ePractice Check Up Newsletter

July 29, 2010

In This Issue

What is Meaningful Use
Core Objectives
Menu Set Objectives

Meeting Stage 1 Meaningful Use With PrimeSuite Chart Electronic Health Records

If you are already using PrimeChart to chart patient encounters and prescribe electronically, you are well on your way to achieving Meaningful Use with the HITECH Act of 2009. The final rules for Meaningful Use were published on July 28th by CMS (Centers for Medicare and Medicaid). In the final rules, 15 "core" objectives are outlined and 10 "menu set" objectives - of which providers must meet 5 of 10 to quality for stimulus incentives.

What is Meaningful Use?

Meaningful Use Stage 1 priorities are tied to the core and menu set objectives that must be achieved to qualify for stimulus funds:

• Improve quality, safety, efficiency, and reduce health disparities.
• Engage patients and families in their health care.
• Improve care coordination.
• Improve population and public health.
• Ensure adequate privacy and security protections for personal health information.

Stage 1 Meaningful Use (qualifying years 2011 and 2012) should be the goal for most MDS customers using PrimeChart to chart patient encounters and ePrescribe. Stage 1 Meaningful use includes both a core set and a menu set of objectives that are specific for eligible professionals and hospitals. For Eligible Professionals, there are a total of 25 meaningful use objectives. 20 of the objectives must be completed to qualify for an incentive payment. 15 are core objectives that are required, and the remaining 5 objectives may be chosen from the list of 10 menu set objectives.

Why should Stage 1 (qualifying years 2011 - 2012) be an aggressive goal for MDS customers? Aside from the obvious financial benefits (see Medicare and Medicaid payment schedules for achieving meaningful use) Stage 1 rules are substantially less rigorous than Stage 2's proposed objectives. In Stage 2, ALL menu set objectives will be required (instead of choosing 5 of 10 for Stage 1), and other thresholds will be increased.

Core Meaningful Use Objectives (All 15 Required)

1. CPOE (computerized physician order entry) for medication orders. Specifically, more than 30% of unique patients with at least one medication in their medication list seen by the eligible provider must have at least one medication order entered using CPOE.
2. Implement drug to drug and drug allergy interaction checks.
3. Maintain up to date problem list of current and active diagnoses for 80% of patients.
4. More than 40% of permissible prescriptions written are generated and transmitted electronically using certified EHR technology.
5. Maintain active medication list for 80% of patients.
6. Maintain active drug allergy list for 80% of patients.
7. Record demographic info, such as gender and race, for 50% of patients seen by eligible providers.
8. Record and chart changes in vital signs, such as height, weight, BMI, blood pressure, for more than 50% of patients over age 2.
9. Record smoking status for more than 50% of patients over age 13.
10. Clinical summaries provided to patients for more than 50% of all office visits within 3 business days.
11. Report clinical quality measures to the Centers for Medicare and Medicaid Services.
12. Provide more than 50% of patients with electronic copy of health information upon request within 3 business days.
13. Protect electronic health information created or maintained by certified EHR
14. Implement one clinical decision support rule for EP's specialty or hospital's high priority condition and track compliance with that rule.
15. Perform at least one test of certified e-health record's capability to electronically exchange key clinical information (interoperability), such as problem list or medication list, among providers of care or patient-authorized entities.

Menu Set Meaningful Use Objectives

CHOOSE 5 and DEFER 5
* Must complete one of these two

1. Drug formulary access.
2. Import/store 40% of lab results as structured data.
3. Generate at least 1 report listing patients with a specific condition.
4. More than 20% of all unique patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period
5. Provide greater than 10% of patients with health record within 4 days of updating.
6. Provide greather than 10% of patients with patient-specific education resources.
7. Perform medication reconciliation for more than 50% of transitions of care.
8. Provides a summary of care record for more than 50% of transitions of care and referrals.
9. * Submit immunization data to registries (at least one test/follow-up)
10. * Submit syndromic surveillance data to public health agencies (at least one test/follow-up)