Dr. David Blumenthal, the national health IT coordinator, sent a strong signal to healthcare providers and vendors to expect that more complex requirements for health information exchange and clinical decision support tools will be among forthcoming requirements for the next stage of meaningful use.
The Office of the National Coordinator for Health IT is now beginning to do "early reconnaissance" around development of stage 2 meaningful use requirements, according to Blumenthal.
"We know there were a set of unfinished tasks, things we passed over in the effort to get the first stage of meaningful use out the door," he said at an industry event Sept. 21 about states which are leading in electronic prescribing and where he took the opportunity to communicate some future plans.
The provider and vendor community "should look forward to a much more robust set of requirements around health information exchange, an exchange that consciously ignores economic relationships, geographic relationships and political jurisdictions.
"We want information to follow patients," Blumenthal said.
Also, he anticipates a bigger push in stage two for clinical decision support, which stage one only hinted at. "I can tell you as a user of an electronic heath records that I value the information that it has made possible, knowing that I could find old radiological reports without scrambling through a folder."
"Even more, I value the way clinical decision support made me a better doctor, the way you can make decisions better and more scientific and more consistent with the patients' needs," he added.
Blumenthal delivered his remarks at an event acknowledging the 10 top states in which physicians are using e-prescribing. Massachusetts led the states, followed by Michigan and Rhode Island, according to health IT firm Surescripts, which conducted a nationwide survey on e-prescribing.
Physicians and other health professionals in Massachusetts sent more than 11 million prescriptions electronically in 2009, representing 32.3 percent of all prescriptions in the state, according to Surescripts, which sponsored the event.
The other states in the Surescripts top 10 were Delaware, North Carolina, Connecticut, Pennsylvania, Hawaii, Indiana and Florida. E-prescribing use is growing substantially across all states in the U.S. In 2009, 47 states more than doubled their use of prescription routing while 39 more than doubled their use of prescription benefit information, according to the findings.
More than 200,000 providers now use e-prescribing, according to Surescripts. But Blumenthal highlighted the fact that the number represented just one third of all physicians. "A lot has been done but an enormous amount remains to be done," he said.
Electronic prescribing can be a gateway for many health care providers to get started on the path to meaningful use by introducing physicians to electronic transactions, he said.
Although e-prescribing is just part of the larger activities of using EHRs for meaningful use, "I think once physicians get used to using the computer to e-prescribe, they may be a little more comfortable moving to the full electronic health record," Blumenthal said.
Prescribing medications electronically helps physicians accomplish four measures required in stage one of meaningful use criteria: to maintain a medication list, route prescriptions electronically, check patients' drug benefits and reconcile medications among care settings, he said.
