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Stage 2 meaningful use criteria already in the crosshairs

Stage 1 meaningful use requirements aren’t yet finalized, but policymakers and industry stakeholders are already turning their eyes to what might be coming down the pike for Stage 2.

By 2012, providers will have to begin implementing Stage 2 requirements, whatever they might be. The Centers for Medicare and Medicaid Services, tasked with rolling out meaningful use under the HITECH Act, is now at work on crafting a final rule for Stage 1 criteria – set to go in effect in 2011 – and plans to publish two more proposed rules governing stages 2 and 3.

Recommendations being drafted now by a federal work group would ensure providers and vendors focus more on patient safety reporting in the Stage 2 meaningful use requirements. The certification and adoption work group of the Health IT Policy Committee met this week to discuss its suggestions, which it plans to present to the full policy committee at an April 21 meeting.

One idea the work group is floating is to create a national patient information reporting system that could collect and analyze data on errors, adverse events and “near misses” – a situation in which a patient might have been harmed, but the error was caught – during medical care. By analyzing that information, researchers can see where systems break down and help providers make improvements to their operations and deliver safer care, officials say.

Such patient information systems already exist, in the form of Patient Safety Organizations (PSOs). The creation of PSOs was mandated through the Patient Safety and Quality Improvement Act of 2005, and the first PSOs were designated in 2008. The Agency for Healthcare Research and Quality (AHRQ) oversees the program, which is not mandatory for hospitals and doctors to participate in. Doctors and hospitals also already have been accustomed to reporting some information about errors and other population health issues to state agencies and organizations like the Joint Commission, but all the systems largely collect information in different ways.

The AHRQ is developing common formats to make reporting information more seamless for providers, according to William Munier, a physician who is director of the agency’s Center for Quality Improvement and Patient Safety. PSOs are currently designed to accept submissions in paper form, but eventually reporting systems will have to be populated by electronic health records so that data analysis can be accomplished easily.

The certification and adoption work group initially considered suggesting that the PSO program become the national reporting system. But in its final recommendations it will likely instead say that the Office of the National Coordinator for Health IT should conduct a formal study regarding the relationship between patient safety and technology, and develop actions from that analysis.

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