Members of the Health IT Policy Committee approved a set of recommendations Tuesday that will bring meaningful use Stage 3 requirements one step closer to federal approval and scale back the initial Stage 3 proposals by 33 percent. 

Leaving 19 measures as part of the proposal, the recommendations, presented as a Stage 3 matrix developed by the meaningful use workgroup, will be sent on to Kathleen Sebelius, secretary of Health and Human Services for consideration in developing the final Stage 3 MU requirements. More public hearings and a notice of proposed rulemaking to inform HHS’s final requirements are expected to follow in 2015.

The Stage 3 requirements approved Tuesday reflect an effort to eliminate some of the measures and bring more focus to the measures that remain, said Paul Tang, chair of the meaningful use workgroup. His workgroup was charged with focusing on four areas of emphasis: clinical decision support; patient engagement; care coordination: and population management. The workgroup also tried to weigh the impact measures would have on provider workflow, in addition to avoiding requirements were standards are not yet mature, Tang said.

[See also: Stage 3 MU must tackle care disparities.]

The 19 objectives included in the recommendations are:
Under improving quality:
Clinical decision support
Order tracking
Demographics and patient information
Care planning—advance directive
Electronic notes
Hospital labs
Unique device identifiers

Under patients and families in care:
View, download and transmit
Patient generated health data
Secure messaging
Visit summary and clinical summary
Patient education

Under improving care coordination:
Summary of care at transitions
Notifications
Medication reconciliation

Under improving population and public health:
Immunization history
Registries
Electronic lab reporting
Syndromic surveillance

The panel approved the recommendations by a vote of 13 to 3, though some of the panelists who approved the recommendations did so only if a letter expressing their various concerns could also be included with the recommendations as they go to HHS.

[See also: Stage 3 MU now in the making.]

Karen DeSalvo, national coordinator for health Information technology urged approval of the recommendations.

“Meaningful use is one of the many tools that we have been given through HITECH and that we have an opportunity to use to advance the use of health information technology to improve care, lower costs and improve health and create a learning system for our country,” she said. “Let’s keep that in mind.”

Meaningful use Stage 3 is “a chapter,” but “not the last chapter,” in moving the country forward, DeSalvo said. She encouraged the group’s approval of the recommendations to give federal regulators a framework to begin the work of forming the final regulations.

By approving the recommendations, the panel would also allow vendors and providers the opportunity to see what might be included in the final requirements with as much time as possible to prepare –acknowledging that by no means are these the final recommendations.

Some members of the group expressed concern that the recommendations, if approved Tuesday, would be premature. They would not include analysis of how providers managed with Stage 2, which was intended to inform Stage 3 recommendations.

DeSalvo said approval of the recommendations would not keep regulators from adding discoveries about Stage 2 into the mix later.