Meaningful Use Of Your
Electronic Health Records or EHR

Meaningful Use refers to the requirements that must be demonstrated by eligible providers in the use of their electronic health records software. Read this article for straightforward directions on how to obtain your EHR federal stimulus funds.

1. Register with CMS for the incentive program at:

   https://ehrincentives.cms.gov
   

   What you will need:

   • National Provider Identifier or NPI
   • Tax identification number
   • Your NPPES User ID and Password (you created these when you signed up for your NPI)
   • You must be enrolled in the PECOS system for Medicare incentive payments

2. Use your certified electronic health records system for a 90 consecutive day reporting period during which time you demonstrate meaningful use.

   Meaningful Use: You are required to meet all fifteen objectives in the Core Set and a minimum of five objectives in the Menu Set.

3. Attest to meaningful use or MU through the CMS' web-based Medicare Incentive Program Registration and Attestation System. In this system, you will fill in numerators and denominators for the MU objectives and clinical quality measures.

   What are numerators and denominators? Here's an example: the denominator for the electronic prescriptions measure consists of the total number of prescriptions written for drugs during the 90-day reporting period. The numerator consists of the number of prescriptions generated and transmitted electronically using your EHR. In order to meet the objective for MU, 40% of all permissible prescriptions written must be generated and transmitted electronically. If you wrote 100 prescriptions in the 90-day period, 40 of them would need to be processed electronically. You will need to attest to this fact.

4. Once providers have completed a successful online submission through the Attestation System, they will qualify for a Medicare EHR incentive payment.

The following are the meaningful use criteria:

---

CORE SET

You must meet all fifteen objectives in the following Core Set in order to demonstrate Meaningful Use.

1. Demographics
   • Date of Birth
   • Gender
   • Race
   • Ethnicity
   • Preferred Language

   Requirement: Record patient demographics in the patient data section of the patient’s electronic chart. Maintain this during the 90-day MU reporting period. All demographic fields listed above must be recorded for more than 50% of patients.

2. Vital signs

   • Height
   • Weight
   • Blood Pressure

   Requirement: More than 50% of patients 2 years of age or older must have the vital signs listed above recorded during the 90-day reporting period.

3. Up-to-date problem list of current and active diagnosis.

   Requirement: More than 80% of patients have at least one entry recorded as problem list data or an indication that the patient has no problems during the reporting period.

4. Active medications list.

   Requirement: Have at least one medication entered into the routine medication list or indicate the patient is not on any medications for more than 80% of patients.

5. Medication allergy list.

   Requirement: Have at least one medication allergy recorded or indicate that the patient has no allergies for more than 80% of the patients during the reporting period.

6. Smoking status.

   Requirement: Record smoking status for more than 50% of patients 13 years of age or older during 90-day reporting period.

7. Provide encounter summary to a patient.

   Requirement: Within 3 business days of request, provide encounter summaries to 50% of patients requesting summaries. The clinical summary must include:

   • Diagnostic test results
   • Problem list
   • Medication list
   • Medication allergy list

8. Provide electronic copies of records to patients.

   Requirement: Upon request, provide patients with an electronic copy of their health information (diagnostic test results, problem list, medication list, and medication allergies list). More than 50% of requesting patients must receive an electronic copy within 3 business days.

9. Electronically prescribe medications for patients.

   Requirement: Generate and electronically transmit more than 40% permissible (non controlled substances) prescriptions using certified EHR technology during reporting period.

10. Medication Order Entry.

    Requirement: More than 30% of patients with at least one medication in their medication list must have at least one medication ordered through ‘computerized physician order entry’ (CPOE).

11. Perform a drug and allergy interaction check.

    Requirement: Implement drug to drug and drug to allergy interaction checks for the entire reporting period.

12. Demonstrate the capacity to electronically exchange information.

    Requirement: Exchange clinical information and patient summary among providers and other patient-authorized entities. Providers need to be able to send, receive, and display information from other organizations on a minimum of healthcare criteria:

    • Diagnostic test results
    • Problem list
    • Medication list
    • Medication allergy list
    It is only necessary to perform one test demonstrating this capability during the 90-day reporting period.

