Electronic Medical Records Stimulus
EMR Software Stimulus - Meaningful Use Final Rules
Frequently Asked Questions on the Final Rules for Meaningful Use Released 7/13/2010
QUICK LINKS
15 Core Meaningful Use Objectives
5 Meaningful Use Menu Objectives
The earliest adopters who adopt EHR software today and demonstrate 'meaningful use' of the EHR software by 2011 will realize the highest possible electronic medical records software payments through the stimulus package. Eligible providers that elect not to utilize an EHR system by 2015 will see Medicare/Medicaid reimbursement penalties. The meaningful use final ruling outlines a graduated approach - meaningful use requirements will be increasingly stringent in the years following 2012 (Stage 2 and 3).
The following Q&A is MDS's interpretation of the final rules of the Centers for Medicare and Medicaid Programs (CMS); Electronic Health Record Incentive Program as outlined by the Department of Health and Human Services in this document.
What features of the EHR do I need to use in order to qualify for 'Meaningful Use' as outlined in the final rules?
The final rules for stage 1 meaningful use (qualifying year 2010 or 2011) contain 15 "core" objectives that eligible providers must meet.
- 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.
- Implement drug to drug and drug allergy interaction checks.
- Maintain up to date problem list of current and active diagnoses for 80% of patients.
- More than 40% of permissible prescriptions written are generated and transmitted electronically using certified EHR technology.
- Maintain active medication list for 80% of patients.
- Maintain active drug allergy list for 80% of patients.
- Record demographic info, such as gender and race, for 50% of patients seen by eligible providers.
- Record and chart changes in vital signs, such as height, weight, BMI, blood pressure, for more than 50% of patients over age 2.
- Record smoking status for more than 50% of patients over age 13.
- Provide clinical summaries.
- Report clinical quality measures to the Centers for Medicare and Medicaid Services.
- Provide more than 50% of patients with electronic copy of health information upon request within 3 business days.
- Protect electronic health information created or maintained by certified EHR
- Implement one clinical decision support rule for EP's specialty or hospital's high priority condition and track compliance with that rule.
- 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.
For a complete look at the final rules for meaningful use, please review the document in its entirety: http://www.ofr.gov/OFRUpload/OFRData/2010-17207_PI.pdf
What are the additional "menu set" features of the EHR that are covered in Stage 1 Meaningful Use rules?
The final rules for stage 1 meaningful use (qualifying year 2010 or 2011) contain 10 "menu set" objectives - where eligible providers need to achieve 5 out of 10. Providers choose which menu set rules to select and defer. *Must choose one of these two.
- Drug formulary access
- Import/store 40% of lab results
- Patient lists by condition
- Provide patient-specific educational materials (>10%)
- Medication reconciliation between care settings (>50% in transitions of care)
- Care summaries to referred/transitioned patients (>50%)
- * Submit immunization data to registries (at least one test/follow-up)
- * Submit syndromic surveillance data to public health agencies (at least one test/follow-up)
- Patient reminders (>20% patients age 65+ or <5) # Eligible Providers Only
- Provide patients with health record (>10% within 4 days of updating)
When do I have to be up and running on EMR to get my first $18,000 Medicare Incentive in 2011?
You must be able to report starting no later than 90 days prior than December 31, 2010 (i.e. October 3rd 2010)
. The EHR reporting period may be any continuous 90-day period within the first payment year and the entire payment year for all subsequent payment years. Qualifying providers who adopt and are "meaningfully using" a certified EHR system by 2011 and 2012 will realize the highest incentive of $44,000. Providers who adopt in 2011 will receive the first payment of $18,000 beginning in 2011. CMS expects the first payments to begin in March of 2011.
