Policy Committee Drills Down on Stage 2 Data

March 10, 2015
As they await the release of the Stage 3 proposed rule, Health IT Policy Committee members studied Stage 2 hospital reporting details that included care transitions, patient engagement, patient safety and public health.

Hospitals that have attested to Stage 2 of meaningful use report that, on average, 15 percent of their patients viewed, downloaded, or transmitted their electronic health information at least once. That was just one data point Health IT Policy Committee members heard during a March 10 drill-down into Stage 2 hospital reporting details that included care transitions, patient engagement, patient safety and public health.

Care Transitions

On average, Stage 2 hospitals are sending electronic summaries of care for 36 percent of all transitions, said Dawn Heisey-Grove, an analyst with the Office of the National Coordinator for Health IT. She noted that critical access hospitals reported the highest summary-of-care rates, at 44 percent, compared to 32 percent for large hospitals, but she said ONC does not have data to explain the difference.

Patient Engagement

On average, 15 percent of Stage 2 hospitals’ patients viewed, downloaded, or transmitted (VDT) their electronic health information at least once, Heisey-Grove reported. She said the longer hospitals have been meaningful users, the better their performance on this measure. Hospitals that have been meaningful users since 2011 have the highest average rates (18 percent).

Even during 2014, there was movement on this measure. With an average of 17 percent, hospitals that attested in November had the highest rates of patients viewing, downloading, or transmitting their electronic health information at least once. Those attesting in April and May had much lower rates of patients VDT compared to November, she said.

Patient Safety

On average, 70 percent of medications administered in Stage 2 hospitals had all doses tracked through an electronic medication administration record (eMAR). Medium-size hospitals and hospitals that first attested to meaningful use in 2011 reported the highest average eMAR tracking rates.

• The e-prescribing upon discharge measure is an optional measure in Stage 2. On average, hospitals that selected this measure used e-prescribing for 56 percent of all permissible discharge medications.  Of the hospitals that selected the measure, critical access hospitals and other small hospitals reported the highest average discharge e-prescribing rates at 64 percent, Heisey-Grove said. Medium-size hospitals had the lowest average discharge e-prescribing rates at 48 percent.

Public Health

Three public health measures that were optional for Stage 1 are required reporting for Stage 2. Seven in 10 Stage 2 hospitals reported, without exclusion, on all three public health measures. Even 5 percent of Stage 1 hospitals reported, without exclusion, on all three public health measures.

Heisey-Grove said these figures illustrate that most public health agencies and hospitals have the capability to exchange data for immunization reporting, electronic lab reporting and syndromic surveillance.

ONC also just released a data brief showing that of Stage 2 hospitals, 88 percent were electronically reporting to immunization registries, 85 percent were electronically submitting lab results, and 75 percent successfully reported the syndromic surveillance measure.

Committee members seemed impressed by the presentation. The numbers “tell a very positive story about quality benefits of EHR incentive program,” said David Bates, M.D., senior vice president and chief innovation officer for Brigham and Women’s Health.

Paul Tang, M.D., vice chair of the committee, said the data shows the transformative nature of the program. “We have gone from zero to sixty in provider settings,” he said. As the next presentation at the meeting was to focus on big data, Tang reminded the committee that there wouldn’t be any big data without the widespread adoption of EHRs fostered by the meaningful use program.

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