Stage 2 Objectives: Cancer and Special Registries

Two new menu objectives included in the Stage 2 rules of meaningful use for eligible professionals include cancer and specialized registries notifications. Both objectives are designed to improve population and public health overall by encouraging the electronic reporting of public health information.

The two objectives read as follows: 1.) Capability to identify and report cancer cases to public health central cancer registry, except where prohibited, and in accordance with applicable law and practice; and, 2.) Capability to identify and report specific cases to a specialized registry (other than a cancer registry), except where prohibited, and in accordance with applicable law and practice.

Success for both objectives requires successful ongoing submission of specific case information from Certified EHR Technology to a specialized registry for the entire EHR reporting period.

Naomi Levinthal, consultant and health IT advisor at The Advisory Board, said several barriers exist for reporting on the two objectives.

"First and foremost," Levinthal said, "there is no overarching list to use that would tell you where these cancer or disease specific registries exist. So, I don't think that these will be reported on much when we look at Stage 2 data."

Exclusions for the two objectives seem fairly straightforward. Physicians who don’t diagnose or treat cancer could be excluded from cancer case reporting. Levinthal said the same goes for any diseases that would fall under the specialized disease reporting registry objectives.

"The other category exclusions are, based on where you are locally, if there's nobody around you that you could submit that information to," Levinthal said. "Or let's say there is somebody locally that's available, but they can't accept the information in the specific standards that the offices of the national coordinator require."

However, Levinthal said the exclusion doesn’t count toward the total of three menu objectives that providers have to report on, a new rule for 2014.

Stage 2 attestation by eligible professionals appears to be gaining momentum. In early August, CMS reported that 1,898 eligible professionals had attested to the Stage 2 rules of meaningful use, which was a little less than double the amount reported the previous month.

According to Mary Griskewicz, senior director of healthcare information systems for Health Information and Management Systems Society, before practices select one or both objectives they should follow a few necessary steps.

"Make sure they have the data, identify if they can support the reporting requirements, and partner with their vendors to ensure the data can be shared and is interoperable with their certified products," Griskewicz said.