13. Demonstrate the steps necessary to meet One Clinical Decision Support Rule.

    Requirement: Implement one clinical decision support rule and have the ability to track compliance with the rule. This needs to be an automated, electronic rule based on data elements included in the problem list, medication list, demographics, and lab test results. Notifications also need to be automatically and electronically generated to indicate real-time notifications and care suggestions based on the rule.

Examples of clinical decision support rules: mammograms every year for women over 40, hypertension, blood pressure check every year.

14. Demonstrate the ability to protect privacy and security of patient data.

    Requirement: Conduct or review a security risk analysis, implement security updates as necessary, and correctly indentify security deficiencies.

15. Demonstrate the ability to report clinical quality measures to CMS or states.

    Requirement: Capture all of the following items as structured data:

    • Blood pressure
    • Tobacco use
    • Weight
    • Three clinical quality measures specified by CMS




---

MENU SET

To demonstrate Meaningful Use, you must meet a minimum of five objectives in the following Menu Set.

1. Demonstrate the ability to conduct formulary checks.

   Requirement: Drug formulary check system is implemented and has access to at least one internal or external drug formulary for the entire reporting period.

2. Demonstrate the ability to incorporate laboratory test results into EHR as structured data.

   Requirement: More than 40% of lab results during the reporting period should be in positive/negative or numeric format and incorporated as structured data.

3. Demonstrate the ability to generate lists of patients by specific conditions.

   Requirement: Generate lists of patients by specific condition (Active Problems) to use for quality improvement, reduction of disparities, research, or outreach. Attest that at least one list was created during the 90-day reporting period.

4. Use EHR to identify patient-specific education resources and provide those resources to the patients as appropriate.

   Requirement: More than 10% of patients are provided with patient-specific education resources during reporting period.

5. Demonstrate the ability to perform medication reconciliation between care settings.

   Requirement: Perform medication reconciliation between care settings for more than 50% of transitions of care during reporting period.

6. Demonstrate the ability to provide summary of care records from EHR for patients referred or transitioned to another provider.

   Requirement: Provide clinical summaries for more than 50% of patient transitions or referrals during the 90-day reporting period.

7. Demonstrate the ability to submit electronic data to immunization registries or immunization information systems using EHR.

   Requirement: Submit electronic data to immunization registries or immunization information systems. Perform at least one test of data submission and follow-up submission. Only one test per reporting period is required.

8. Demonstrate the ability to submit electronic syndromic surveillance data to public health agencies using EHR

   Requirement: Submit electronic syndromic surveillance data to public health agencies. At least one test of data submission and follow-up submission must be performed during the reporting period. There is no requirement for an ongoing, working exchange of information.

9. Demonstrate the ability to send reminders to patients for preventative and follow-up care using EHR.

   Requirement: Send reminders to patients for preventative and follow-up care for more than 20% of patients 65 and older or 5 and younger. Clinics need to issue these reminders based on conditions, recalls, medications, and demographic parameters.

10. Demonstrate the ability to provide patients with timely electronic access to their health information using EHR

    Requirement: Provide patients with timely electronic access to their health information including:

    • Lab results
    • Problem list
    • Medication list
    • Medication allergies

    This requirement must be accomplished for more than 10% of requesting patients within four days of it being updated in the EHR. This includes patient capability to create copies of their clinical summaries.

In summary, you need to comply with all fifteen items in the Core Set and a minimum of five in the Menu Set. Ask your software vendor for assistance to help guide you through the meaningful use process.




From Meaningful Use Back To Electronic Health Records
From Meaningful Use Back To Home Page

---

Medical-Billing-Guide.com 53 Charro Drive Santa Rosa, CA 95401 © Copyright 2008 Medical-billing-guide.com No reproduction permitted without permission.


SBI!