Joseph Rugg's Health Law Blog

The website, PhysiciansPractice.com, has published a helpful checklist for “meaningful use” in EHR.   The checklist is reprinted below, but the website provides some useful CMS links.

Meaningful Use Checklist

In order to access federal incentive dollars through your EHR, you must prove “meaningful use,” the goal of which is to improve care and outcomes for your patients.

As defined by CMS, to achieve meaningful use you must first meet 15 core objectives plus 5 additional objectives from the menu below:

15 Core Objectives (You must meet all 15)

1. Computerized provider order entry (CPOE)
2. Drug-drug and drug-allergy interaction checks
3. Maintain an up-to-date problem list of current and active diagnoses
4. E-Prescribing (eRx) (CMS does not currently have e-prescribing guidelines available; check their EHR Web site for updates.)
5. Maintain active medication list
6. Maintain active medication allergy list
7. Record demographics
8. Record and chart changes in vital signs
9. Record smoking status for patients 13 years or older
10. Report ambulatory clinical quality measures to CMS/States
11. Implement one clinical decision support rule
12. Provide patients with an electronic copy of their health information, upon request
13. Provide clinical summaries for patients for each office visit
14. Capability to exchange key clinical information among providers of care and patient-authorized entities electronically
15. Protect electronic health information

10 Additional Objectives (You must choose 5)

1. Drug-formulary checks
2. Incorporate clinical lab test results as structured data
3. Generate lists of patients by specific conditions
4. Send reminders to patients per patient preference for preventive/follow up care
5. Provide patients with timely electronic access to their health information
6. Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate
7. Medication reconciliation
8. Summary of care record for each transition of care/referrals
9. Capability to submit electronic data to immunization registries/systems (At least 1 public health objective must be selected)
10. Capability to provide electronic syndromic surveillance data to public health agencies (At least 1 public health objective must be selected)

Clinical Quality Measures (You must choose 6)

CMS also requires that you also meet 6 clinical quality measures –

One-Half of the clinical quality measures must be either the CMS core quality measures:

(NQF Measure Number & PQRI Implementation Number / Clinical Quality Measure Title)
* NQF 0013 /Hypertension: Blood Pressure Measurement
* NQF 0028 / Preventive Care and Screening Measure Pair:  a) Tobacco Use Assessment; b) Tobacco Cessation Intervention]
* NQF 0421, PQRI 128 / Adult Weight Screening and Follow-up

Or the CMS alternate core measures: 

(NQF Measure Number & PQRI Implementation Number / Clinical Quality Measure Title)
* NQF 0024 / Weight Assessment and Counseling for Children and Adolescents
* NQF0041 / PQRI 110
* Preventive Care and Screening:  Influenza Immunization for Patients 50 Years Old or Older / NQF 0038

You choose 3 more quality measures from a menu of 38 measures.

For more information on clinical quality measures, go to the following link.  In total, to achieve meaningful use, you will need to meet 26 requirements: 18 mandatory objectives and measures and another 8 of your choosing. 

You can get more information directly from CMS.