Medical Practice Management

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 an eligible professional (EP) and qualify for his/her 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
Record Patient Demographics	Sex, race, ethnicity, DOB, and preferred language as structured data	80%	50%
Record Vital Signs and Chart Changes	Height, weight, blood pressure, BMI, and growth charts for children as structured data	80%	50%
Maintain Up-to-date Problem List	One entry recorded as structured data	80%	80%
Maintain Active Medication List	One entry recorded as structured data	80%	80%
Maintain Active Medication Allergy List	One entry recorded as structured data	80%	80%
Record Smoking Status	Patients age 13 and older as structured data	80%	50%
Provide Patients with Clinical Summaries	For each office visit to patients within 3 business days	80%	50%
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
Generate and Transmit Permissible Prescriptions Electronically	Using a certified EHR technology	75%	40%
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
Implement Drug-Drug and Drug-Allergy Interaction Checks	Enable functionality	Entire Reporting Period	Entire Reporting Period
Implement Ability to Exchange Key Clinical Information	Electronically among providers and patient-authorized entities	One Test	One Test
Implement Clinical Decision Support and Track Compliance	One Rule implemented and tracked	5 Rules	1 Rule
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
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
Implement Drug Formulary Checks	Must be implemented and must access at least one internal or external drug formulary	During Reporting Period	During Reporting Period
Incorporate Clinical Lab Test Results into EHR	Incorporated as structured data – positive/negative or numerical format – within the EHR	50%	40%
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
Use EHR for Patient-Specific Education Resources	Provide patient-specific education resources to patients, as appropriate	Did Not Exist	10%
Perform Medication Reconciliation	During transitions of care	80% of relevant encounters and transitions of care	50% during transitions of care
Provide Summary of Care Record	Patients referred or transitioned to another provider or setting	80%	50%
Submission of Electronic Immunization Data to Registry/Information Systems	Submission and follow-up submission (where registries can accept electronic submissions)	One Test	One Test
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
Send Reminders to Patients	Preventative and follow-up care for patients aged 65+ or age 5 or less	50% of All Patients	20%
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%

EMB 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. As demonstrated by SuccessEHS’s achievement of CCHIT 2011 fully certified with Child Health and a 5-star usability rating, SuccessEHS currently meets and exceeds the above federal requirements. Additionally, clients can be confident that SuccessEHS will continue to fulfill all additional stages of Meaningful Use set forth through future rulemaking because EMB will always strive for gold level