Meaningful Use Preliminary Definition from HHS - 1/1/10

8/14/2019 Meaningful Use Preliminary Definition from HHS - 1/1/10

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Objective # Objective

1 CPOE

2 Drug screening

3 Maintain problem list in ICD-9-CM or SNOMED-CT

4 Transmit prescriptions electronically

5 Maintain active medication list



6 Maintain active medication allergy list

7 Record demographics

8 Record vital signs

9 Record smoking status for patients 13 and over

10 Lab results



11

12 Report quality measures to CMS or states

13

14

15 Check insurance eligibility

15 Submit insurance claims electronically

16

Generate patient lists based on specific

conditions.

Send reminders to patients based on patientpreferences and selected by specific criteria.

Implement five clinical decision rules, other thandrug-drug interactions and drug-allergycontraindications, based on demographic data,diagnosis, conditions, test results, and/ormedication list

Provide patients with an electronic copy of theirinformation



17

18

19 Provide a clinical summary for each visit

20

Provide patients with an electronic copy of theirdischarge instructions and procedures at time of discharge

Provide patients with electronic access to theirinformation within 96 hours of availability

Exchange clinical information electronically withother providers



21 Perform medication reconciliation

22 Provide summary of care record

23 Submit data to immunization registries

24 Submit reportable lab results to public healthagencies



25

26 Protect health information

Submit syndromic surveillance data to publichealth agencies



Proposed Stage 1 Meaningful Use Criteria for EHR Use

By Mr. HIStalk

Last Updated 12/31/09

Practice Hospital

b. Electronic formulary check b. Electronic formulary check

a. Enable e-prescribing.

a. Enter orders for medications,laboratory, radiology, and providerreferrals.

a. Enter of orders for medications, laboratory,radiology, blood bank, PT, OT, RT, rehab,dialysis, provider consults, and discharge andtransfer.

a. Real-time alerts for drug-druginteractions and drug allergycontraindications.

a. Real-time alerts for drug-drug interactionsand drug allergy contraindications.

c. Enable user to maintain drug-drugand drug-allergy warnings.

c. Enable user to maintain drug-drug anddrug-allergy warnings.

d. Track number of alerts that wereresponded to.

d. Track number of alerts that wereresponded to.

a. Enable user to manage problem liststhat span multiple visits.

a. Enable user to manage problem lists thatspan multiple visits.

a. Enable user to manage an activemedication list.

a. Enable user to manage an activemedication list.



a. Preferred language a. Preferred language

b. Insurance type b. Insurance type

c. Gender c. Gender

d. Race d. Racee. Ethnicity e. Ethnicity

f. Date of birth f. Date of birth

g. Date and cause of death

a. Height a. Height

b. Weight b. Weight

c. Blood pressure c. Blood pressure

d. Calculated body mass index d. Calculated body mass index

e. Growth charts for patients 2-20 years old

a. Current smoker a. Current smoker

b. Former smoker b. Former smoker

c. Never smoked c. Never smoked

b. Enable user to manage a medicationhistory that spans multiple visits.

b. Enable user to manage a medicationhistory that spans multiple visits.

a. Enable user to record, modify, andretrieve an active medication allergy list.

a. Enable user to record, modify, and retrievean active medication allergy list.

b. Enable user to manage an allergyhistory that spans multiple visits.

b. Enable user to manage an allergy historythat spans multiple visits.

Enable user to manage patientdemographic data.

Enable user to manage patient demographicdata.

e. Growth charts for patients 2-20 yearsold

a. Receive structured results and displayin readable format

a. Receive structured results and display inreadable format



b. Display results containing LOINC codes

a. Patient demographics a. Patient demographics

b. Medication list b. Medication list

c. Specific conditions c. Specific conditions

a. Calculate and display as specified a. Calculate and display as specified

a. Patient demographics

b. Medication list

c. Specific conditions

a. To public and private payers a. To public and private payers

a. Test results a. Test results

b. Problem list b. Problem list

c. Medication list c. Medication list

d. Medication allergy list d. Medication allergy list

e. Immunizations e. Immunizations

f. Procedures f. Procedures

g. Discharge summary

b. Display results containing LOINCcodes

c. Enable user to change a patient'srecord based on a lab result

c. Enable user to change a patient's recordbased on a lab result

a. Real-time alerts based on rules andevidence a. Real-time alerts based on rules andevidence

d. Track number of alerts that wereresponded to

d. Track number of alerts that wereresponded to

a. Submit electronic eligibility query andreceive a response

a. Submit electronic eligibility query andreceive a response



a. Discharge instructions

b. Procedures

a. Lab results

b. Problem list

c. Medication list

d. Medication allergy list

e. Immunizations

f. Proceduresa. Diagnostic test results

b. Medication list

c. Medication allergy list

d. Procedures

e. Problem list

f. Immunizations

a. Receive diagnostic test results a. Receive diagnostic test results

b. Receive problem list b. Receive problem list

c. Receive medication list c. Receive medication list

d. Receive medication allergy list d. Receive medication allergy list

e. Receive immunizations e. Receive immunizations

f. Receive procedures f. Receive procedures

g. Receive discharge summary



a. Send diagnostic test results a. Send diagnostic test results

b. Send problem list b. Send problem list

c. Send medication list c. Send medication list

d. Send medication allergy list d. Send medication allergy list

e. Send immunizations e. Send immunizations

f. Send procedures f. Send procedures

g. Send discharge summary

a. Record, retrieve, and transmit a. Record, retrieve, and transmit

a. Record, retrieve, and transmit

a. Compare and merge two or more listsinto a single list

a. Compare and merge two or more lists intoa single list

This item does not appear to bementioned in the meaningful usedefinition, only in the incentivedocument.



a. Record, retrieve, and transmit a. Record, retrieve, and transmit

c. Enable sessions timeouts. c. Enable sessions timeouts.d. Encrypt data per local policy d. Encrypt data per local policy

e. Encrypt exchanged data per local policy

f. Maintain record-level audit logs f. Maintain record-level audit logs

h. Verify user identity h. Verify user identity

a. Assign a unique identifer to users andcontrol access

a. Assign a unique identifer to users andcontrol access

b. Enable emergency access toauthorized users

b. Enable emergency access to authorizedusers

e. Encrypt exchanged data per localpolicy

g. Verify integrity of health informationsent or received

g. Verify integrity of health information sentor received

i. Record disclosures made fortreatment, payment, and operations

i. Record disclosures made for treatment,payment, and operations



rs

Measurement

Functionality is enabled.

