Stage 1 Meaningful Use Objectives and Measures Author: Mia Evans About Technosoft Solutions: Technosoft Solutions is a healthcare technology consulting, dedicated to providing software development services to US healthcare market for more than ten years. Technosoft has extensive experience developing and maintaining healthcare software. Technosoft Solutions bring deep domain knowledge in healthcare IT and applied operational experience in a variety Strategic, Implementation and Operational areas. For more information about Technosoft please visit www.techno-soft.com *Courtesy CMS Data Source: http://www.cms.gov/ehrincentiveprograms/
Stage 1 Meaningful Use Objectives and Measures For Professionals (EPs), (EHs) and Critical Access Hospitals (CAHs) Sorted by Core and Menu Set Core Measures professionals, hospitals and critical access hospitals must report measures on ALL core objectives as identified below. There are 15 core measures for EPs and 14 core measures for EHs and CAHs. CORE SET Improving Use CPOE for Use CPOE for More than 30% of : quality, safety, medication orders medication orders unique patients with at Denominator based on efficiency, and directly entered by any directly entered by any least one medication in counting actions for reducing health licensed healthcare licensed healthcare their medication list seen patients whose records disparities professional who can professional who can by the EP or admitted to are maintained using enter orders into the enter orders into the the eligible hospital s or certified EHR medical record per medical record per CAH s inpatient or technology. state, local and state, local and emergency department professional guidelines professional guidelines (POS 21 or 23) have at least one medication order entered using CPOE Implement drug-drug Implement drug-drug The EP/eligible Yes/No Attestation and drug-allergy and drug-allergy hospital/cah has interaction checks interaction checks enabled this functionality for the entire EHR reporting period Generate and transmit N/A More than 40% of all : permissible permissible prescriptions Denominator based on prescriptions written by the EP are counting actions for electronically (erx) transmitted electronically patients whose records using certified EHR are maintained using technology certified EHR technology. Record demographics Record demographics More than 50% of all : - preferred language - preferred language unique patients seen by Denominator of unique - gender - gender the EP or admitted to the patients regardless of - race - race eligible hospital s or whether the patient's - ethnicity - ethnicity CAH s inpatient or records are maintained - date of birth - date of birth emergency department using certified EHR - date and preliminary (POS 21 or 23) have technology cause of death in the demographics recorded event of mortality in as structured data the eligible hospital or CAH
Health Policy Priority CORE SET Stage 1 Objectives Stage 1 Measures Method of Measure Professionals and CAHs Maintain an up-to-date Maintain an up-to-date More than 80% of all : problem list of current problem list of current unique patients seen by Denominator of unique and active diagnoses and active diagnoses the EP or admitted to the patients regardless of eligible hospital s or whether the patient's CAH s inpatient or records are maintained emergency department using certified EHR (POS 21 or 23) have at technology least one entry or an indication that no problems are known for the patient recorded as structured data Maintain active Maintain active More than 80% of all : medication list medication list unique patients seen by Denominator of unique the EP or admitted to the patients regardless of eligible hospital s or whether the patient's CAH s inpatient or records are maintained emergency department using certified EHR (POS 21 or 23) have at technology least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data. Maintain active Maintain active More than 80% of all : medication allergy list medication allergy list unique patients seen by Denominator of unique the EP or admitted to the patients regardless of eligible hospital s or whether the patient's CAH s inpatient or records are maintained emergency department using certified EHR (POS 21 or 23) have at technology least one entry (or an indication that the patient has no known medication allergies) recorded as structured data Record and chart Record and chart For more than 50% of all : changes in vital signs: changes in vital signs: unique patients age 2 Denominator based on - Height - Height and over seen by the EP counting actions for - Weight - Weight or admitted to eligible patients whose records - Blood pressure - Blood pressure hospital s or CAH s are maintained using - Calculate and - Calculate and inpatient or emergency certified EHR display BMI display BMI department (POS 21 or technology. - Plot and display - Plot and display 23), height, weight and growth charts for growth charts for blood pressure are children 2-20 years, children 2-20 years, recorded as structured including BMI including BMI data
