Software Solutions/EHR

Adapt Your Practice to Meet Stage 2 Meaningful Use Goals

By Brett M. Paepke, OD


Meeting Stage 2 Meaningful Use requirements requires changes to your practice operations. Take it step by step.


REVIEW STAGE 1& 2 OBJECTIVES. Stage 1 involves successfully meeting measures for 14 core and 5 menu objectives. Stage 2 differs with 17 required core objectives (representing mainly a blend of a number of Stage 1 core and menu objectives) plus the choice of 3 of 6 menu objectives. Click HERE for more information.

PROMOTE PATIENT ENGAGEMENT. Offer an online, secure patient portal where patients can access their health information.

ENABLE SECURE ELECTRONIC MESSAGING. Your practice needs the ability to send and receive secure electronic messages.

Like many practices, mine is in the process of adapting to Stage 2 Meaningful Use requirements from the federal government’s electronic records incentive program.

Here is a brief summary of Stage 1 objectives and what is needed to meet Stage 2 objectives, followed by a description of how we’re meeting this challenge in two key areas in my practice, and how we are attempting to reduce associated costs.

In 2014, Stage 1 involves successfully meeting measures for 14 core and 5 menu objectives. Stage 2 differs with 17 required core objectives (representing mainly a blend of a number of Stage 1 core and menu objectives) plus the choice of three of six menu objectives.

The key changes for an OD moving to Stage 2 are recognizing that the measures are statistically more challenging and that patient engagement will need to promoted and encouraged. Stage 2 will be the first time that eligible professionals (EPs) will actually be “graded” on the actions of their patients.

Stage 2 measures need to be met in the EP’s third year of Meaningful Use. 2014 represents a unique year in that all EPs, regardless of stage, will not need to demonstrate MU for a full 365-day period. EPs starting Stage 1 in 2014 will choose any 90-day period; Second year Stage 1 and EP’s in Stage 2 will need their MU period to correspond to a calendar quarter.

Promote Patient Engagement

An example of how patient engagement will need to be promoted in Stage 2 is the “Record Demographics” requirement that mandates the provider record date of birth, gender, preferred language, ethnicity and race. Stage 1 required 50 percent of unique patients to have this data recorded, while Stage 2 requires 80 percent.

Patient engagement and involvement in their health care is a fundamental goal of Meaningful Use. Stage 2 requires:

• 50 percent of patients be given online access to their health information within four business days of being seen
• 5 percent of patients need to use that access to view, download or transmit their health information
• 5 percent will need to send a secure message to the provider.

We have altered our intake process to include a simple question: “Is there an e-mail address that we can utilize to give you access to our patient portal?” More than 50 percent of the time, that one question results in us getting the information we need to meet the first of the measures mentioned above. Often, that question is met with “What’s that?” or “What’s a patient portal?” After tinkering with our answers, we’ve found the most warmly received explanation is: “Our patient portal, available online through our practice web site, allows you to securely communicate back and forth with your doctor.” We have a form that we give to patients explaining the benefits of the portal, as well as an orientation page on our web site which includes an instructional video.

Enable Patients to Use Secure Electronic Messaging

Further plans to increase patient engagement will be for our practice to send secure messages to patients as a means of providing a “progress check.” Our EHR, RevolutionEHR, allows us to send a secure message to the patient’s portal while simultaneously notifying him/her via regular e-mail that they have a message from their eye doctor waiting. After logging into the portal, the patient can then respond directly to our message just as they would to any other e-mail, which results in us getting Stage 2 MU credit.

Five percent of the patients seen during the Stage 2 reporting period need to send a secure electronic message to the practice. These messages do not need to be initiated by the patient. For example, if the patient was seen for a red eye and therapy was initiated, a secure message could be sent to the patient’s portal later in the day asking for a progress update.

Adapt to Demands on Staff Time and Resulting Revenue Losses

We have re-arranged our schedule by cutting out an appointment every Friday morning to allow for full-staff education/meetings. These are held weekly, so we can hit the ground running on April 1. While that cost will vary based on the practice and practitioner, we know that sacrificed appointment time for us would typically generate $250-$300. Thus, over a 12-week period, we’re looking at an investment of between $3,000 and $3,600. Early appointments on Friday are the lower revenue generators in our practice, so we chose that time for our education and planning in an effort to limit cost.

Related ROB Articles

Meaningful Use Stage 2: Action Points to Ready Your Practice

The ROB Electronic Records Resource

EHR: Essential Chronic Condition Management Tool

Brett M. Paepke, OD, practices with his father, Charles Paepke, OD, of FirstView Eye Care Associates in Plattsburgh, NY. He also serves as an advisor for Stage 1 Meaningful Use with RevolutionEHR. To contact him:

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