Meaningful Use: Core Measures
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Meaningful Use: Core Meaningful Use: Core MeasuresMeasures
Lori HinesLori Hines
Associate Vice PresidentAssociate Vice President
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EHR Incentive Programs EHR Incentive Programs HighlightsHighlights
• Medicare EHR Incentive Program– Requires demonstration of Meaningful
Use of Certified EHR Technology beginning in Year One (90 day reporting period)
– Up to $44,000 over five years
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EHR Incentive Programs EHR Incentive Programs HighlightsHighlights
• Medicare EHR Incentive Program– Payment adjustment in 2015 and after
for EPs who do not successfully demonstrate MU
– Participation can begin as early as 2011
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EHR Incentive Programs EHR Incentive Programs HighlightsHighlights
• Medicaid EHR Incentive Program– First year: Adopt, implement, upgrade or
demonstrate MU of certified EHR technology
– Requires demonstration of Meaningful Use in subsequent years
– Up to $63,750 over six years4
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EHR Incentive Programs EHR Incentive Programs HighlightsHighlights
• Medicaid EHR Incentive Program– No payment adjustment
– Program is voluntarily offered by individual states and may begin as early as 2011, depending upon the state
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Requirements for Demonstration Requirements for Demonstration of Meaningful Useof Meaningful Use
• Must meet all 15 Core Measures*
*Some exclusions are allowed for specific measures, reducing the number of required measures accordingly
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Requirements for Demonstration Requirements for Demonstration of Meaningful Useof Meaningful Use• Must achieve compliance with 5 out of
10 Menu Set measures*– One of the five Menu Set measures must
be related to Public Health (either Immunization Registry or Electronic Syndromic Surveillance)
*Some exclusions are allowed for specific measures, reducing the number ofrequired measures accordingly
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Core Measures Affecting Core Measures Affecting Physician Workflow RoutinePhysician Workflow Routine
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Record Vital Signs: Record Vital Signs: Core Measure #8Core Measure #8• Record and chart changes in the following
vital signs:
– Height, Weight, Blood Pressure
– Calculate and display BMI• Plot and display growth charts for children
2-20 years• Stage One Threshold: > 50% of unique
patients >=2 years old• Exclusion: EP who sees no patients >=2
years old or who believes all three vitals have no relevance to their scope of practice
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Documentation of Vitals & Documentation of Vitals & Smoking StatusSmoking Status
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Record Smoking Status:Record Smoking Status:Core Measure #9Core Measure #9• For all patients 13 and older, assess
smoking status• Stage One Threshold: > 50% of
patients 13 and older seen during the reporting period
• Exclusion: EP who sees no patients >=13 years old
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CPOE: Core Measure #1CPOE: Core Measure #1
• Use computerized provider order entry (CPOE) for medication orders
• Stage One Threshold: > 30% of unique patients seen during the reporting period
• Exclusion: EP who writes fewer than 100 Rx’s during the reporting period
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Active Medication Allergy List:Active Medication Allergy List:Core Measure #6Core Measure #6• Maintain active medication allergy
list; document allergies or document “No Known Allergies”
• Stage One Threshold: > 80% of unique patients seen during the reporting period
• No exclusion
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Active Medication List:Active Medication List:Core Measure #5Core Measure #5• Maintain active medication list.
Document medications patient is taking using structured drug database or document “No Known Current Medications”
• Stage One Threshold: > 80% of unique patients seen during the reporting period
• No exclusion14
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Documentation of Active Documentation of Active MedicationsMedications
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Drug Interaction Checks:Drug Interaction Checks:Core Measure #2Core Measure #2• Implement drug-drug and drug-
allergy checks• Stage One Threshold: By attestation
(EP has this functionality for the entire reporting period)
• No Exclusion
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Documentation of Warning Documentation of Warning Override ReasonOverride Reason
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Electronic Prescribing: Electronic Prescribing: Core Measure #4Core Measure #4• Generate & transmit permissible
prescriptions electronically (eRx)– Contact SuccessEHS Support to enroll if
you’re not already eRx’ing
• Stage One Threshold: > 40% of permissible prescriptions written during reporting period are transmitted electronically
• Exclusion: EP who writes <100 Rxduring reporting period
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e-Prescribing (eRx)e-Prescribing (eRx)
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More Reasons to e-Prescribe!More Reasons to e-Prescribe!
• 2012 Medicare Payment Adjustment–1% Medicare Payment Adjustment
for physicians reimbursed under PFS unless National Claims History database receives 10 qualifying encounters with G8553 (or single hardship code) between January 1, 2011 & June 30, 2011!
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More Reasons to e-Prescribe!More Reasons to e-Prescribe!
• 2011 eRx Incentive– Receive 1% bonus in 2012 if >=25
qualifying encounters with G8553 verified in NCH database for DOS 1/1/2011 – 12/31/2011
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Maintain Problem List:Maintain Problem List:Core Measure #3Core Measure #3• Maintain an up-to-date problem list
of current and active diagnoses. Document problems (or “No Known Problems”) as structured data
• Stage One Threshold: > 80% of unique patients seen during the reporting period
• No Exclusion
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Documentation of ProblemsDocumentation of Problems
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Clinical Decision Support:Clinical Decision Support:Core Measure #11Core Measure #11• Implement one clinical decision
support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule
• Stage One Threshold: Attestation• No Exclusion
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Clinical Decision Support Clinical Decision Support RulesRules
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Clinical Decision Support Clinical Decision Support Preferences & AlertsPreferences & Alerts
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Clinical Summaries:Clinical Summaries:Core Measure #13Core Measure #13• Provide clinical summaries for
patients for each office visit• Stage One Threshold: > 50% of all
office visits (provided within three business days)
• Exclusion: EP who has no office visits during EHR reporting period.
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Clinical Quality Measures: Clinical Quality Measures: Core Measure #10Core Measure #10• Report ambulatory clinical quality
measures (CQMs) to CMS in the manner specified by CMS to meet the measure
• Stage One Threshold: Attestation • No Exclusion
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Electronic Copy of Health Electronic Copy of Health Information: Core Measure #12Information: Core Measure #12• Provide patients with electronic copy
of HI upon request• Stage One Threshold: < 50% of all
patients requesting electronic copy receive it within 3 business days
• Exclusion: Any EP that has no requestsfor electronic copy during the entirereporting period.
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Other Core MeasuresOther Core Measures
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Record Demographics:Record Demographics:Core Measure #7Core Measure #7• Record all of the following
demographics: Preferred language, Gender, Race, Ethnicity, DOB
• Stage One Threshold: < 50% of all unique patients seen during the reporting period
• No Exclusion
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Exchange of Clinical Data:Exchange of Clinical Data:Core Measure #14Core Measure #14• Perform at least one test of certified
EHR technology’s capacity to electronically exchange key clinical information
• Stage One Threshold: by attestation• No Exclusion
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Exchange of Clinical DataExchange of Clinical Data
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Protect Electronic Health Info:Protect Electronic Health Info:Core Measure #15Core Measure #15• Conduct or review a security risk
analysis and implement security updates/correct deficiencies as necessary
• Stage One Threshold: by attestation• No Exclusion
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Interested in learning more about Meaningful Use? Visit http://www.successehs.com/item/hitech-meaningful-use-certified-systems/registering-for-meaningful-use.htm for more information.
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