Stage 2 of meaningful use will impact clinical laboratories in the United States. At least 30% of lab orders must be entered into the electronic health record (EHR) through computerized physician order entry (CPOE).

Fifty five percent of lab orders must be incorporated in the EHR as structured data. Lab results must have standardized codes associated with them so that other EHR can more easily interpret and display them. For clinical laboratories, the government chose Logical Observation Identifiers Names and Codes (LOINC) as the standardized code.

Hospitals and physicians must be measured by quality metrics that rely on lab data. Hospitals must implement 5 clinical decision support interventions related to 4 or more clinical quality measures. These can be based on lab results.

EHR must be capable of generating lists of patients by specific conditions to use for quality improvement, reduction of disparities, and research or outreach. These lists can be based on lab results in combination with other variables.

Providers must show patient engagement by demonstrating that patients actively download or transmit their electronically accessed health information. Hospitals must provide >50% of patients with an electronic copy of their health information upon request. More than 5% of all unique patients discharged from the inpatient or emergency department must view, download or transmit their health information to a third party.

Hospitals and physicians need to use clinically relevant information to identify patients who should receive reminders for preventive or follow-up care and send these patients reminders. Lab results may be used along with other variables.

Hospitals are required to electronically transmit reportable lab results to state public health agencies. Hospitals may chose to delegate this function to the laboratory. Some laboratory information systems have been certified as EHR modules.

If these conditions are not met, payment cuts will begin in 2015. 


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