CORE SET Record smoking status Record smoking status More than 50% : for patients 13 years for patients 13 years (changed from 80%) of Denominator based on old or older old or older all unique patients 13 counting actions for years old or older seen patients whose records by the EP or admitted to are maintained using the eligible hospital s or certified EHR CAH s inpatient or technology. emergency department (POS 21 or 23) have smoking status recorded data Implement one clinical Implement one clinical Implement one clinical Yes/No Attestation decision support rule decision support rule decision support rule relevant to specialty or related to a high high clinical priority priority hospital along with the ability to condition along with track compliance with the ability to track that rule compliance with that rule Report ambulatory Report hospital clinical For 2011, provide See Clinical Quality clinical quality quality measures aggregate numerator, Measure Reporting measures denominator, and exclusions through attestation. For 2012, electronically submit the clinical quality measures Engage patients Provide patients with Provide patients with More than 50% of all : and their an electronic copy of an electronic copy of patients of the EP or the Denominator based on families on their their health information their health information inpatient or emergency counting actions for health care (including diagnostic (including diagnostic departments of the patients whose records test results, problem test results, problem eligible hospital or CAH are maintained using list, medication lists, list, medication lists, (POS 21 or 23) who certified EHR medication allergies), medication allergies, request an electronic technology. upon request discharge summary, copy of their health procedures), upon information are provided request it within 3 business days N/A Provide patients with More than 50% of all : an electronic copy of patients who are Denominator based on their discharge discharged from an counting actions for instructions at time of eligible hospital or CAH s patients whose records discharge, upon inpatient department or are maintained using request emergency department certified EHR (POS 21 or 23) and who technology. request an electronic copy of their discharge instructions are provided it
CORE SET Provide clinical N/A Clinical summaries : summaries for patients provided to patients for Denominator based on for each office visit more than 50% of all counting actions for office visits within 3 patients whose records business days are maintained using certified EHR technology. Improve care Capability to exchange Capability to exchange Performed at least one Yes/No Attestation coordination key clinical information key clinical information test of certified EHR (for example, problem (for example, technology's capacity to list, medication list, discharge summary, electronically exchange medication allergies, procedures, problem key clinical information diagnostic test results), list, medication list, among providers of medication allergies, care and patient diagnostic test results), authorized entities among providers of electronically care and patient authorized entities electronically Ensure Protect electronic Protect electronic Conduct or review a Yes/No Attestation adequate health information health information security risk analysis per privacy and created or maintained created or maintained 45 CFR 164.308 (a)(1) security by the certified EHR by the certified EHR and implement security protections for technology through the technology through the updates as necessary personal health implementation of implementation of and correct identified information appropriate technical appropriate technical security deficiencies as capabilities capabilities part of its risk management process Menu Set Measures professionals, hospitals and critical access hospitals must each report on ALL BUT five measures shown in the Menu Set below. There is one limitation for the menu set: All EPs and hospitals must choose at least one of the population and public health measures to demonstrate as part of the menu set. This is the only limitation placed on which five objectives can be deferred from the menu set. MENU SET Improving quality, Implement drug- Implement drug- The EP/eligible hospital/cah Yes/No Attestation safety, efficiency, formulary checks formulary checks has enabled this functionality and reducing and has access to at least health disparities one internal or external drug formulary for the entire EHR reporting period
MENU SET N/A Record advance More than 50% of all unique : directives for patients patients 65 years old or older Denominator based 65 years old or older admitted to the eligible on counting actions hospital s or CAH s inpatient for patients whose department (POS 21) have records are an indication of an advance maintained using directive status recorded certified EHR technology Incorporate clinical Incorporate clinical More than 40% of all clinical : lab-test results into lab-test results into lab tests results ordered by Denominator based certified EHR certified EHR the EP or by an authorized on counting actions technology as technology as provider of the eligible for patients whose structured data structured data hospital or CAH for patients records are admitted to its inpatient or maintained using emergency department (POS certified EHR 21 or 23) during the EHR technology reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data Generate lists of Generate lists of Generate at least one report Yes/No Attestation patients by specific patients by specific listing patients of the EP, conditions to use for conditions