Meaningful Use Core and Menu Requirements

Core Objectives and Measures

All core objectives must be met, unless an exception applies. Several objectives do not allow exceptions.

Core Objective: Use computerized physician order entry (CPOE) for medication orders directly entered by any licensed health care professional who can enter orders into the medical record per state, local and professional guidelines.

Measure: More than 30 percent of unique patients with at least one medication in their medication list seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (place of service 21 Inpatient hospital or 23 Emergency room – hospital) have at least one medication order entered using CPOE.

Core Objective: Implement drug/drug and drug/allergy interaction checks.

Measure: The EP/eligible hospital/CAH has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period.

Core Objective: Maintain an up-to-date problem list of current and active diagnoses.

Measure: More than 80 percent of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have at least one entry, or an indication that no problems are known for the patient recorded as structured data.

Core Objective: Maintain active medication list.

Measure: More than 80 percent of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data.

Core Objective: Maintain active medication allergy list.

Measure: More than 80 percent of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data.

Core Objective: Record and chart changes in vital signs, including:

  • Height
  • Weight
  • Blood pressure
  • Calculate and display BMI
  • Plot and display growth charts for children 2-20 years, including BMI

Measure: For more than 50 percent of all unique patients age 2 and over seen by the EP or admitted to eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23), height, weight and blood pressure are recorded as structured data.

Core Objective: Record smoking status for patients 13 years-old or older.

Measure: More than 50 percent of all unique patients 13 years-old or older seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have smoking status recorded.

Core Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies), upon request.

Measure: More than 50 percent of all patients of the EP or the inpatient or emergency departments of the eligible hospital or CAH (POS 21 or 23) who request an electronic copy of their health information are provided it within three business days.

Core Objective: Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.

Measure: Performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information. There are no exceptions to this requirement.

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

Measure: Conduct or review a security risk analysis as required under the HIPAA Security Rule, and implement security updates as necessary and correct identified security deficiencies as part of its risk management process. There are no exceptions to this requirement.

Core Objective — EP only: Generate and transmit permissible prescriptions electronically (eRx).

Measure: More than 40 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

Core Objective — EP only: Record demographics, including:

  • preferred language
  • gender
  • race
  • ethnicity
  • date of birth

Measure: More than 50 percent of all unique patients seen by the EP have demographics recorded as structured data.

Core Objective — EP only: Implement one clinical decision support rule relevant to specialty or high clinical priority, along with the ability to track compliance that rule.

Measure: There are no allowable exclusions for this objective.

Core Objective — EP only: Report ambulatory clinical quality measures to CMS or states.

Measure: For 2011, provide aggregate numerator, denominator, and exclusions through attestation. For 2012, electronically submit clinical quality measures.

Core Objective — EP only: Provide clinical summaries for patients for each office visit.

Measure: Clinical summaries provided to patients for more than 50 percent of all office visits within three business days.

Core Objective — Hospital/CAH only: Record demographics, including:

  • preferred language
  • gender
  • race
  • ethnicity
  • date of birth
  • date and preliminary cause of death in the event of mortality in the eligible hospital or CAH

Measure: More than 50 percent of all unique patients admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data.

Core Objective — Hospital/CAH only: Implement one clinical decision support rule related to a high priority hospital condition, along with the ability to track compliance with that rule.

Measure: There are no exclusions for this objective and its associated measure.

Core Objective — Hospital/CAH only: Report hospital clinical quality measures to CMS or states.

Measure: For 2011, provide aggregate numerator, denominator, and exclusions through attestation. For 2012, electronically submit clinical quality measures.

Core Objective — Hospital/CAH only: Provide patients with an electronic copy of their discharge instructions at time of discharge, upon request.

Measure: More than 50 percent of all patients who are discharged from an eligible hospital or CAH’s inpatient department or emergency department (POS 21 or 23) and who request an electronic copy of their discharge instructions are provided it.

Menu Objectives

Five of 10 menu objectives must be met, unless exceptions apply. One of the five objectives chosen must be a population health-related objective, which are the first three objectives listed below.

Menu Objective: Capability to submit electronic data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable law and practice.

Measure: Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP, eligible hospital or CAH submits such information have the capacity to receive the information electronically).

Menu Objective: Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice.

Measure: Performed at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP, eligible hospital or CAH submits such information have the capacity to receive the information electronically).

Menu Objective — Hospital/CAH only: Capability to submit electronic data on reportable (as required by state or local law) lab results to public health agencies and actual submission in accordance with applicable law and practice.

Measure: Performed at least one test of certified EHR technology’s capacity to provide electronic submission of reportable lab results to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which eligible hospital or CAH submits such information have the capacity to receive the information electronically).

Menu Objective: Implement drug formulary checks.

Measure: The EP/eligible hospital/CAH has enabled this functionality and has access to at least one internal or external drug formulary for the entire EHR reporting period.

Menu Objective: Incorporate clinical lab-test results into certified EHR technology as structured data.

Measure: More than 40 percent of all clinical lab tests results ordered by the EP or by an authorized provider of the eligible hospital or CAH for patients admitted to its inpatient or emergency department (POS 21 or 23) during the EHR reporting period, whose results are either in a positive/negative or numerical format, are incorporated in certified EHR technology as structured data. The percentage is based on labs ordered for patients whose records are maintained using certified EHR technology.

Menu Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach.

Measure: Generate at least one report listing patients of the EP, eligible hospital or CAH with a specific condition. Specific conditions are those conditions listed in the active patient problem list.

Menu Objective: Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate.

Measure: More than 10 percent of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) are provided patient-specific education resources.

Menu Objective: The EP, eligible hospital or CAH who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.

Measure: The EP, eligible hospital or CAH performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23).

Menu Objective: The EP, eligible hospital or CAH who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary of care record for each transition of care or referral.

Measure: The EP, eligible hospital or CAH who transitions or refers their patient to another setting of care or provider of care, provides a summary of care record for more than 50 percent of transitions of care and referrals.

Menu Objective — EP only: Send reminders to patients per patient preference for preventive/follow up care.

Measure: More than 20 percent of all unique patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period.

Menu Objective — EP only: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, medication allergies) within four business days of the information being available to the EP.

Measure: More than 10 percent of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP’s discretion to withhold certain information.

Menu Objective — Hospital/CAH only: Record advance directives for patients 65 years old or older.

Measure: More than 50 percent of all unique patients 65 years old or older admitted to the eligible hospital’s or CAH’s inpatient department (POS 21) have an indication of an advance directive status recorded.

Source: Federal Register, Table 2, pages 44370-44374.

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