What EMRs will be expected to do in stage 2, year 2014

Physicians would need to use their EMRs to meet 20 functionality objectives at minimum levels to earn bonuses and avoid penalties.

Core set (must meet all objectives listed below)

Use computerized physician order entry for medication, lab and radiology orders
Prescribe electronically
Record patient demographics
Record and chart vital signs
Record smoking status
Use clinical decision support
Incorporate clinical lab results into EMR
Generate lists of patients by specific condition
Set patient reminders for preventive and follow-up care
Provide patient portal access
Provide clinical summaries for patients
Identify education resources for patients
Use secure messaging with patients
Use medication reconciliation
Send summary of care records for referrals and care transitions
Send electronic data to immunization registries
Ensure EMR privacy and security

Menu set (must select and meet 3 objectives from the list below)

Access imaging results
Record patient family histories as structured data
Send electronic syndromic surveillance data to public health agencies
Have ability to report cancer cases to state registries
Have ability to report noncancer cases to state registries

Electronic medical record (EMR) - review of pros and cons in the Cleveland Clinic medical journal

Some negatives regarding the use of EMR:

- So far, electronic systems are not interconnectable
- Do electronic records improve or worsen the quality of care?
- Accuracy vs copying and pasting
- A third party in the examination room
- Devoid of real medical thought

A contrasting view:

- Connectivity will improve
- Staying focused on the patient, even with a computer in the room
- Doctor-doctor communication is enhanced

References:

Centers for Medicare & Medicaid Services, Electronic Health Record Incentive Program -- Stage 2, Feb. 23, 2012.
First look at the next stage of meaningful use - amednews.com

The electronic medical record: Diving into a shallow pool? CCJM.
The electronic medical record: Learning to swim. CCJM.
"The iPatient is getting wonderful care across America. The real patient wonders, "Where is everybody?" NYTimes, 2011.

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