to use for eligible hospital or CAH with quality improvement, quality improvement, a specific condition reduction of reduction of disparities, research or disparities, research outreach or outreach Send reminders to N/A More than 20% of all unique : patients per patient patients 65 years or older or Denominator based preference for 5 years old or younger were on counting actions preventive/ follow-up sent an appropriate reminder for patients whose care during the EHR reporting records are period maintained using certified EHR technology Engage patients Provide patients with N/A More than 10% of all unique : and their families timely electronic patients seen by the EP are Denominator of on their health access to their health provided timely (available to unique patients care information (including the patient within four regardless of lab results, problem business days of being whether the list, medication lists, updated in the certified EHR patient's records are medication allergies) technology) electronic maintained using within four business access to their health certified EHR days of the information information subject to the technology being available to the EP s discretion to withhold EP certain information
MENU SET Use certified EHR Use certified EHR More than 10% of all unique : technology to identify technology to identify patients seen by the EP or Denominator of patient-specific patient-specific admitted to the eligible unique patients education resources education resources hospital s or CAH s inpatient regardless of and provide those and provide those or emergency department whether the resources to the resources to the (POS 21 or 23) are provided patient's records are patient if appropriate patient if appropriate patient-specific education maintained using resources certified EHR technology Improve care The EP, eligible The EP, eligible The EP, eligible hospital or : coordination hospital or CAH who hospital or CAH who CAH performs medication Denominator based receives a patient from receives a patient reconciliation for more than on counting actions another setting of care from another setting 50% of transitions of care in for patients whose or provider of care or of care or provider of which the patient is records are believes an encounter care or believes an transitioned into the care of maintained using is relevant should encounter is relevant the EP or admitted to the certified EHR perform medication should perform eligible hospital s or CAH s technology reconciliation medication inpatient or emergency reconciliation department (POS 21 or 23) The EP, eligible The EP, eligible The EP, eligible hospital or : hospital or CAH who hospital or CAH who CAH who transitions or refers Denominator based transitions their patient transitions their their patient to another on counting actions to another setting of patient to another setting of care or provider of for patients whose care or provider of setting of care or care provides a summary of records are care or refers their provider of care or care record for more than maintained using patient to another refers their patient to 50% of transitions of care certified EHR provider of care should another provider of and referrals technology provide summary of care should provide care record for each summary of care transition of care or record for each referral transition of care or referral Improve Capability to submit Capability to submit Performed at least one test Yes/No Attestation population and electronic data to electronic data to of certified EHR technology's public health immunization registries immunization capacity to submit electronic or Immunization registries data to immunization Information Systems or Immunization registries and follow-up and actual submission Information Systems submission if the test is in accordance with and actual submission successful (unless none of applicable law and in accordance with the immunization registries to practice applicable law and which the EP, eligible practice hospital or CAH submits such information have the capacity to receive the information electronically)
MENU SET Health Policy Priority Stage 1 Objectives Stage 1 Measures Method of Measure Professionals and CAHs N/A Capability to submit Performed at least one test Yes/No Attestation electronic data on of certified EHR technology s reportable (as capacity to provide electronic required by state or submission of reportable lab local law) lab results results to public health to public health agencies and follow-up agencies and actual submission if the test is submission in successful (unless none of accordance with the public health agencies to applicable law and which eligible hospital or practice CAH submits such information have the capacity to receive the information electronically) Capability to submit Capability to submit Performed at least one test Yes/No Attestation electronic syndromic electronic syndromic of certified EHR technology's surveillance data to surveillance data to capacity to provide electronic public health agencies public health agencies syndromic surveillance data and actual submission and actual submission to public health agencies and in accordance in accordance follow-up submission if the with applicable law with applicable law test is successful (unless and practice and practice 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)