September 2012 Edition Vol.11, Issue 9

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

Stage 2 Core & Menu Objectives

17 Core Objectives Requirements & Choice of 3 Menu Objectives Reporting

  1. Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders
  2. Generate and transmit permissible prescriptions electronically (eRx)
  3. Record demographic information
  4. Record and chart changes in vital signs
  5. Record smoking status for patients 13 years old or older
  6. Use clinical decision support to improve performance on high-priority health conditions
  7. Provide patients the ability to view online, download and transmit their health information
  8. Provide clinical summaries for patients for each office visit
  9. Protect electronic health information created or maintained by the CEHRT
  10. Incorporate clinical lab-test results into CEHRT
  11. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach
  12. Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care
  13. Use CEHRT to identify patient-specific education resources
  14. Perform medication reconciliation
  15. Provide summary of care record for each transition of care or referral
  16. Submit electronic data to immunization registries
  17. Use secure electronic messaging to communicate with patients on relevant health information

Choose 3 of 6 Menu Objectives:

  1. Submit electronic syndromic surveillance data to public health agencies
  2. Record electronic notes in patient records
  3. Imaging results accessible through CEHRT
  4. Record patient family health history
  5. Identify and report cancer cases to a State cancer registry
  6. Identify and report specific cases to a specialized registry (other than a cancer registry)

Stage 2 & Patient Use Expectations & CQM

Higher Patient Use of Technology & Quality Measures Electronic Submission

Stage 2 measures also include Patient Access Objectives to use health information technology (HIT). EPs are expected to encourage patient use of HIT with the goal to further the patient’s own healthcare. Core objectives include providing patients the ability to view online, download and transmit their health information with more than 5% of patients seen by the EP and use secure electronic messaging to communicate with patients on relevant health information. The secure message must be sent using the electronic messaging function of the certified EHR by more than 5% of unique patients seen by the EP during the EHR reporting period, according to CMS.

All providers are required to report on clinical quality measures (CQMs) in order to demonstrate meaningful use. Beginning in 2014, all providers regardless of their stage of MU use will report on CQMs in the same way and the EP is required to report on 9 out of 64 total CQMs.

CQMs are to be selected from at least three of the six key health care policy domains recommended by the Department of HHS National Quality Strategy:

  1. Patient and Family Engagement
  2. Patient Safety
  3. Care Coordination
  4. Population and Public Health
  5. Efficient Use of Healthcare Resources
  6. Clinical Processes/Effectiveness

In 2014, all Medicare-eligible providers beyond their first year of demonstrating MU must electronically report their CQM data to CMS. What’s available to oncologists to aid their information, education, transition, and support of HIT use?

Is HIT A Long Road for Oncologists to Adopt EMR Technology?

EHR MU Education & Use Available Information

Using a certified-as-complete EHR for meeting MU in 2011 was immensely successful in aiding physicians to adopt and use EMR technology.  In September 2012, CMS[4] reports a total of $6.9 billion in incentives paid out to EPs and hospitals for successfully attesting to MU with their certified EHR. And available certified-as-complete EHRs are well-known and established in the oncology market. An oncology-specific EMR was first initiated in 1993[5] and in the past two decades, both web-based and client server oncology-specific EMR technology were developed. Physician adoption escalated with EMR web-based technology that incorporated ePrescribing, patient portal, and Meaningful Use training inclusion without additional costs and that avoided server costs and additional onsite or outsourced technology resources.

In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted as part the ARRA of 2009. The final rule for ARRA/HITECH MU incentives for Stage 1 was released July 2010. EMR developers were required to achieve certification as a complete EHR for meeting MU measurements[6] in order for EPs to successfully attest to MU.  

There’s worthwhile news in the support to practices[7] to further assist oncology practices with understanding MU and attestation. CMS initiated a Listserv for program information that also includes attestation registration, updates, and the payment process specifics[8] and well as CMS provides several tipsheets[9] on an overview of Stage 2 and 2014 CQM as readily available.

ARRA incentive payments will be provided to EPs for achieving MU for several years to come. Ultimately, there will be reduced reimbursement to EPs for failing to use a certified EHR and attesting to MU use. Undoubtedly, this may not come as welcome news to an oncologist who is already feeling that expectations are expanding, and with heightened complexity and scrutiny.

The upside is that oncology-specific EMRs represent progressing prospective opportunities to arm the oncologist with quick access to knowledge of their patient population, treatments, and patient response as well as empower their patients or respective identified caregivers to be involved in accessing the health information.

There’s also power and revenue considerations to the oncologist in readily available clinical reporting knowledge and identification of patients for inclusion or exclusion of clinical trials, whether for the industry, government regulations, payer requirements, or claim denials. All of these initiatives are already on the radar screen or may be lurking on the horizon, however with these, CMS is providing oncologists with the roadmap[10]!

By: Barbara Robbins

Barbara Robbins, RN, BSN, MBA is a frequent author in oncology-specific EMR implementation, practice workflow changes, and ROI. She has presented oncology-specific EMR topics and ROI modeling analysis at both oncology and technology professional conferences. Ms. Robbins is the director of marketing with Altos Solutions, Inc., Los Altos, CA. USA.




Altos Solutions is the pioneer in web-based oncology software applications focusing on intuitive Electronic Medical Records, Practice Management, and Patient and Provider Portals that provide high-quality oncology-specific features with low-cost implementation. Oncology Metrics, a division of Altos Solutions, Inc., fosters a network of oncology practices to provide a platform of knowledge-based products and services. With an installed base of more than 1,000 oncology providers and thousands of daily users, OncoEMR™ is the answer for all oncology practices from the solo practitioner oncologist to multi-location cancer centers. Altos Solutions is headquartered in Los Altos, California, USA. To learn more about Altos Solutions, call (888) 662-6367 or 888-OncoEMR, or visit


[4] Government Health IT. CMS EHR incentive payments flirt with $7 billion. September 2012

[5] Vital Software, Inc., in 1993.

[7] Wood, C. C. (2011). “10 Steps to Achieve Meaningful Use.” Innovation and Change for Community Oncology. Oncology Practice Management, 1(4). December.“meaningful-use


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