prescribing
Change: Additional exclusion to the objective for electronic prescribing for providers who are not within a 10 mile radius of a pharmacy that accepts electronic prescriptions
Timing: 2013 and onward
Record and Chart Changes in Vital Signs
Change: Age limit increased for recording blood pressure in patients from ages 2 to ages 3; no age limit for height and weight
Timing: Optional in 2013; required starting in 2014
Change: Exclusion if the EP sees no patients 3 years or older, if all three vital signs are not relevant to their scope of practice, if height and weight are not relevant to their scope of practice, or if blood pressure is not relevant to their scope of practice
Timing: Optional in 2013; required starting in 2014
Public Health Reporting Objectives
Change: Require that providers perform at least one test of their certified EHR technology's capability to send data to public health agencies, except where prohibited
Timing: Required in 2013 and onward (for all Stage 1 public health objectives)
Electronic Exchange of Key Clinical Information
Change: Objective for electronic exchange of key clinical information no longer required for Stage 1 for EPs, eligible hospitals, and CAHs
Timing: No longer required in 2013 and onward
For more details about each of these changes review the CMS Stage 1 Changes Tipsheet.
http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage1ChangesTipsheet.pdf
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