DEC 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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December 2012 EW NEWS & OPINION 3 Expert: Stage 2 final rule includes changes A health insurance expert outlined Stage 2 meaningful use for participation in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs in a recent webinar, sponsored by ASCRS���ASOA, discussing updates and changes to Stage 1 and answering questions specific to ophthalmologists. Robert Anthony, health insurance specialist, Office of E-Health Standards and Services (OESS), Centers for Medicare & Medicaid Services (CMS), spoke at the webinar. The webinar presented an overview of the new Stage 2 final rule, which was published by CMS on Sept. 4. All eligible professionals (EPs) must meet CMS��� specifications after first completing meaningful use in the Stage 1 requirements. Changes ���Even though we call this the Stage 2 rule, there���s a bit more in this than just Stage 2 meaningful use,��� Mr. Anthony said. ���There are some changes, retroactively, to the Stage 1 requirements of meaningful use. There are details about new clinical quality measures, and they���re not just new clinical quality measures for Stage 2 participants; there are new clinical quality measures for everybody who is taking part in the program. Everybody will begin using them in 2014.��� Electronic exchange Patient engagement in EHRs was a major goal of Stage 2, according to Mr. Anthony, and he outlined the electronic exchange measurements involving patients that EPs must follow. ���In Stage 2, there are a couple of objectives where we have introduced an actual measurement of patient use as a portion of that. One of them is in a new objective in the core [objectives] for EPs of sending secure messages���2014 certified technology will have the ability to do secure messaging between the EP and the patient, and one of the measures is that more than 5% of patients actually use that technology to send a secure message to their EP,��� he said. In addition, 50% of patients must receive access to health infor- by Erin L. Boyle EyeWorld Senior Staff Writer mation online, and more than 5% of patients must access that information. During the webinar���s question and answer period, a participant asked how patients could be required to take part in electronic exchange if they do not want to. ���This is a concern that came up quite often during the public comment process,��� Mr. Anthony said. ���Certainly you can���t force patients, but in the same way that you can���t force patients to take medication, we do believe that the EPs and their practice have a considerable influence on patients and can have a considerable influence on their use of health information technology.��� Vital signs Reporting of vital signs is also changing by 2014, Mr. Anthony said, with patients 3 years and older requiring blood pressure measurement and no age limit for height and weight measurements. However, the exclusion for scope of practice remains, so ophthalmologists who are eligible will not need to take vital sign measurements. ���We���re also introducing a new exclusion,��� Mr. Anthony said. ���Currently the only exclusion for vital signs is if all three elements of blood pressure, height, and weight are not relevant to scope of practice. ��� There are some specialists who will be taking blood pressure but not height and weight, or height/weight but not blood pressure. So you can continue to claim the exclusion for all three elements that aren���t relevant to scope of practice, but you also will be able to separate them out.��� EW Editors��� note: Mr. Anthony is health insurance specialist, Office of E-Health Standards and Services, Centers for Medicare & Medicaid Services. Contact information Anthony: Robert.anthony@cms.hhs.gov For more information, visit www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/ Stage_2.html

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