Meaningful Use (WG6)
From VistApedia
Discussion of How VistA Meets, or Can Meet,
Meaningful Use, Stage 1
45 CFR Part 170
Official document published in the Federal Register
Contents
- 1 Background discussion
- 2 All-in-one vs. Composite systems
- 3 Possible $ Bonus amounts
- 4 Listing of Criteria for Stage 1 of Meaningful Use
- 4.1 Use Computerised Provider Order Entry (CPOE)
- 4.2 Implement drug-drug, drug-allergy, drug-formulary checks
- 4.3 Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOWMED CT
- 4.4 Generage and transmit permissible prescriptions electronically (eRx)
- 4.5 Maintain active medication list
- 4.6 Maintain active medication allergy list
- 4.7 Record demographics
- 4.8 Record and chart changes in vital signs
- 4.9 Record smoking status for patients 13 yrs old or older
- 4.10 Incomporate clinical lab-test results into EHR as structured data
- 4.11 Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities and outreach
- 4.12 Report quality measures to CMS or the States
- 4.13 Send reminders to patients per patient preference for preventative/followup care
- 4.14 Implement 5 clinical decision support rules
- 4.15 Check insurance eligibility electronically frompublic and private payers
- 4.16 Submit claims electronically to public and private payers
- 4.17 Provide patients with an electronic copy of their health information upon request
- 4.18 Provide patients with an electronic copy of their discharge instructions and procedures at time of discharge, upon request
- 4.19 Provide patients with timely electronic access to their health information (including lab results, problem lists, medication lists, allergies) within 96 hours of the information being available to the eligible professional
- 4.20 Provide clinical summaries for patients for each office visit
- 4.21 Capability to exchange key clinical information among providers of care and patient authorized entities electronically.
- 4.22 Provide summary care records for each transition of care and referral
- 4.23 Perform medication reconciliation at relevant encounters and each transition of care
- 4.24 Capability to submit electronic data to immunization registries and actual submission where required and accepted.
- 4.25 Capability to provide electronic submission of reportable lab results (as required by state or local law) to public health agencies and actual submission where is can be received
- 4.26 Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice
- 4.27 Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
Background discussion
- The texts discusses EHR's as being Certified. It is not yet clear how this certification status will be awarded.
- The criteria herein are just for Stage 1 (beginning 2011). Further criteria are likely to be unveiled as the program progresses.
- Stage 2 will begin in 2013; Stage 3 in 2015
- Professionals must not only adopt/install a certified EHR, but must also demonstrate meaningful use. Thus just have a system capable of the features below will not be sufficient. They must be implemented and used.
All-in-one vs. Composite systems
Details from 45 CFR Part 170 describe the ability of a eligible system to be constructed from modules, and thus VistA doesn't have to meet all of the meaningful use criteria by itself.
Possible $ Bonus amounts
Up to $65k, maximum amount available under Medicaid
Up to $44k, maximum amount available under Medicare
Listing of Criteria for Stage 1 of Meaningful Use
Use Computerised Provider Order Entry (CPOE)
- VistA Status
- [x ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Implement drug-drug, drug-allergy, drug-formulary checks
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOWMED CT
- VistA Status
- [x] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Generage and transmit permissible prescriptions electronically (eRx)
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Maintain active medication list
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Maintain active medication allergy list
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Record demographics
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Record and chart changes in vital signs
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Record smoking status for patients 13 yrs old or older
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Incomporate clinical lab-test results into EHR as structured data
- VistA Status
- [x] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities and outreach
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Report quality measures to CMS or the States
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Send reminders to patients per patient preference for preventative/followup care
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Implement 5 clinical decision support rules
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Check insurance eligibility electronically frompublic and private payers
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Submit claims electronically to public and private payers
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Provide patients with an electronic copy of their health information upon request
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Provide patients with an electronic copy of their discharge instructions and procedures at time of discharge, upon request
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Provide patients with timely electronic access to their health information (including lab results, problem lists, medication lists, allergies) within 96 hours of the information being available to the eligible professional
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Provide clinical summaries for patients for each office visit
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Capability to exchange key clinical information among providers of care and patient authorized entities electronically.
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Provide summary care records for each transition of care and referral
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Perform medication reconciliation at relevant encounters and each transition of care
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Capability to submit electronic data to immunization registries and actual submission where required and accepted.
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Capability to provide electronic submission of reportable lab results (as required by state or local law) to public health agencies and actual submission where is can be received
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
- VistA Status
- [ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>
- Discussion/Details Page
