The recent release of the Final Rule on Medicaid and Medicare Incentive Programs for Electronic Health Records includes the Stage 1 meaningful use criteria that eligible professionals (EP), such as Physicians, Nurse Practitioners or Physician Assistants, and eligible hospitals (EH) must achieve to qualify for incentive funding. What hasn't been exactly clear in many discussions is the actual number of meaningful use criteria that are now required in order to reach Stage 1 meaningful use.
The list of criteria was reduced from the “all or nothing” approach recommended in the proposed rule to a new model. EPs or EHs now must achieve the core criteria (15 for EPs and 14 for EHs) plus achieve an additional 8 criteria from a menu of 12 options listed below. So for EPs, a total of 23 measures must be achieved to reach Stage 1, and for EHs a total of 22 measures will be required to reach Stage 1.
Eligible professionals and hospitals can select any five of the optional menu items TO DEFER, however, they must always achieve at least one of the population and public health criteria and related measures.
The menu set of criteria (from which 5 may be deferred) include:
• Implement drug-formulary checks for prescribing/medication ordering
• Record advanced directives (applies to hospitals only)
• Incorporate clinical laboratory test results into certified EHR technology as structured data
• Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach
• Send reminders to patients per patient preference for preventive or follow-up care (applies to eligible professionals only)
• Provide patients with timely electronic access to their health information (eligible professionals only)
• Use certified EHR technology to identify patient-specific education resources and provide those to the patient if appropriate
• Perform medication reconciliation when a patient is received from another setting or provider
• Provide a summary care record when transferring or referring a patient
• Capability to submit electronic data to immunization registries in accordance with applicable law and practice
• Capability to submit reportable laboratory test result data to public health agencies (hospitals only)
• Capability to submit electronic syndromic surveillance data to public health agencies in accordance with applicable law and practice
The final rule recognizes that in some cases these criteria cannot be accomplished because of a lack of infrastructure or readiness. For example, if there is no state immunization registry in place or it is not capable of receiving electronic data. In these cases the EP or EH can indicate the criteria is not applicable. Otherwise, all EPs and EHs will need to review the menu set to determine what is applicable and feasible and determine whether any criteria can or should be deferred.
The Colorado Rural Health Center and ClinicNet operating as a Regional Extension Center (“REC”) Contractor will be providing a meaningful use analysis to all eligible professionals or hospitals who enroll with us as their primary REC Contractor.
Join our next Consortium Webinar August 19th, 12-1:15 pm where we will begin discussing meaningful use and the final rule in greater detail.
