Enacted under the American Recovery and Reinvestment Act of 2009 (ARRA), HITECH promotes adoption of electronic health records by health care providers through financial incentives under Medicare or Medicaid. On January 13, 2010, CMS published its proposed rule for incentives, hailed by many as Meaningful Use. Six months and 2,000 comments later, the long-awaited final rule for Stage 1 Meaningful Use was announced on Tuesday, July 13, 2010, outlining the initial criteria for providers to become eligible professionals (EPs) and qualify for their portion of $27B in available incentive dollars.
The final rule relaxes the proposed Stage 1 measures by dividing the 25 objectives into a core set of 15 requirements for all providers and a “menu” set of 10 objectives from which an EP will choose five. Additionally, HHS has lowered the calculation thresholds, reduced quality metrics, and removed administrative requirements for electronic claims and eligibility checking.
| 15 Core Objectives – Required for All EPs |
| Objective | Measure | Old Threshold | New Threshold |
| 1 |
Record Patient Demographics |
Sex, race, ethnicity, DOB, and preferred language as structured data |
80% |
50% |
| 2 |
Record Vital Signs and Chart Changes |
Height, weight, blood pressure, BMI, and growth charts for children as structured data |
80% |
50% |
| 3 |
Maintain Up-to-date Problem List |
One entry recorded as structured data |
80% |
80% |
| 4 |
Maintain Active Medication List |
One entry recorded as structured data |
80% |
80% |
| 5 |
Maintain Active Medication Allergy List |
One entry recorded as structured data |
80% |
80% |
| 6 |
Record Smoking Status |
Patients age 13 and older as structured data |
80% |
50% |
| 7 |
Provide Patients with Clinical Summaries |
For each office visit to patients within 3 business days |
80% |
50% |
| 8 |
Electronic Copy of Health Information |
Upon request, including diagnostic test results, problem list, medication list, and medication allergies |
80% within 48 hours of request |
50% within 3 business days of request |
| 9 |
Generate and Transmit Permissible Prescriptions Electronically |
Using a certified EHR technology |
75% |
40% |
| 10 |
Computerized Provider Order Entry (CPOE) |
Patients with at least one medication in their medication list must have at least one medication ordered through CPOE |
80% of All Orders |
30% of Medication Orders Only |
| 11 |
Implement Drug-Drug and Drug-Allergy Interaction Checks |
Enable functionality |
Entire Reporting Period |
Entire Reporting Period |
| 12 |
Implement Ability to Exchange Key Clinical Information |
Electronically among providers and patient-authorized entities |
1 Test |
1 Test |
| 13 |
Implement Clinical Decision Support and Track Compliance |
One Rule implemented and tracked |
5 Rules |
1 Rule |
| 14 |
Implement Systems to Protect Privacy and Security of Patient Data |
Conduct/review a security risk analysis; implement security updates as necessary and correct security deficiencies |
During Reporting Period |
During Reporting Period |
| 15 |
Report Clinical Quality Measures |
To CMS or states |
CY2011 provide aggregate numerator/denominator through attestation; CY2012 electronic submission of measures |
CY2011 provide aggregate numerator/denominator through attestation; CY2012 electronic submission of measures |
| 10 Menu Objectives – EPs Choose 5 |
| Objective | Measure | Old Threshold | New Threshold |
| 1 |
Implement Drug Formulary Checks |
Must be implemented and must access at least one internal or external drug formulary |
During Reporting Period |
During Reporting Period |
| 2 |
Incorporate Clinical Lab Test Results into EHR |
Incorporated as structured data – positive/negative or numerical format – within the EHR |
50% |
40% |
| 3 |
Generate Lists of Patients by Condition |
For use in quality improvement, reduction of disparities, research or outreach. |
1 List with a Specific Condition |
1 List with a Specific Condition |
| 4 |
Use EHR for Patient-Specific Education Resources |
Provide patient-specific education resources to patients, as appropriate |
Did Not Exist |
10% |
| 5 |
Perform Medication Reconciliation |
During transitions of care |
80% of relevant encounters and transitions of care |
50% during transitions of care |
| 6 |
Provide Summary of Care Record |
Patients referred or transitioned to another provider or setting |
80% |
50% |
| 7 |
Submission of Electronic Immunization Data to Registry/Information Systems |
Submission and follow-up submission (where registries can accept electronic submissions) |
One Test |
One Test |
| 8 |
Submission of Electronic Syndromic Surveillance Data |
Data submission and follow-up submission to Public Health agencies (where agencies can accept electronic data) |
One Test |
One Test |
| 9 |
Send Reminders to Patients |
Preventative and follow-up care for patients aged 65+ or age 5 or less |
50% of All Patients |
20% |
| 10 |
Timely Electronic Access to Health Information |
Including lab results, problem list, medication list, medication allergies – within 4 days of being updated in the EHR |
10% |
10% |
EHS is committed to meeting all HHS requirements so that its clients can achieve Meaningful Use and eligibility for HITECH incentives. This includes providing the software features necessary to comply with Stage 1 Meaningful Use as published by the U.S. Department of Health & Human Services. EHS currently meets and exceeds the federal requirements, as outlined above. This is clearly demonstrated with the approval of CareRevolution® 5.3, as a fully CCHIT Certified® 2011 Ambulatory EHR with additional certification in Child Health and a 5-star usability rating. Additionally, clients can be confident that EHS will continue to fulfill all additional stages of Meaningful Use set forth through future rulemaking, because EHS will always strive for gold level certification.
EHS believes adoption and meaningful use of its EHR solution is about more than technology. It is about being entrusted to deliver solutions that drive quality of care and value for the patient. We look forward to serving you.
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