All EHRs certified by ONC for the Meaningful Use program for 2014 must be able to integrate with Direct, and Direct supports the MU requirements for providers below. Meaningful Use also aligns with requirements for the Patient-Centered Medical Home and Accountable Care Organizations, the California Pay-for-Performance program, and other payer incentives.
Patient Access to Information
- Stage 1 and 2: Eligible Professionals must provide at least 50% of their patients seen during the 90-day Meaningful Use reporting period with electronic access to their health information within four days of the information becoming available to the provider.
- Stage 2: At least five percent of patients must access the data shared with them.
- Stage 2: Eligible professionals must use secure messaging to communicate with at least 5% of unique patients seen during the reporting period.
- Stage 2: For at least 10% of patients seen during the reporting period, identify patient-specific education resources and provide those resources to the patient. This becomes a core measure with Stage 2.
- Direct impact: Direct can be used to transmit messages securely from a certified EHR to a patient-owned Personal Health Record (PHR) such as HealthVault or to a provider-owned portal such as NoMoreClipboard. Promoting a PHR to patients and using Direct to send them information is a low-cost way to satisfy this requirement, in contrast to the fees EHR vendors may charge for a portal service.
Read more about PHRs and patient engagement.
Transitions of Care
- Stage 2: The transitions of care requirement increases significantly in Stage 2. Eligible professionals must provide a summary of care record for 50% of transfers and referrals, with 10% provided electronically. In addition, providers must submit at least one summary of care record electronically to a provider with a different EHR system, or to a CMS test EHR.
- Direct impact: ONC requires that EHRs certified for 2014 must be able to send summary of care records electronically using Direct. CMS requires that providers send 10% of summary of care records electronically using either Direct or one of two other transport methods (SOAP or NwHIN), but these other two are not required for EHR certification and so the expectation is that Direct will be used by the vast majority of providers to meet this requirement.
Public Health Reporting – Immunizations
- Stage 1 and 2: For providers in the regions served by the California Immunization Registry (CAIR), improvements to CAIR’s ability to receive Meaningful Use-compliant immunization reports mean that providers now must follow new CAIR guidelines for electronic submission.
- Stage 2: Ongoing submission of immunization data for the entire reporting period.
- Direct impact: CAIR encourages providers to submit immunization reports to approved “hubs,” which then transmit results to CAIR using the required SOAP standards. Some hubs, such as Axesson and other service providers and HIOs, can receive data via interfaces or Direct, and use SOAP to submit it to CAIR. Providers using such a service do not need to install SOAP onto their EHR (note that it is not offered as part of California Direct, but is an add-on service from Axesson). Some county health departments are considering offering similar translation services.
Please visit Resources to find links about meeting Meaningful Use Requirements.