Meaningful Use
by David Herrig, Training Manager
We are all hearing a lot about “Meaningful Use” in recent days, but also a lot of confusing statements about what that means and how physicians who use an EMR are going to be affected. While “Meaningful Use” is very much a work in progress, there are some things that are known that will help us all prepare for this very important aspect of using an EMR. It is our hope that the following FAQs will assist your practice in dealing with “Meaningful Use”.
Q. What is happening with EMR certification, and is Patient Chart Manager certified?
A. The lefts for Medicare and Medicaid Services (CMS) has just recently certified three certifying bodies that will provide the certification for EMRs. All EMR vendors will apply for certification of their programs. There will be no “grandfathering” of any previously certified EMRs, such as those who have a prior CCHIT certification. Prime Clinical Systems will be applying for certification and is currently in the process of making the necessary updates to Patient Chart Manager to meet the certification guidelines.
Q. What are the certification requirements?
A. CMS has identified 15 core objectives that must be met and an additional 10 optional objectives of which 5 must be met. Both lists are included at the end of this document.
Q. Will Prime Clinical Systems’ Patient Chart Manager meet these requirements?
A. Patient Chart Manager programmers have reviewed all the criteria and many of the requirements are already in place. Some require additional modification to meet the new requirements and a couple are in development. When certification is applied for, all requirements will be met.
Q. What will my practice have to do to meet the requirements?
A. First you will need to have the latest version of Patient Chart Manager. You will also then need to be using it as it is designed. Prime Clinical Systems will be offering workshops and ongoing training to assist you in any new features that you will need to learn.
Q. When is the latest I can start using “Meaningful Use and get my full rebate?
A.
Practices must use a certified EMR for at least 90 days prior to December
31, 2012 to qualify for the full rebate. The earliest practices can start
is January 1,2011 meaning that a practice must at least use a Meaningful
Use EMR until March 31, 2011 to qualify.
Core set of objectives to be achieved by all eligible professionals, hospitals, and critical access hospitals to qualify for incentive payments:
1. Record patient demographics (sex, race, ethnicity, date of birth, preferred language. Over 50% of patients’ demographic data recorded as structured data.
2. Record vital signs and chart changes (height, weight, blood pressure, body-mass index, growth charts for children). Over 50% of patients 2 years of age or older have height, weight, and blood pressure recorded as structured data.
3. Maintain up-to-date problem list of current and active diagnoses. Over 80% of patients have at least one entry recorded as structured data.
4. Maintain active medication list. Over 80% of patients have at least one entry recorded as structured data.
5. Maintain active medication allergy list. Over 80% of patients have at least one entry recorded as structured data.
6. Record smoking status for patients 13 years of age or older. Over 50% of patients 13 years of age or older have smoking status recorded as structured data.
7. Provide patients with clinical summaries for each office visit. Clinical summaries provided to patients for over 50% of all office visits who ask for it
8. On request, provide patients with an electronic copy of their health information (including diagnostic-test results, problem list, medication lists, medication allergies). Over 50% of requesting patients receive electronic copy within 3 business days
9. Generate and transmit permissible prescriptions electronically. Over 40% are transmitted electronically using certified EHR technology.
10. Computer provider order entry (CPOE) for medication orders. Over 30% of patients with at least one medication in their medication list have at least one medication ordered through CPOE.
11. Implement drug–drug and drug–allergy interaction checks. Functionality is enabled for these checks for the entire reporting period.
12. Implement capability to electronically exchange key clinical information among providers and patient-authorized entities. Perform at least one test of EHR’s capacity to electronically exchange information.
13. Implement one clinical decision support rule and ability to track compliance with the rule.
14. Implement systems to protect privacy and security of patient data in the EHR. Conduct or review a security risk analysis, implement security updates as necessary, and correct identified security deficiencies.
15. Report clinical quality measures to CMS or states. For 2011, provide aggregate numerator and denominator through attestation; for 2012, electronically submit measures.
Of the following 10 items, 5 must be used. At least one of the five must be either 9 or 10.
1. Implement drug formulary checks. Drug formulary check system is implemented and has access to at least one internal or external drug formulary for the entire reporting period.
2. Incorporate clinical laboratory test results into EHRs as structured data. Over 40% of clinical laboratory test results whose results are in positive/negative or numerical format are incorporated into EHRs as structured data.
3. Provide summary of care record for patients referred or transitioned to another provider or setting. Summary of care record is provided for over 50% of patient transitions or referrals.
4. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach. Generate at least one listing of patients with a specific condition.
5. Use EHR technology to identify patient-specific education resources and provide those to the patient as appropriate. Over 10% of patients are provided patient-specific education resources.
6. Send reminders to patients (per patient preference) for preventive and follow-up care. Over 20% of patients 65 years of age or older or 5 years of age or younger are sent appropriate reminders.
7. Provide patients with timely electronic access to their health information (including laboratory results, problem list, medication lists, medications and allergies). Over 10% of patients are provided electronic access to information within 4 days of its being updated in the EHR.
8. Perform medication reconciliation between care settings Medication reconciliation is performed for over 50% of transitions of care. Must document the input of medications from another provider with the medications currently being taken, keeping the medication list updated.
9. Submit electronic immunization data to immunization registries or immunization information systems. Perform at least one test of data submission and follow-up submission (where registries can accept electronic submissions).
10. Submit electronic syndromic surveillance data to public health agencies. Perform at least one test of data submission and follow-up submission (where public health agencies can accept electronic data).