Meeting Stage 1 Meaningful Use Criterion Carlos A. Leyva, Esq. Digital Business Law Group, P.A. www.digitalbusinesslawgroup.com Stage 1 Meaningful Use Core Set Health Outcomes Policy Priority Objectives Eligible Professionals Improving quality safety, efficiency, and reducing health disparities Measures Eligible Hospitals and CAHs CPOE for medication orders Implement drug-drug and drug-allergy interaction checks. Generate and transmit permissible prescriptions electronically > 30% of patients with at least one medication ordered with CPOE Enabled for entire EHR reporting period > 40% of all permissible prescriptions transmitted electronically Record demographics: language, Record demographics: language, > 50% gender, race, ethnicity, DOB gender, race, ethnicity, DOB, date and preliminary cause of death in the event of mortality in eligible hospital or CAH Maintain up-to-date problem list of current and active diagnoses > 80% have at least one entry or indication of no known problems Maintain active medication list > 80% Maintain active medication allergy list > 80% Record and chart changes in vital signs: height, weight, blood > 50% unique patients ages 2 pressure, calculate and display BMI, Plot and display growth charts and over for children 2-20 years, including BMI Record smoking status for patients 13 years and older Implement one clinical decision support rule relevant to specialty or high clinical priority along with ability to track compliance > 50% Implement one clinical decision support rule Stage 1 Meaningful Use Core Set (Cont.) Health Outcomes Policy Priority Objectives Eligible Professionals Eligible Hospitals and CAHs Report ambulatory clinical quality measures to CMS or States Engage patients and families in their health are Provide clinical summaries for patients for each office visit Ensure adequate privacy and security protections for personal health information For 2011, provide aggregate number, denominator and exclusions through attestation. For 2012, electronically submit clinical quality measures. Provide patients with an electronic copy of health information > 50% inpatient or ED departments or (including diagnostic test results, problem list, medication lists, hospital or clinic/provider's office medication allergies) upon request within 3 business days Provide patients with an electronic copy of discharge instructions at time of discharge, upon request Improve care coordination Measures > 50% at time of discharge > 50% within 3 business days Capability to exchange key clinical information among providers Performed at least one test of EHR of care and patient authorized entities electronically. technology's capability to electronically exchange key clinical information Protect electronic health information crated by or maintained by certified EHR technology through implementation of appropriate technical capabilities Conduct or review a security risk analysis per 45 CF4 164.308(a)(1) and implement security updates as necessary as part of risk management process Stage 1 Meaningful Use Menu Set Health Outcomes Policy Priority Objectives Eligible Professionals Eligible Hospitals and CAHs Report ambulatory clinical quality measures to CMS or States Improving quality safety, efficiency, and reducing health disparities Measures Implement drug-formulary checks For 2011, provide aggregate number, denominator and exclusions through attestation. For 2012, electronically submit clinical quality measures. Enabled access to at least one internal or external drug formulary Record advance directives for patients 65 or older > 50% Incorporate clinical lab-test results into certified EHR technology > 40% of all clinical lab tests as structured data during EHR reporting period with results in a positive/negative or numerical format Generate lists of patients by specific conditions to use for quality Generate at least one report improvement, reduction of disparities, research or outreach listing patients with a specific condition Send reminders to patients per patient preference for preventative/follow up care > 20% patients 65 or older or 5 yrs or younger were sent reminder during reporting period Stage 1 Meaningful Use Menu Set Health Outcomes Policy Priority Objectives Eligible Professionals Engage patients and families in their health are Eligible Hospitals and CAHs Provide patients with timely electronic access to their health information within 4 business days of information being available to provider > 10% subject to EP's discretion to withhold certain information Use certified EHR technology to identify patient-specific education resources and provide those resources to patient if appropriate Improve population and public health Measures Capability to submit electronic data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable law and practice > 10% Performed at least one test of certified EHR technology's capacity to submit electronic data and follow up submission if successful test Capability to submit electronic data on reportable lab results to public health agencies and actual submission in accordance with applicable law and practice Performed at least one test and follow-up submission if test is successful Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice Performed at least one test and follow-up submission if test is successful Stage 1 Meaningful Use Measures with a Denominator of Unique Patients Regardless of Whether the Patient's Records Are Maintained Using Certified EHR Technology Objectives Eligible Professionals Measures Eligible Hospitals and CAHs Maintain an up-to-date problem list of current and active diagnoses > 80% Maintain active medication list > 80% Maintain active medication allergy list > 80% Record demographics: language, gender, race, ethnicity, DOB Record demographics: language, gender, race, ethnicity, DOB, date and preliminary cause of death in the event of mortality in eligible hospital or CAH Provide patients with timely electronic access within 4 business days of information available to EP Use certified EHRE technology to identify patient-specific education resources and provide if appropriate > 50% > 10% > 10% Stage 1 Meaningful Use Measures with a Denominator Based on Counting Actions for Patients whose Records are Maintained Using Certified EHR Technology Objectives Eligible Professionals Measures Eligible Hospitals and CAHs Use CPOE for med orders Generate and transmit permissible prescriptions electronically > 30% > 40% Record and chart changes in vital signs: height, weight, blood pressure, calculate and display BMI, Plot and display growth charts for children 2-20 years, including BMI Record smoking status for patients 13 years and older Record advance directives for patients 65 and older Incorporate clinical lab-test results into certified EHR technology as structured data Provide patients with electronic copy of health information upon request Provide electronic copy of D/C instructions at time of discharge upon request > 50% recorded as structured data > 50% > 50% > 40% during reporting period for results either positive/negative or numerical format as structured data > 50% within 3 business days > 50% Provide clinical summaries for patients for each office visit > 50% within 3 business days Send reminders to patients per preference for preventative follow up care > 20% For EP, eligible hospital or CAH who receives patient from another setting should perform medication reconciliation For EP eligible hospital or CAH who transitions their patient to another setting of care should provide summary of care record for each transition of care or referral > 50% of transitions of care > 50% of transitions of care or referral Stage 1 Objectives and Measures Requiring Only a Yes/No Attestation Objectives Eligible Professionals Measures Eligible Hospitals and CAHs Implement drug-rug and drug-allergy interactions checks Implement drug-formulary checks Implement one clinical decision support rule relevant to specialty or high clinical priority with ability to track compliance Implement one clinical decision support rule relevant to high priority hospital condition with ability to track compliance Capability to exchange key clinical information among providers of care and patient authorized entities electronically Has enabled this functionality for entire reporting period Enabled for entire reporting period and has access to at least one internal or external drug formulary Implement one clinical decision support rule At least one test of capacity to exchange key clinical information Capability to submit electronic data to immunization registries or Immunization Performed at least one test Information Systems and actual submission in accordance with applicable law and practice Capability to submit electronic data on Performed at least one test to provide reportable lab results to public health submission to public health agency agencies and actual submission Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice Performed at least one test Protect electronic health information created or maintained by the certified EHRE Conduct or review a security risk technology through implementation of appropriate technical capabilities 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