The latest electronic health records guidelines are now out, with priorities of making the technologies work together and finding ways to get patients and their doctors to use the technology more.

Welcome to stage 2 of the “Meaningful Use” program intended to encourage physicians to implement and use EHR systems in their practices. The stage 2 guidelines were widely expected to be released during the HIMSS2012 conference. The Centers for Medicare & Medicaid Services filed the 455 page document on the Federal Register as a proposed rule-making Thursday evening; the public has 60 days to comment for tweaks or adjustments. But any changes are expected to be minor. By now, EHR vendors are familiar with the meaningful use guidelines and the latest version is intended to build on the stage 1 platform.

Stage 1 defined the kinds of meaningful uses of technology that qualify for federal incentives. Physicians can be awarded up to $44,000 per practice for participating in the Medicare incentives program; up to $63,750 for practices participating in the Medicaid program. While the latest guidelines are open for comment, stage 1 guidelines remain in effect. Stage 2 guidelines won’t take effect until 2014 to give vendors enough time to make any necessary software adjustments.

Abhi Muthiyan, cofounder and chief technology officer of Cary-based EHR provider Patagonia Health, said the stage 2 guidelines put an emphasis on interoperability of EHR technologies.

That means that if a person in North Carolina needs to see a doctor while on a California trip, the California doctor will be able to pull up the North Carolina records by connecting through Health Information Exchanges, or HIEs, to share patient health data. EHR vendors will be required to connect to the HIEs and they’ll also have to support direct messaging to allow doctors to communicate. These capabilities must be supported even if physicians are using different EHR systems.

Patient engagement is also emphasized in stage 2, Muthiyan said. A patient who wishes to discuss test results with his or her family can easily pull up test results and other documentation electronically from home. Under the guidelines, 50 percent of patients must have access to their records within four business days of their medical visit. Under stage 2, more e-prescription and lab results will be electronic. Physicians’ notes will also have to be electronic, which was not a stage 1 requirement. Digitizing patient records was step 1, Muthiyan said. Now, connecting them together and making them available will provide a larger opportunity to improve outcomes and reduce healthcare costs. Muthiyan says he expects stage 2′s introduction will come easier than stage 1.

“It’s too early to tell, but it should be smoother because we’re already familiar with the processes,” he said.

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