Meaningful Use Requirements?
James K. Kirchner, OD
By James K. Kirchner, OD
With so much money at stake over the next five years, the government entity overseeing EHR incentives, the Centers for Medicare & Medicaid Services (CMS), needed a process to ensure doctors were not simply buying EHR software, but that they were effectively putting it to use every day in their practice. This daily, transformative use of the software is what is meant by the term “meaningful use.” To make it practical and reportable, CMS developed a list of 25 meaningful use criteria that your use of EHR software must meet.
In 2011, the government is allowing doctors to prove meaningful use by tracking use of the software during a 90-day period. Beginning in 2012, the doctor will have to prove meaningful use for a full 12 months. In 2011, the reporting of the successful fulfillment of the Meaningful Use objectives utilizing certified EHR software is provided through personal attestation. This is accomplished by providing CMS with the fulfillment numbers detailed in the 25 objectives. A note of importance is that for 2011 and 2012, doctors will have to fulfill 20 out of the 25 Meaningful Use Objectives. Beginning in 2012, this process of reporting the use of the certified software, known as attestation, will be taken out of the doctor’s hands, with the software sending reports of usage directly–and automatically–to CMS.
The maximum payment for 2011 is $18,000 per eligible provider (EP). Each EP in your practice can collect, but each can only receive a maximum of $18,000 during 2011, regardless of how many locations they practice in. An extra incentive of $1,800 can be received if you’re practicing in a Health Professional Shortage Area. The maximum total payment per eligible provider is $44,000 over five years. To receive this full amount, you must enroll and demonstrate meaningful use of a certified EHR program during 2011 or 2012. But remember, in 2011 you can be successful in demonstrating meaningful use for 90 days, in 2012 it will be required for the full 12 months.
For tips on achieving meaningful use and other aspects of transitioning to electronic heath records, visit Eyefinity OfficeMate’s Meaningful Use page, and see my latest blog post, “Dr. Kirchner Explains Meaningful Use Objectives and Exclusions.”
25 CMS Meaningful Use Objectives
You will need to fulfill at least 20 of these criteria to qualify for the incentive (all 15 core objectives and five out of 10 menu objectives).You have the ability to fulfill an objective by exclusion. The exclusions are specific to certain objectives and are clarified in a list developed by CMS. You can find this list, along with links to dig deeper into meaningful requirements at https://www.cms.gov/EHRIncentivePrograms/Downloads/EP-MU-TOC.pdf, or at the Eyefinity web site, www.eyefinity.com.
Eligible Professional Core Measures (fulfill all 15)
- Implement drug-drug and drug-allergy interaction checks.
- 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.
- Maintain an up-to-date problem list of current and active diagnoses.
- Generate and transmit permissible prescriptions electronically (eRx).
- Maintain active medication list.
- Maintain active medication allergy list.
- Record all of the following demographics:
(A) Preferred language.
(B) Gender.
(C) Race.
(D) Ethnicity.
(E) Date of birth. - Record and chart changes in the following vital signs:
(A) Height.
(B) Weight.
(C) Blood pressure.
(D) Calculate and display body mass index (BMI).
(E) Plot and display growth charts for children 2–20 years, including BMI. - Record smoking status for patients 13 years old or older.
- Report ambulatory clinical quality measures to CMS or, in the case of Medicaid EPs, the States.
- Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule.
- Provide patients with an electronic copy of their health information (including diagnostics test results, problem list, medication lists, medication allergies) upon request.
- Provide clinical summaries for patients for each office visit.
- 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.
- Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
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Implement drug formulary checks.
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Incorporate clinical lab-test results into EHR as structured data.
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Generate patient lists by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.
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Send patient reminders per patient preference for preventive/follow-up care.
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Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, and allergies) within four business days of the information being available to the EP.
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Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate.
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The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.
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The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral.
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Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice.
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Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice.
