Will MU Stage 3 Do a Better Job of Addressing Specialists' Needs?

Societies of several medical specialties have long argued that the Meaningful Use program should be restructured to better fit their needs.

As it begins work on Stage 3 of Meaningful Use, the Health IT Policy Committee continues to struggle with how to make the requirements more “meaningful” to medical specialists and how to engage more of them in health information exchange. To that end, the Meaningful Use Workgroup has created a subcommittee to look at how Stage 3 might better address specialists’ needs. That group held its first meeting Oct. 18.

Led by Michael Barr, M.D., senior vice president in the Division of Medical Practice, Professionalism & Quality of the American College of Physicians, the team is setting out to address both hospital-based physicians such as pathologists who may use laboratory information systems but not necessarily certified electronic health records, as well as the concerns of other specialists such as ophthalmologists that the measures in Stage 1 (and Stage 2) are too primary-care focused and have little relevance to their day-to-day practices.

“One question would be is there a way to have pathologists and radiologists continue to use their current technology and take part in meaningful use?” Barr said. “Could there be other type of expectations for noncertified systems, such as exchanging patient reports as structured documents or contributing data to a disease-specific registry?”

(Some vendors of radiology information systems are adding ambulatory features that radiologists don’t really use just so they can get certified for meaningful use, noted a representative of the American College of Radiologists calling in to the hearing. If the requirements were more flexible, he added, vendors wouldn’t feel the need to add features physicians don’t use.)

Another challenge is identifying clinical quality measures that are both relevant to specialists and that can be e-specified. The Office of the National Coordinator has several contracts with outside organizations to identify such measures for specialties such as behavioral health and pediatrics for inclusion in Stage 2.

Committee member Eva Powell, director of health information technology programs at the National Partnership for Women & Families, noted that specialists’ needs must be factored in as Stage 3 offers greater specificity about care coordination and communication. “Every specialist should have a role,” she said. ONC’s job is to figure out how to get more of them to participate.

The subcommittee plans to meet again and get feedback from specialists before making recommendations to the Meaningful Use Workgroup.