Discussion of How VistA Meets, or Can Meet,
Meaningful Use, Stage 1
45 CFR Part 170

Official document published in the Federal Register

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 bot adopt 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

The text defines several similar by different terms:
- Qualified EHR --
- EHR Module
- Complete EHR
- Certified EHR

Note: A composite system composed of individually certified modules, to make a complete system.

Possible $ Bonus amounts

Listing of Criteria for Stage 1 of Meaningful Use

Use Computerised Provider Order Entry (CPOE)

Enable a user to electronically record, store, retrieve and manage, at a minimum, the following order types:

1. Medications
2. Laboratory
3. Radiology/Imaging
4. Provider referrals

Implement drug-drug, drug-allergy, drug-formulary checks

VistA

Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOWMED CT

VistA

Generage and transmit permissible prescriptions electronically (eRx)

Maintain active medication list

Maintain active medication allergy list

Record demographics

Record and chart changes in vital signs

Record smoking status for patients 13 yrs old or older

Incomporate clinical lab-test results into EHR as structured data

Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities and outreach

Report quality measures to CMS or the States

Send reminders to patients per patient preference for preventative/followup care

Implement 5 clinical decision support rules

Check insurance eligibility electronically frompublic and private payers

Submit claims electronically to public and private payers

Provide patients with an electronic copy of their health information upon request

Provide patients with an electronic copy of their discharge instructions and procedures at time of discharge, upon request

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

Provide clinical summaries for patients for each office visit

Capability to exchange key clinical information among providers of care and patient authorized entities electronically.

Provide summary care records for each transition of care and referral

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 (as required by state or local law) to public health agencies and actual submission where is can be received

Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice

Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.

Meaningful Use (WG6)

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