Anticlue

This past week, we received a refinement on the meaningful use criteria. I hope everyone is updating their strategic plans and collaborating with clinical departments. This will be a great project for all, if we plan it right!

I broke the matrix out into hospitals and all providers for the objectives and adoption year (2011 through 2013)

2011 objectives, first adoption year:

All Providers

• Use computerized physician order entry for all orders, including medications.
• Implement drug-drug, drug-allergy, drug-formulary checks
• Up to date problem list of current and active diagnoses using SNOMED or ICD9
• Generate and transmit prescriptions electronically.
• Maintain active medication listing
• Maintain active medication allergy listing
• Record demographics of preferred language, ethnicity, race, gender and insurance type
• Record advanced directives
• Record vital signs height weight blood pressure, automatically calculate BMI
• Record smoking status
• Have lab results in the clinical repository
• Generate listing of patient specific conditions
• Send reminders to patients for preventative maintenance and follow up
• Report ambulatory quality measures to CMS
• Implement one clinical decision rule relevant to specialty or high clinical priority
• Document progress notes
• Electronically check insurance eligibility.
• Submit claims electronically to payers.
• Provide patients with an electronic copy of their health information (lab results, problem list, medication lists, allergies) upon request
• Provide patient with timely electronic access to their health information including lab results, problem list, medication lists, allergies)
• Provide access to patient-specific education resources
• Provide clinical summaries for patients for each encounter
• Capability to exchange key clinical information (problem list, medication list, allergies, test results) among providers of care and patient authorized entities electronically
• Perform medication reconciliation at relevant encounters and each transition of care
• Capability to submit electronic data to immunization registries and actual submission where required and accepted
• Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice
• Compliance with HIPAA Privacy and Security Rules
• Compliance with fair data sharing practices set forth in the Nationwide Privacy and Security Framework.

Hospitals

• Use of computerized physician order entry with 10% of all orders by an authorized provider
• Implement drug-drug, drug-allergy, drug-formulary checks
• Up to date problem list of current and active diagnoses using SNOMED or ICD9
• Maintain active medication listing
• Maintain active medication allergy listing
• Record demographics of preferred language, ethnicity, race, gender and insurance type
• Record advanced directives
• Record vital signs height weight blood pressure, automatically calculate BMI
• Record smoking status
• Have lab results in the clinical repository
• Generate listing of patient specific conditions
• Report hospital quality measures to CMS
• Implement one clinical decision rule relevant to high priority hospital condition
• Electronically check insurance eligibility.
• Submit claims electronically to payers.
• Provide patients with an electronic copy of their health information (lab results, problem list, medication lists, allergies, discharge summaries, procedures) upon request
• Provide patient with an electronic copy of their discharge instructions and procedures at the time of discharge upon request.
• Provide access to patient-specific education resources
• Capability to exchange key clinical information (discharge summary, procedures, problem list, medication list, allergies, test results) among providers of care and patient authorized entities electronically (to be specified by HIE Work Group of HIT Policy Committee)
• Perform medication reconciliation at relevant encounters and each transition of care
• Capability to submit electronic data to immunization registries and actual submission where required and accepted
• Capability to provide electronic submission of reportable lab results to public health agencies and actual submission where it can be received.
• Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice
.
• Compliance with HIPAA Privacy and Security Rules
• Compliance with fair data sharing practices set forth in the Nationwide Privacy and Security Framework.

2013 objectives, third adoption year:

All Providers

• Use CPOE for all orders
• Use evidence-based order sets
• Manage chronic conditions using patient lists and decision support
• Provide clinical decision support at the point of care (reminders and alerts)
• Specialists report to relevant external disease and device registries approved by CMS (cardiology, thoracic surgery, cancer)
• Access for all patients to PHR which is populated in real time with health data
• Offer secure patient provider messaging capability
• Provide access to patient-specific educational resources in common primary languages
• Record patient preferences (preferred communication methods, advance directives, healthcare proxies, treatment options)
• Documentation of family medical history
• Upload data from home monitoring device
• Retrieve and act upon electron prescription fill data
• Produce and share an electronic summary care record for every transition in care (place of service, consults, discharge)
• Perform medication reconciliation at each transition of care from one healthcare setting to another
• Receive immunization histories and recommendations from immunization registries
• Receive health alerts from public health agencies
• Provide sufficiently anonymized electronic syndrome surveillance data to public health agencies with capacity to link to personal identifiers
• Use summarized or de-identified data when reporting data for population health purposes assuring information is available with a minimal privacy risk.

Hospitals

• Use CPOE for all order types
• Use evidence-based order sets
• Record clinical documentation in HER
• Generate and transmit permissible discharge prescriptions electronically
• Manage chronic conditions using patient lists and decision support
• Provide clinical decision support at the point of care (reminders and alerts)
• Specialists report to relevant external disease and device registries approved by CMS (cardiology, thoracic surgery, cancer)
• Conduct closed loop medication management including eMAR and computer-assisted administration
• Access for all patients to PHR which is populated in real time with health data
• Provide access to patient-specific educational resources in common primary languages
• Record patient preferences (preferred communication methods, advance directives, healthcare proxies, treatment options)
• Documentation of family medical history
• Retrieve and act upon electron prescription fill data
• Produce and share an electronic summary care record for every transition in care (place of service, consults, discharge)
• Perform medication reconciliation at each transition of care from one healthcare setting to another
• Receive immunization histories and recommendations from immunization registries
• Receive health alerts from public health agencies
• Provide sufficiently anonymized electronic syndrome surveillance data to public health agencies with capacity to link to personal identifiers

2015 objectives (5th adoption year)

• Achieve minimal levels of performance on quality, safety, and efficiency measures
• Implement clinical decisions support for national high priority conditions
• Medical device inter-operability
• Multimedia support (x-rays)
• Patients have access to self-management tools
• Electronic reporting on experience of care
• Access comprehensive patient data from all available sources
• Use of epidemiologic data
• Automated real-time surveillance(adverse events, near misses, disease outbreaks, bioterrorism)
• Clinical dashboards
• Dynamic and Adhoc quality reports
• Provide patients on request with an accounting of treatment, payment, and healthcare operations disclosures
• Protect sensitive health information to minimize reluctance to patient to seek care because of privacy concerns

Source:

• Meaningful use matrix

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