The proposed rules for Meaningful Use Stage 2 impact the standards that are used for data exchange and the required utilization of interoperabilityInteroperability refers to the ability of two or more systems or components to exchange information ... More by providers. Some of the areas that are most impacted by the proposed rules include:

  • Patient Summary
  • Clinical Messages
  • Electronic Prescribing
  • Transport Specifications

Patient Summary

Meaningful Use Stage 1: HL7HL7 is a Standards Developing Organization accredited by the American National Standards Institute (... More CCDContinuity of Care Document (CCD) The HL7 CCD is the result of a collaborative effort between the He... More (C32), or CCRContinuity of Care Record (CCR) is an XML-based standard for the movement of “documents” between... More

Meaningful Use Stage 2: Consolidated CDAClinical Document Architecture (CDA) HL7 CDA uses XML for encoding of the documents and breaks down ... More

Consolidated CDA is the new document standard for Stage 2 Meaningful Use. CCRContinuity of Care Record (CCR) is an XML-based standard for the movement of “documents” between... More and CCDContinuity of Care Document (CCD) The HL7 CCD is the result of a collaborative effort between the He... More (the C32 version) are no longer included in the ruling. Consolidated CDAClinical Document Architecture (CDA) HL7 CDA uses XML for encoding of the documents and breaks down ... More was chosen as the new standard because there is now one single implementation guide for CDAClinical Document Architecture (CDA) HL7 CDA uses XML for encoding of the documents and breaks down ... More, and all of the template constraints are now located in one place. This makes it much easier for implementers and providers to analyze and understand the standard.

The CDAClinical Document Architecture (CDA) HL7 CDA uses XML for encoding of the documents and breaks down ... More schema itself does not change, so this repackaging of the standard does not impact the ability of an existing application to parse, route, or map a document. When the final rule is released, it is likely that the content of the Care Summary for Consolidated CDAClinical Document Architecture (CDA) HL7 CDA uses XML for encoding of the documents and breaks down ... More will be very similar to the existing CCDContinuity of Care Document (CCD) The HL7 CCD is the result of a collaborative effort between the He... More.

The hurdle for providers to demonstrate the electronic transfer of Patient Summaries has also increased. When a provider transitions their patient to another setting of care, they must electronically transmit a summary of care record to an unaffiliated organization that uses a different Certified EHRElectronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The ... More Technology vendor for at least 10 percent of all transitions of care and referrals. In comparison, Stage 1 only required one test to verify that this functionality was possible.

Clinical Messages

Meaningful Use Stage 1: HL7HL7 is a Standards Developing Organization accredited by the American National Standards Institute (... More 2.3.1 and 2.5.1

Meaningful Use Stage 2: HL7HL7 is a Standards Developing Organization accredited by the American National Standards Institute (... More 2.5.1 only

Many criteria that allowed for either HL7HL7 is a Standards Developing Organization accredited by the American National Standards Institute (... More v2.3.1 or HL7HL7 is a Standards Developing Organization accredited by the American National Standards Institute (... More v2.5.1 messaging in Stage 1 will now only allow HL7HL7 is a Standards Developing Organization accredited by the American National Standards Institute (... More v2.5.1 messaging, including:

  • Electronic submission of lab results to Public Health agencies.
  • Electronic submission for surveillance reporting to Public Health agencies.
  • Electronic submission to immunization registries.
  • Electronic incorporation and transmission of lab results.

And for the first time, a standard for images was called out in the Meaningful Use criteria. In Stage 2 images must be transferred using DICOMDigital Imaging and Communications in Medicine (DICOM) is a common format for image storage. It allo... More PS3 – 2011.

Electronic Prescribing

Meaningful Use Stage 1: NCPDPThe National Council for Prescription Drug Programs (NCPDP) creates and promotes the transfer of dat... More 8.1 and 10.6

Meaningful Use Stage 2: NCPDPThe National Council for Prescription Drug Programs (NCPDP) creates and promotes the transfer of dat... More 10.6 only

For electronic prescribing, only NCPDPThe National Council for Prescription Drug Programs (NCPDP) creates and promotes the transfer of dat... More 10.6 will be allowed for Meaningful Use Stage 2.

Transport Specifications

Meaningful Use Stage 2: Direct ProjectThe Direct Project was launched by the ONC within Health and Human Services (HHS) on March 1, 2010. ... More (Push type)

Meaningful Use Stage 2: NwHIN Specifications (Query type)

The Direct ProjectThe Direct Project was launched by the ONC within Health and Human Services (HHS) on March 1, 2010. ... More was initiated to allow for a low-level entry for secure health transport. These specifications are known as push-based, meaning that the patient health data must be pushed-to the next provider. The initiating provider must know the address of the provider needing the data to make the push.

There are two distinct transport types defined by the Direct ProjectThe Direct Project was launched by the ONC within Health and Human Services (HHS) on March 1, 2010. ... More: Point-to-point web servicesWeb services are a standardized way of integrating applications. Using open standards, businesses ca... More, based on the XDRCross-enterprise Document Reliable Interchange (XDR) – What it’s used for: The exchange of healt... More IHEIntegrating the Healthcare Enterprise (IHE) is an initiative by healthcare professionals and industr... More profile; and secure e-mail, based on the XDMCross-enterprise Document Media Interchange (XDM) – What itss used for: According to IHE, XDM tran... More IHEIntegrating the Healthcare Enterprise (IHE) is an initiative by healthcare professionals and industr... More profile.

The NwHIN Exchange specifications are established to foster the transfer of patient health data on a national scale. These specifications are known as query-based, meaning that patient health data is requested from another provider. This transport is centered on SOAP-Based secure web servicesWeb services are a standardized way of integrating applications. Using open standards, businesses ca... More. The standard utilizes IHEIntegrating the Healthcare Enterprise (IHE) is an initiative by healthcare professionals and industr... More Cross Community profiles along with OASIS standards for privacy and security.

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