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Meaningful Use Defined

In the summer of 2010 on July 28, the Department of Health and Human Services (HHS) published in the Federal Register the final rules for meaningful use and certification standards of electronic health record (EHR) systems under the Health Information Technology for Economic and Clinical Health (HITECH) provisions of the American Recovery and Reinvestment Act (ARRA). The rules establish the requirements for eligible hospitals and providers to qualify for Medicare and Medicaid incentives for meaningful use of certified EHRs. For a summary of the regulations, you may want to read The New England Journal of Medicine article by David Blumenthal, MD, MPP (national coordinator for HIT at HHS) and Marilyn Tavenner, RN, MHA (principal deputy administrator for Medicare and Medicaid Services) located Here.

The Stages of Meaningful Use
  • Stage 1 (2011) - The electronic capture of patient data
  • Stage 2 (2013) - Improved Clincal Processes
  • Stage 3 (2015) - Quality Measurement and Improvement

Stage 1 of Meaningful Use
The goal for stage 1 of meaningful use requirements (2011-2012) are going to be the simplest of the requirements. The goals of stage 1 are:
  • Improve quality, safety and efficiency of healthcare
  • Engage Patients and families in their healthcare
  • Improve care coordination
  • Ensure adequate privacy and security protections for personal health information
  • Improve population and public health

Stage 1 Meaningful Use Requirements and Measures for Eligible Professionals
Core Set

All of the following Entries must be met in order to achieve meaningful use.

Eligible Professionals must prescribe electronically for at least 40% of prescriptions for unique patients. In Stage 2, this number is expected to increase to 60% and may increase even more in stage 3. In addition, drug-drug and drug-allergy checks must be implemented.

Computerized Physician Order Entry (CPOE)
At least 30% of unique patients with at least one medication in their list must have at least one medication order entered using CPOE.

Clinical Decision Support
Eligible professionals must implement at least one clinical decision support rule that is relevant to specialty or high clinical priority. The technology must provide the ability to track compliance of the implemented rule.

Quality Measures
For at least 80% of unique patients, data must be gathered regarding the following:

  • Active Diagnoses
  • Active Medication
  • Active Allergy
  • Active Medication Allergy
    • (if patient has none, there must be an indication)

For at least 80% of unique patient, data must be gathered and charted regarding the following:
  • Hypertension and Blood Pressure Management
  • Tobacco Use and Cessation Intervention
  • Adult Weight Screenings (BMI must be charted) and follow-up sessions
  • Plus, 3 additional measures chosen from a list of 38
  • For pediatricians, growth charts and BMI must be plotted for children between the ages of 2 and 20

Record Demographics
For at least 50% of unique patients, the following data must be gathered:
  • Preferred language
  • Gender
  • Race
  • Ethnicity
  • Date of Birth

Maintain Up to Date Lists
For at least 80% of unique patients, up to date lists must be maintained regarding the following:
  • Problem List of Current and Active Diagnoses
  • Active Medication List
  • Active Medication Allergy List

Provide Patients with Electronic Access to their Health Information (Upon Request)
At least 50% of patients, who request copies, must be provided with electronic access within 3 business days for the following:
  • Diagnostic Test Results
  • Problem list
  • Medication list
  • Medication Allergies
  • Clinical Summary

Exchange key information
The eligible provider must demonstrate the ability to exchange key information like problem list, medication list, medication allergies, etc. among other providers. This must be tested at least once.

Ensure Adequate Privacy and Security
Conduct or review a security risk analysis per 45 CFR 164.308 (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

Menu Set
At least 5 out of the following 10 entries must be met in addition to the above requirements in order to achieve meaningful use. The five choices must include at least one of the following:
  • Submit to immunization registries
  • Submit to syndromic surveillance
  • Submit to reportable lab registries

If such registries do not exist in your area, you will not be penalized by CMS.

Implement Drug-Formulary checks

This must be enabled in the EHR system

Incorporate lab results

More than 40% clinical lab results must be recorded in the EHR software as structure data.

Clinical Reporting
Providers must generate at least one report listing patients with a specific condition.

Send Reminders for Preventative / Follow Up Care

For at least 20% of patients 65+ or under the age 5, appropriate reminders must be sent.

Provide Patients with Electronic Access to their Health Information
At least 50% of patients, who request copies, must be provided with electronic access within 4 business days of being available to the provider for the following:
  • Diagnostic Test Results
  • Problem list
  • Medication list
  • Medication Allergies
  • Clinical Summary

Patient Education
Provide more than 10% of unique patients are provided with patient-specific electronic resources or education materials.

Perform Medication Reconciliation (if relevant)

For at least 50% of transitions of care in which a patient was referred to the provider, the provider must perform medication reconciliation.

Provide Summary of Care Record
The physician must provide a summary of care when a patient is referred to another provider for at least 50% of transitions.

Submit Immunization Data
The provider must perform at least one test of the ability to submit data to immunization registries.

Submit Electronic Syndromic Surveillance Data
Performed at least one test of certified EHR technology's capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP, eligible hospital or CAH submits such information have the capacity to receive the information electronically)

Precision HealthCare hosts online and in person webinars on the stimulus package and demonstrations of EMR software. Contact us or call us at 516-771-7554.

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