Optometrists transition from stage 1 to stage 2 meaningful use

ATLANTA – Many optometrists are concerned about meeting the requirements of stage 2 meaningful use, according to a speaker here at SECO.

Zachary McCarty, OD, said that most providers attested to stage 1 in 2014 but have not yet moved onto stage 2.

He said that 22,612 optometrists have become meaningful users, compared to 13,000 ophthalmologists, and nearly $275 million has been paid to ODs.

“If we are not meaningful users and did not attest for 2014, we now receive reduced payments from Medicare in 2015,” he added. He also noted the requirement to use electronic health record (EHR) technology that is certified.

McCarty detailed several core objectives of particular concern to optometrists.

“There’s a lot of contention with core objective 4, vital signs,” he said. “If you don’t think the measures of blood pressure, height, weight and BMI apply, you can claim an exemption, which a lot of ODs are doing. It’s hard to say blood pressure has no relevance to the eye. They haven’t said which specialties can or cannot claim exemptions.

“If you are checking these, in stage 2 you must check them in 80% of patients age 3 and up,” he added.

An audience member asked if the doctor must measure them or merely ask the patient, and McCarty said, “Right now, you can just ask the patient.”

Core objective 7 is another source of contention: patients viewing, downloading and transmitting their health information. Patients must be provided with the ability to sign up for the patient portal, and they can decline it.

“In stage 2, you still have to have 50% of patients with the ability to sign up, and you have 4 business days to make the information available,” McCarty said. “But part 2 of this is that more than 5% of all patients must actually log into the patient portal and view, download or transmit information and send their health information to a third party.

“This is one we’re all scared of,” he continued. “Practices must look at what they need to do to get patients to do this. It also works for the patient’s representative – an older patient’s son or daughter or caretaker can do it on behalf of the patient.”

Core objective 17, secure messaging, has a new requirement in stage 2: 5% of our patients must send us a secure message, McCarty said.

“It can be any message through the patient portal – they can be asking for your office hours – no specific message is required,” he added.

The final rules for stage 3 have not been written, McCarty said. Some possibilities include having EHRs record an advanced directive or unique device identifiers.

“They want patients to be able to make electronic amendments to their record,” McCarty continued. “We don’t know how this would work. They want to allow patients to submit patient-generated health data. Information from FitBits, home blood pressure monitoring. They want doctors to be able to query and locate applicable clinical trials from within the EHR.

“They’re talking about increasing the percentage for the view, download and transmit requirement so more people are going to the portals,” he added. – by Nancy Hemphill, ELS, FAAO

Disclosure: McCarty reports no relevant financial disclosures.