Paul Tang, M.D.The same package the committee approved included a set of recommendations to the Office of the National Coordinator. Among these are that many requirements that were menu items in Stage 1 become core requirements in Stage 2. There also are several new requirements, especially dealing with patient and family engagement and care coordination:• Hospital labs send (directly or indirectly) structured electronic clinical lab results to outpatient providers for 40 percent or more of electronic orders received (note challenge to small hospitals; may require exclusions).• 30 percent of eligible provider visits have at least one electronic eligible provider note and 30 percent of hospital patient days have at least one electronic note; non-searchable, scanned notes do not qualify.• Hospital medication orders automatically tracked via electronic medication administration record (in use in at least one hospital ward/unit).• Hospitals: 10 percent of patients/families view and have ability to download information about a hospital admission. Information is available for all patients within 36 hours of the encounter.• Eligible providers: patients are offered secure messaging online and at least 25 patients have sent secure messages online.• Eligible providers: Patient preferences for communication medium recorded for 20 percent of patients.The committee also referred several Stage 2 objectives to the Health IT Standards Committee for recommendations on applicable standards. The Centers for Medicare & Medicaid Services has another year to consider adoption of Stage 1 and public comments before issuing a final rule for Stage 2.
