Welcome to AIM EMR’s Stimulus Center. Our goal in collecting the information provided in these pages is to help you in your understanding of the government stimulus and most importantly what constitutes Meaningful Use. Although we’ve tried to include the most critical information, we know how complex this issue is. If we’ve left anything out that will further help in your understanding of these government incentives and in making your EMR acquisition decision, please contact us.

 

Ruling

Meaningful Use has become a commonly used term in the medical industry. After months of waiting for the definitions of achieving “meaningful use”, on July 13, 2010, the Centers for Medicare and Medicaid (CMS) announced the final ruling for the EHR Incentive Program.

CMS will implement the meaningful use criteria in a three stage process, starting with Stage 1 of Meaningful Use (2011 and 2012). This phase of adoption is focused on healthcare professionals using certified EHR technology [such as IMS] to improve health outcomes in the following areas:

• Electronically capturing health information in a coded format
• Using that information to track key clinical conditions and communicating that information for care coordination purposes
• Implement clinical decision support tools to facilitate disease and medication management
• Reporting clinical quality measure and public health information

Stage One: The Criteria

CMS regulations outline five priorities for health outcomes:

• Improve quality, safety, efficiency, and reducing health disparities
• Engage patients and families
• Improve care coordination
• Improve population and public health
• Ensure adequate privacy and security protection of PHI [personal health information]

CMS presents 15 required “core” Objectives representing actions that meaningful users must take in order to demonstrate meaningful use. In addition to the 15 required “core” objectives an eligible professional must select 5 objectives from a menu of 10.

Core Objectives

Use computerized provider order entry (CPOE) for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines.
MEASURE: Subject to paragraph (c) of this section, more than 30 percent of all unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE.
EXCLUSION: In accordance with paragraph (a)(2) of this section Any EP who writes fewer than 100 prescriptions during the EHR reporting period.
OBJECTIVE: Implement drug-drug and drug-allergy interaction checks.
MEASURE: The EP has enabled this functionality for the entire EHR reporting period.
OBJECTIVE: Maintain an up-to-date problem list of current and active diagnoses.
MEASURE: More than 80 percent of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data.
OBJECTIVE: Generate and transmit permissible prescriptions electronically (eRx).
MEASURE: Subject to paragraph (c) of this section, more than 40 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.
EXCLUSION: In accordance with paragraph (a)(2) of this section Any EP who writes fewer than 100 prescriptions during the EHR reporting period.
OBJECTIVE: Maintain active medication list.
MEASURE: More than 80 percent of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data.
OBJECTIVE: Maintain active medication allergy list.
MEASURE: More than 80 percent of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data.
OBJECTIVE: Record all of the following demographics:

• Preferred language
• Gender
• Race
• Ethnicity
• Date of Birth

MEASURE: More than 50 percent of all unique patients seen by the EP have demographics recorded as structured data.
OBJECTIVE: Record and chart changes in the following vital signs:

• Height
• Weight
• Blood Pressure
• Calculate and display body mass index (BMI)
• Plot & display growth charts for children 2 – 20 years, including BMI

MEASURE: Subject to paragraph (c) of this section, more than 50 percent of all unique patients age 2 and over seen by the EP, height, weight and blood pressure are recorded as structured data.
EXCLUSION: In accordance with paragraph (a)(2) of this section. Any EP who either see no patients 2 years or older, or who believes that all three vital signs of height, weight, and blood pressure of their patients have no relevance to their scope of practice.
OBJECTIVE: Record smoking status for patients 13 years old or older.
MEASURE: Subject to paragraph (c) of this section, more than 50 percent of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data.
EXCLUSION: In accordance with paragraph (a)(2) of this section. Any EP who sees no patients 13 years or older.
OBJECTIVE: Report ambulatory clinical quality measures to CMS or, in the case of Medicaid EPs, the States.
MEASURE: Subject to paragraph (c) of this section, successfully report to CMS (or, in the case of Medicaid EPs, the States) ambulatory clinical quality measures selected by CMS in the manner specified by CMS (or in the case of Medicaid EPs, the States).
OBJECTIVE: Implement one clinical decision support rules relevant to specialty or high clinical priority along with the ability to track compliance with that rule.
MEASURE: Implement one clinical decision support rule.
OBJECTIVE: Provide patients with an electronic copy of their health information (including diagnostics test results, problem list, medication lists, medication allergies) upon request.
MEASURE: Subject to paragraph (c) of this section, more than 50 percent of all patients who request an electronic copy of their health information are provided it within 3 business days.
EXCLUSION: In accordance with paragraph (a)(2) of this section. Any EP who has no office visits during the EHR reporting period.
OBJECTIVE: Provide clinical summaries for patients for each office visit.
MEASURE: Subject to paragraph (c) of this section, clinical summaries provided to patients for more than 50 percent of all office visits within 3 business days.
EXCLUSION: In accordance with paragraph (a)(2) of this section. Any EP who has no office visits during the EHR reporting period.
OBJECTIVE: Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.
MEASURE: Performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information.
OBJECTIVE: Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
MEASURE: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.