September 2012 Edition Vol.6, Issue 5

Oncology Practices Be Prepared! Meaningful Use Stage 2 Is Here! Well Almost

Oncology Practices Be Prepared! Meaningful Use Stage 2 Is Here! Well Almost

Oncology-specific EMR with Patient Portal & Meaningful Use Training Provide Attestation Answers

The Office of the National Coordinator (ONC) for Health IT and The Centers for Medicare & Medicaid Services (CMS) released final requirements for Stage 2 Electronic Health Records (EHR) Incentive programs on August 23. After a Stage 2 delay that originally was to begin in 2012, the Meaningful Use (MU) final rule is now complete and the Standards and Certification Criteria are available for oncology practices to compare attestation preparation.

Stage 2 attestation with a certified-as-complete EHR for meeting MU measurements begins in 2014. American Recovery and Reinvestment Act (ARRA) incentives continue and Medicare eligible professionals (EPs) who first demonstrated MU Stage 1 in 2011 or 2012 will continue with Stage 1 criteria attestation in 2013. Then, beginning Stage 2 attestation in 2014, gives EPs more time to meet Stage 2 criteria. EPs must attest to MU Stage 1 prior to attesting to Stage 2; here’s how to get started!

Oncologists Stage 1 Attestation—There’s Still Time!

Stage 1 Attestation Required Prior to Stage 2

Oncologists still have time to attest to Stage 1, which then entitles the oncologist to the full $44,000 available throughout the attestation stages as determined by CMS. “Engaging and teaching the staff was crucial to achieving meaningful use[1]”, said Mithi Govil, MD.

If an oncologist has not attested to Stage 1, October 3, 2012 is the last day for the EP to begin their 90-day reporting period to demonstrate MU for the Medicare EHR Incentive. To get the maximum incentive payment of $44,000, EPs must begin participation by 2012 and Stage 1 attestation is required prior to moving onto Stage 2. See below CMS table of Medicare provider timeline for MU stages and participation.

EPs successfully demonstrating MU in 2011 have three years of MU with Stage 1 criteria before the Stage 2 criteria requirements become effective in 2014.

“Lake Norman Oncology was the first oncology practice to attest to Stage 1 in April 2011 with the support of our EHR vendor we were able to complete the attestation process shortly after CMS opened its portal for submission of data[2]”, stated David Eagle, MD.

Oncologists initially attesting in 2012 to Stage 1 have two years of MU Stage 1 criteria before advancing to the Stage 2 criteria. Stage 2 attestation does not begin until 2014 and only then in 2014 is a 3-month EHR reporting period required.

Stage 2 Attestation Begins in 2014

90 day EHR Reporting Period

With the initiation of Stage 2, oncology practices received another big reason for deploying an oncology-specific EMR certified as a complete EHR for meeting MU measurements. As expected, successful attestation includes an increase use of a patient portal, physician communication, and demonstrated use of core measures within a certified EMR.

For 2014 only, whether the EP is attesting to Stage 1 in 2014 or is eligible for Stage 2 attestation, the EP is only required to demonstrate MU for a 3-month EHR reporting period. If the EP is a Medicare provider, the 3-month reporting period is fixed to the quarter of either the fiscal year of the eligible hospital or critical access hospital (CAH) or the calendar year for the EP. Stage 2 has new core measurements and menu set aspects as well as incorporates a higher threshold of Stage 1 objectives. 

Stage 2 – What’s New? Core & Menu Set Items[3]

Includes Some Stage 1 Objectives

Many of Stage 1 objectives are now Stage 2 criteria core objectives with a higher threshold required to meet MU. There are some new objectives in Stage 2 with most of these being menu objectives. In Stage 2, the EP is to meet 17 core objectives and 3 menu objectives. The EP may select from a total of 20 core objectives.

The new Stage 2 objectives include:

  1. Use secure electronic messaging to communicate with patients on relevant health information.
  2. Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP.
  3. Emphasis on health information exchange between providers to improve care coordination for patients. One of the core objectives requires providers who transition or refer a patient to another setting of care or provider of care to provide a summary of care record for more than 50% of those transitions of care and referrals. Additionally, there are new requirements for the electronic exchange of summary of care documents: for more than 10% of transitions and referrals of the patient to another setting of care or provider of care must provide a summary of care record electronically.

The new Stage 2 menu objectives include:

  1. Record electronic notes in patient records
  2. Imaging results accessible through certified EHR technology (CEHRT)
  3. Record patient family health history
  4. Identify and report cancer cases to a state cancer registry (for EPs only)
  5. Identify and report specific cases to a specialized registry (other than a cancer registry)

All of the above are new Stage 2 objectives; however there are 17 core objectives, and EPs can choose three menu objectives from a choice of six.


[1] Mithi Govil, Carla Wood, and Thomas R. Barr. “Achieving Meaningful Use and Operational Efficiency.” Presented at the Cancer Center Business Summit, Chicago, October 13-14, 2011.

[2] David Eagle, MD, Thomas R. Barr, MBA. Achieving Meaningful Use of Electronic Health Records for the Oncologist. ONCOLOGY. Vol. 25 No. 8 July 11, 2011.

[3] Stage 2, Centers for Medicare and Medicaid Services,

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