Overview of Meaningful Use Objecctives

CMS Signal for HITPC Aug '09 Stage 2 (or Stage 1 not HITPC Aug '09 Public Hearing CQMs that Could
Stage 1 Final Rule
Stage 2 included) Stage 3 Recommendations Address Objective

Key:
Astrick (*) indicates an objective that potentially could be retired in future MU stage because it would be presumed with a higher-order objective. Where a ppropriate, a new
measure is put on the same row as a Stage 1 measure that could be retired with introduction of the new.
Italics indicates optional measure for Stage 1 (CMS signaled core for Stage 2)

Improving Quality, Safety, Efficiency & Reducing Health Disparities

Longitudinal/delta
CPOE for Rx orders* (30%) CPOE for all orders

Core set of across-

settings CQMs &
additional speciality-
specific measures
Use evidence-based order sets

Core set of across-

settings CQMs &
additional speciality-
specific measures
Drug-drug/drug-allergy interaction checks
E-prescribing discharge prescriptions
E-prescribing (EP) (40%) (EH)
Stratified electronic CQM reporting by Use IOM 2009 categories for
Record demographics* (50%) disparity variables granular disparity variables
Stratified electronic CQM reporting by
Report CQM electronically* disparity variables
Maintain problem list* (80%)
Maintain active med list* (80%)
Maintain active med-allergy list* (80%)
Record vital signs* (50%)
Record smoking status* (50%)
Use CDS at point of care (e.g., reminders,
Implement 1 CDS rule* alerts)
Implement drug formulary checks
Record advance directives (EH) (50%) Record advance directives (EP)

Bidirectional interface (ordering

and incorporating lab results);
demonstrate a subset of lab
reconciliation with lab results
Incorporate lab results as structured data (40%) coming in and ordered labs
Manage chronic conditions using patient
Generate patient registry lists* registry lists
Reminders appropriate to
Send patient reminders (20%) individuals (demographics,etc.)
Electronic insurance
eligibility
Electronic claims
submission
Document progress note (EP)
Record all clinical documentation in EHR
(EH)
Record family history
Use patient-specific care plans
Specialists report to external disease
registries
Conduct closed loop medication
management (EH)

1
 Overview of Meaningful Use Objecctives

CMS Signal for HITPC Aug '09 Stage 2 (or Stage 1 not HITPC Aug '09 Public Hearing CQMs that Could
Stage 1 Final Rule
Stage 2 included) Stage 3 Recommendations Address Objective

Key:
Astrick (*) indicates an objective that potentially could be retired in future MU stage because it would be presumed with a higher-order objective. Where a ppropriate, a new
measure is put on the same row as a Stage 1 measure that could be retired with introduction of the new.
Italics indicates optional measure for Stage 1 (CMS signaled core for Stage 2)
18-month lead time for certification
criteria (see other issues list at
bottom)

Engage Patients and Families in Their Care

Patient activation
CAHPS
CAHPS for HIT
Hows Your Health
Behavior change
Real-time provision of electronic
Provide electronic copy of health information* (50%) copy

Provide electronic copy of discharge instructions (EH) at discharge (50%)

Provide clinical summaries at end
Provide clinical summaries each office visit (EP)* (50%) of visit
Provide real-time electronic
Provide timely electronic access (EP)* (10%) Provide timely electronic access (EH) access
Provide education in appropriate
language/other demographics &
Patient-specific eduation resources in via mobile devices & make
EHR-enabled patient-specific educational resources* (10%) many languages accessible to all populations
Patient-provider secure
Patient-provider secure messaging messaging
Record patient preferences (e.g.,
communication media, proxies, treatment
options)

Electronic
reporting of
patient
experience data
(caregiver input
Incorporate patient-generated data (e.g., ability w/ pt Incorporate patient-generated
devices) authorization) data (e.g., devices, surveys)

Patient access to
self-management
tools

Improve Care Coordination

Re-admission rates
Robust exchange of
Perform test of HIE* data
4 functions for recon: importing Rx
data from other sources;
Perform medication reconciliation at every comparing Rx lists; ordering meds;
Perform medication reconciliation* (50%) care transition documenting Rx info

Access
comprehensive
patient data from
Produce & share summary care record for all available Produce & share summary care
Provide summary of care record* (50%) every care transition sources record for every care transition
Retrieve and act on eRx data

2
 Overview of Meaningful Use Objecctives

CMS Signal for HITPC Aug '09 Stage 2 (or Stage 1 not HITPC Aug '09 Public Hearing CQMs that Could
Stage 1 Final Rule
Stage 2 included) Stage 3 Recommendations Address Objective

Key:
Astrick (*) indicates an objective that potentially could be retired in future MU stage because it would be presumed with a higher-order objective. Where a ppropriate, a new
measure is put on the same row as a Stage 1 measure that could be retired with introduction of the new.
Italics indicates optional measure for Stage 1 (CMS signaled core for Stage 2)
Allow for group reporting

Interactive & longitudinal care plan

Track who is on care team &
share info with patient

Transfer summary document (care

transition performance set
included in transition
recommendations) with ability to
confirm receipt (include advance
directives)
Closed-loop medication
management & labs/radiology

Improve Population and Public Health

Submit immunization data* Bidirectional immunization data Bidirectional immunization data

Submit reportable lab data

Real-time
bidirectional
Submit surveillance data Bidirectional surveillance data surveillance data Bidirectional surveillance data
Clincial
dashboards
Send to public health button
Incorporation of patient data into
public health reporting

Ensure Adequate Privacy and Security Protections for Personal Health Information

Conduct security review analysis & correct deficiencies

Use summarized/de-identified data for

population health purposes

Provide patients
with accounting
of operations
disclosures
Incorporate
technology to
segment
sensitive data
Clawback for HIPAA violators

Other Issues:

“18” month EHR vendor dilemma—4 options:

o 90-day utilization/12-month QM
o 90-day reporting period
o Certified product in middle
o Certified product at end