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Intregration of
Meaningul Use
Incentive Timeline

Meaningful Use

Meaningful use (MU) is a determined critical level for the use of electronic health records (EHR) and related technology within a healthcare organization. According to the provisions of the Healthcare Information Technology for Economic and Clinical Health Act (HITECH), healthcare organizations that have achieved meaningful use by 2011 will be eligible for incentive payments; those who have failed to achieve that standard by 2015 could be penalized.
The Centers for Medicare & Medicaid Services (CMS) is working with the Office of the National Coordinator for Health IT and other parts of Department of Health and Human Services (HHS) to establish regulations for the first year of the initiatives program. The working group will also establish criteria to determine meaningful use. 
There are a set of a set of 15 criteria that medical providers must meet in order to prove that they are using their EMR as an effective tool in their practice. In addition, 10 extra criteria are considered as side menu items, from which only five need to be demonstrated by the medical provider. A total of 20 Meaningful Use criteria must be completed by the proved to qualify for stimulus payments during stage one of the EHR incentive program.

Meaningful Use includes three stages which spans over five years. Please take a look below:

    •  Stage One: Essentially, use major functionality of a certified EMR. Document set percentages of your visits, diagnoses, prescriptions, immunizations and other relevant health information electronically; use clinical support tools (warnings and reminders that will be included in certified EMRs); share patient information; and report quality measures and public health information.
    • Stage Two: In addition to continuing to use all functionality from stage 1, physicians will be required to use an EMR to send and receive information such as lab orders and results. Proposed stage 2 criteria are currently out for public comment.
    • Stage Three: Continue fulfilling criteria from stages 1 and 2 plus clinical decisions support for national high priority conditions, enrolling patients in a PHR, accessing comprehensive patient data and improving population health. Stage 3 criteria have not yet been defined in detail.

 Mandatory and Meaningful Use Criteria

Main Menu Set: All 15 Measures Required

    • Demographics (50%)
    • Vitals: BP and BMI (50%)
    • Problem list:
      ICD-9-CM or SNOWMED (80%)
    • Active medication list (80%)
    • Medication allergies (80%)
    • Smoking status (50%)
    • Patient clinical visit summary
      (50% in 3 days)
    • Hospital discharge instructions (50%)
      - or -
      Patient with electronic copy (50% in 3 days)
    • e-Prescribing (40%)
    • CPOE (30% including a med)
    • Drug-drug and drug-allergy interactions
      (functionality enabled)
    • Exchange critical information
      (perform test)
    • Clinical decision support
      (one rule)
    • Security risk analysis
    • Report clinical quality
      (BP, BMI, Smoke, plus 3 others)

Core Menu set:  5 of 10 Measures are Required

    • Implement drug-formulary checks.
    • Incorporate clinical lab-test results into HER as structured data.
    • Specific conditions to use for quality improvement, reduction of disparities, research, or outreach.
    • Send reminders to patients per patient preference for preventive/followup care.
    • Provide patients with timely electronic access to their health information within 4 business days.
    • Use certified EHR technology to indentify patient-specific education resources and provide those resources to the patient.
    • The EP who receives a patient from another setting of care should perform medication reconciliation.
    • The EP who transitions their patient to another setting of care should provide summary care record for each referral.
    • Capability to submit electronic data to immunization registries or immunization information systems.
    • Capability to submit electronic syndromic surveillance data to public health agencies.

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