Must be done for 80% for unique patients.


Numerator: number of CPOE orders entered forall patients. Denominator: total number of orders issued. Practices must enter 80% of orders by CPOE. Hospitals must enter 10%.

Must send 75% of non-controlled drugprescriptions electronically.




Must be done for 80% for unique patients,including ALL data elements. Denominator isthe number of patients seen (practice) oradmitted as inpatients (hospital).

Must be recorded for 80% of patients seen(practice) or admitted (hospitals) age 2 andover, including ALL data elements.Denominator is the total number of uniquepatients age 2 and over seen (practice) oradmitted (hospital).

Must be recorded for 80% of unique patientsseen (practice) or admitted (hospital) age 13or older. Denominator is the number of uniquepatients age 13 and older seen (practice) oradmitted (hospital).

At least 50% of test results whose result canbe expressed as positive/negative or as anumber are stored in the EHR as structureddata. The denominator is the number of labtests ordered.



Generate at least one list.

Numerator and denominator provided byattestation.

Reminders sent to at least 50% of uniqiepatients seen (practice )or admitted (hospital)who are age 50 and over.

Check eligibility electronically for at least 80%of patients seen (practice) or admitted(hospital).

File at least 80% of claims electronically.Denominator is the number of claims filed.

Provide an electronic copy of informationrequested by patients within 48 hours. Thedenominator is the number of patients whorequest the information.



Provide an electronic copy of dischargeinstructions and procedures for at least 80% of discharged inpatients who request them. Thedenominator is the number of patients whorequest the information.

Provide timely electronic access to healthinformation for at least 10% of uniquepatients. The denominator is the number of patient seen.

Clinical summaries are provided for at least80% of office visits. The denominator is thenumber of unique patients seen.

Perform at least one test of exchanging keyclinical information. Can be done at any time,including prior to the reporting period. Grouppractices only need to perform one test perEHR.



Medication reconciliation is performed for atleast 80% of relevant encounters andtransitions of care. The denominator is thenumber of relevant encounters and transitionsof care.

Provide summary of care record for at least80% of transitions of care and referrals.Denominator is the number of transitions of care for which the practice or hospital was thetransferring or referring provider.

Perform at least one test of submittingimmunization data. Can be done at any time,including prior to the reporting period. StateMedicaid requirements may supersede. Group

practices only need to perform one test perEHR. Not required if the immunization registryto which the practice or hospital submitsinformation does not have the capability toreceive it electronically.

Perform at least one test of submittingreportable lab results. Can be done at anytime, including prior to the reporting period.State Medicaid requirements may supersede.

Group practices only need to perform one testper EHR. Not required if the public healthagencies to which the hospital submitsinformation do not have the capability toreceive it electronically.



Perform at least one test of submittingelectronic syndromic surveillance data. Can bedone at any time, including prior to thereporting period. State Medicaid requirementsmay supersede. Group practices only need toperform one test per EHR. Not required if thepublic health agencies to which the practice or

hospital submits information do not have thecapability to receive it electronically.

Conduct or review a security risk analysis andimplement security updates as necessary.



Notes

Even a value of "none" must be coded.

Provider must enter orders directly from acomputer and stored in a digital, structuredformat (no image scans). Orders do not haveto be transmitted electronically to therecipient, however. Note that progress notesare not required. Note the requirement tocount all orders issued as the denominator -how can paper orders be counted?

Current, active diagnoses plus pastdiagnoses that are relevant to patient care.Even a value of "none" must be coded.

Note that total number of prescriptions mustbe counted, including paper ones.



Even a value of "none" must be coded.



Relevant to quality metrics.

Not all orders and tests are required to mapto LOINC codes. But, codes received must bemaintained.

Patient may choose the type of reminder(electronic, paper, or telephone, forexample).

Existing federal and state laws dictateappropriate disclosure to guardian or familymember. Acceptable methods include PHR,Web portal, CD, or USB drive.



Acceptable methods include PHR, Webportal, CD, or USB drive.

Evidence of providing access can be theestablishment of a user account on a patientportal.

Alternative encounters, such as by telephoneor Web visit, are excluded. Can be providedby PHR, patient portal, secure e-mail,electronic media, or printed copy.

Includes blood tests, microbiology, urinalysis,pathology tests, radiology, cardiac imaging,nuclear medicine tests, and pulmonaryfunction tests. If the information is onlyavailable in unstructured format, that is anacceptable method of exchange. If the EHRuses the CCD standard for the summaryrecord, must still be able to read and displaya CCR summary, although it can beconverted to text or PDF.



Defined as identifying the most accurate listof medications that the patient is taking,including name, dosage, frequency, androute. Must be done at transfer of care,which includes from clinical setting toanother (inpatient, outpatient, physicianoffice, home health, rehab, long-term care)or from one provider to another.



Expected to be automatic from the EHR,although the description of the disclosurehas not yet been defined and distinguishing

"use" from "disclosure" is difficult.

Documents

Meaningful Use Preliminary Definition from HHS - 1/1/10