Meaningful Use of Electronic Medical Records

A Summary of CMS’ Proposed 25 Criteria
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As you begin down the path of adopting EMR there are many things you and your practice need to consider. One is meaningful use of certified EMR technology. To participate in the HITECH incentive program, part of The American Recovery and Reinvestment Act of 2009, eligible professionals (EPs) must be meaningful users of certified EMR technology beginning as early as 2011. This summary of Stage 1 rules will help you gain a better understanding of the responsibilities you and your practice must take to meet the Centers for Medicare& Medicaid Services (CMS) proposed definition of meaningful use of certified EMR technology.

ALN Medical Management understands the complexity of adopting EMR and will help you navigate this new path to technology. With leading EMR systems and hosted technology, implementation and training, and report and interface customization, ALN provides you tools that help you achieve meaningful use requirements with confidence.

Health Outcomes Policy Priority

Improving quality, safety, efficiency, and reducing health disparities

Care Goals

• Provide access to comprehensive patient health data for patient's health care team
• Use evidence-based order sets and CPOE
• Apply clinical decision support at the point of care
• Generate lists of patients who need care and use them to reach out to patients
• Report information for quality improvement and public reporting

Eligible Professionals – Stage 1

1. Objective: Use CPOE
 Measure: For EPs, CPOE is used for at least 80% of all orders
*Reporting Requirements: 1

2. Objective: Implement drug-drug, drug-allergy, drug-formulary checks
Measure: The EP has enabled this functionality
*Reporting Requirements: 2

3. Objective: Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT®
Measure: At least 80% of all unique patients seen by the EP have at least one entry or an indication of none recorded as structured data
*Reporting Requirements: 1

4. Objective: Generate and transmit permissible prescriptions electronically (eRx)
Measure: At least 75% of all permissible prescriptions written by the EP are transmitted electronically using certified EMR technology 
*Reporting Requirements: 1

5. Objective: Maintain active medication list
Measure: At least 80% of all unique patients seen by the EP have at least one entry (or an indication of “none” if the patient is not currently prescribed any medication) recorded as structured data 
*Reporting Requirements: 1

6. Objective: Maintain active medication allergy list
Measure: At least 80% of all unique patients seen by the EP have at least one entry (or an indication of “none” if the patient has no medication allergies) recorded as structured data
*Reporting Requirements: 1

7. Objective: Record demographics: preferred language, gender, ethnicity, insurance type, race, date of birth
Measure: At least 80% of all unique patients seen by the EP have demographics recorded as structured data 
*Reporting Requirements: 1

8. Objective: Record and chart changes in vital signs: height, weight, blood pressure, calculate and display BMI, plot and display growth charts for children 2-20 yrs, including BMI
Measure: For at least 80% of all unique patients age 2 and over seen by the EP, record blood pressure and BMI; additionally plot growth chart for children age 2-20 years
*Reporting Requirements: 1

9. Objective: Record smoking status for patients 13 years old or older
Measure: At least 80% of all unique patients 13 years old or older seen by the EP have “smoking status” recorded
*Reporting Requirements: 1

10. Objective: Incorporate clinical lab-test results into EMR as structured data
Measure: At least 50% of all clinical lab tests ordered whose results are in a positive/negative or numerical format are incorporated in certified EMR technology as structured data
*Reporting Requirements: 1

11. Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, and outreach
Measure: Generate at least one report listing patients of the EP with a specific condition
*Reporting Requirements: 3

12. Objective: Report ambulatory quality measures to CMS or the States
Measure: For 2011, provide aggregate numerator and denominator through attestation as discussed in section II(A)(3) of this proposed rule. For 2012, electronically submit the measures as discussed in the section II(A)(3) of this proposed rule
*Reporting Requirements: 1

13. Objective: Send reminders to patients per patient preference for preventive follow up care
Measure: Reminder sent to at least 50% of all unique patients seen by the EP that are age 50 or over
*Reporting Requirements: 2

14. Objective: Implement 5 clinical decision support rules relevant to specialty or high clinical priority, including diagnostic test ordering, along with the ability to track compliance with those rules
Measure: Implement 5 clinical decision support rules relevant to the clinical quality metrics the EP is responsible for as described further in section II(A)(3)
*Reporting Requirements: 1

15. Objective: Check insurance eligibility electronically from public and private payers
Measure: Insurance eligibility checked electronically for at least 80% of all unique patients seen by the EP
*Reporting Requirements: 1

16. Objective: Submit claims electronically to public and private payers
Measure: At least 80% of all claims filed electronically by the EP
*Reporting Requirements: 1

Health Outcomes Policy Priority

Engage patients and families in their health care

Care Goals

Provide patients and families with timely access to data, knowledge, and tools to make informed decisions and to manage their health

17. Objective: Provide patients with and electronic copy of their health information (including diagnostic test results, problem list, medication lists, allergies), upon request
Measure: At least 80% of all patients who request an electronic copy of their health information are provided it within 48 hours
*Reporting Requirements: 1

18. Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies) within 96 hours of the information being available to the EP
Measure: At least 10% of all unique patients seen by the EP are provided timely electronic access to their health information
*Reporting Requirements: 1

19. Objective: Provide clinical summaries for patients for each office visit
Measure: Clinical summaries are provided for at least 80% of all office visits 
*Reporting Requirements: 1

Health Outcomes Policy Priority

Improve population and public health

Care Goals

Communicate with public health agencies

23. Objective:  Capability to submit electronic data to immunization registries and actual submission where required and accepted
Measure: Performed at least one test of certified EMR technology's capacity to submit electronic data to immunization registries
*Reporting Requirements: 4

24. Objective: Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice
Measure: Performed at least one test of certified EMR technology's capacity to provide electronic syndromic surveillance data to public health agencies (unless none of the public health agencies to which an EP submits such information have the capacity to receive the information electronically)
*Reporting Requirements: 4

Health Outcomes Policy Priority

Ensure Adequate privacy and security protections for personal health information

Care Goals

Ensure privacy and security protections for confidential information through operating policies, procedures, and technologies and compliance with applicable law. Provide transparency of data sharing to patient

25. Objective: Protect electronic health information created or maintained by the certified EMR technology through the implementation of appropriate technical capabilities
Measure: Conduct or review a security risk analysis per 45 CFR 164.308 (a)(1) and implement security updates as necessary
*Reporting Requirements: 5

* Reporting requirements.
1 – Structured numerator/denominator
2 – Attestation of implementation
3 – Attestation that at least one report was generated
4 – Attestation that at least one test was performed
5 – Attestation that a risk analysis was conducted or reviewed

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