Stage 1 Changes in 2013 and What’s Coming in 2014

In this month’s post, we take a look at Stage 1 changes that took effect this year and what’s to come next year. 

As the end of 2013 draws near, we examine Stage 1 changes that went into effect, those that were optional, and those that will take effect in 2014. It is important to familiarize yourself as you prepare to begin, or continue, participation in the program next year.

Removed in 2013

  • Electronic Exchange of Key Clinical Information: This objective was removed for Stage 1 for EPs, EHs, and CAHs.

Required in 2013

  • Public Health Reporting Objectives: Clarification that providers must perform at least one test of their CEHRT’s capability to send data to public health agencies, except where prohibited.

Optional in 2013+

  • Computerized Physician Order Entry (CPOE): Alternative measure added based on the total number of medication orders created during the EHR reporting period (option to choose the alternative measure in 2013 and beyond).
  • ePrescribing: Additional exclusion to the objective for electronic prescribing for providers who are not within a 10 mile radius of a pharmacy that accepts electronic prescriptions (optional to select the additional exclusion starting in 2013 and beyond).

Required in 2014

  • Public Health Reporting Objectives: Clarification that providers must perform at least one test of their CEHRT’s capability to send data to public health agencies, except where prohibited.
  • Electronic Copy of and Electronic Access to Health Information: In order to better align Stage 1 objectives with the new 2014 capabilities of CEHRT, CMS is replacing several Stage 1 objectives for providing electronic copies of and electronic access to health information with objectives to provide patients the ability to view, download, or transmit their health information or hospital admission information online. The capability to provide patients online access to this information will be a part of CEHRT beginning in 2014, therefore new Stage 1 objectives will be required beginning in 2014.
  • Record and Chart Changes in Vital Signs: Increase in age limit for recording blood pressure in patients to age 3; removal of age limit requirement for height and weight (optional in 2013; required in 2014+)
  • Menu Objective Exclusions: Beginning in 2014, eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) will no longer be permitted to count an exclusion toward the minimum of 5 menu objectives on which they must report if there are other menu objectives which they can select. EPs, EHs, and CAHs will not be penalized for selecting a menu objective and claiming the exclusion if they would also qualify for the exclusions for all the remaining menu objectives.

In addition to the updates above, beginning this year, the Stage 1 objective requiring clinical quality measure (CQM) reporting has been incorporated directly into the definition of a meaningful EHR user.

For more information, visit the CMS EHR Incentive Programs website.

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