The Menu Set Options Not Chosen

Hospitals and eligible professionals are attesting to Meaningful Use at an accelerating rate.    To me, the Stage 1 Menu Set options NOT CHOSEN are the most valuable predictor of the challenging areas in Stage 2, since all the Stage 1 Menu Set items become Core in Stage 2.

At the January HIT Policy Committee, CMS presented an overview of Menu Set items deferred.  Interestingly, the items deferred in Stage 1 are those most likely  required for successful Accountable Care Organizations and interoperability.

The top items hospitals deferred are:  Summary of care at transitions (93% deferred), medication reconciliation (75%), and provide educational resources to patients (62%).

The top items Eligible Professionals deferred are:  Summary of care at transitions (85% deferred), patient reminders sent via patient preference (77%), medication reconciliation (56%), provide timely electronic access to data via PHR (62%), and provide educational resources (49%).

Submitting reportable lab results and syndromic surveillance for Public Health were largely deferred as well.

Since Meaningful Use Stage 2 has a first attestation date of October 1, 2014 with a one year reporting period,  EHR vendors must support these functions via certified systems and clinicians should be using these capabilities by October 1, 2013.

Given that the Stage 2 NPRM will be finalized by August, and you'll have one year to fully implement all this functionality, I suggest working now on these Menu Set options not chosen:

1.  Work with your EHR vendor to create a summary of care document (C32 for now, Consolidated CDA in 2013) and partner with your state HIE or other vendor to send these summaries to stakeholders such as primary care providers.

2.  Work with e-prescribing networks and your EHR vendor to implement medication reconciliation that leverages outpatient prescription records available from national databases.

3.  Work with your EHR vendor and third party knowledge services companies to make patient educational materials available in appropriate languages for your population.

4.  Work with your local or state public health department to implement immunization, reportable lab, and syndromic surveilance transactions

5.  Work with your EHR vendor to implement patient portals tethered to your EHR or transmission of summary data to non-tethered patient portals such as Microsoft Healthvault.

Robert Frost took the road less traveled and it made all the difference.  In 2012, focus on the Menu Set Options Not Chosen and it will make all the difference in your preparations for Stage 2.