EHR Incentive Program Stage 2 Objectives Summary
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Objective Objective Description Measure/Attestation Requirement
Exclusion
1 CPOE for
Medication, Laboratory and Radiology Orders
Use computerized
provider order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed health care professional who can enter orders into the medical record per state, local and professional guidelines.
More than 60% of medication, 30%
of laboratory and 30% of radiology orders are recorded using CPOE.
Any EP who writes fewer than 100
medication, radiology or laboratory orders during the reporting period.
2 ePrescribing (eRx) Generate and transmit permissible prescriptions electronically (eRx).
More than 50% of all permissible prescriptions, or all prescriptions, are queried for a drug formulary and transmitted electronically using CEHRT.
1. Any EP who writes fewer than 100 prescriptions during the reporting period;
OR
2. Any EP who does not have a pharmacy within their organization AND there are no pharmacies that accept electronic prescriptions within 10 miles of the EP’s practice location at the start of the reporting period.
3 Record Demographics Record ALL of the following demographics:
1. Preferred Language, 2. Gender,
3. Race, 4. Ethnicity AND 5. Date of Birth.
Demographics are recorded for more than 80% of all unique patients.
No exclusion.
CORE OBJECTIVES (You must meet all objectives unless exclusion applies.)
TA R G E T I N G C A N C E R C A R ESource, CMS, ALL Stage 2 EHR Meaningful Use Specifi cation Sheets for Eligible Professionals, available at, http://www.cms.gov/Regulations-and-Guid- ance/Legislation/EHRIncentivePrograms/EducationalMaterials.html.
www.astro.org | 2 4 Record Vital Signs Record and chart changes in the
following vital signs:
1. Height 2. Weight
3. Blood Pressure (ages 3 and over)
4. Calculate and display body mass index (BMI)
5. Plot and display growth charts for patients 0–20 years, including BMI.
More than 80% of all unique patients have blood pressure (for patients age 3 and over only) and/
or height and weight (for all ages) recorded as structured data.
1. Any EP who sees no patients 3 years or older is excluded from recording blood pressure; OR
2. Any EP who
believes that all three vital signs of height, weight and blood pressure have no relevance to their scope of practice is excluded from recording them; OR 3. Any EP who believes
that height and weight are relevant to their scope of practice, but blood pressure is not, is excluded from recording blood pressure; OR 4. Any EP who believes
that blood pressure is relevant to their scope of practice, but height and weight are not, is excluded from recording height and weight.
5 Record Smoking Status Record smoking status for patients 13 years old or older.
Smoking status is recorded for more than 80% of all unique patients 13 years old or older.
Any EP who sees no patients 13 years old or older.
6 Clinical Decision Support
Implement clinical decision support to improve
performance on high-priority health conditions.
Measure 1: Implement fi ve clinical decision support interventions related to four or more CQMs at a relevant point in patient care for the entire reporting period. If four or less of the fi ve CQMs do not relate to the EP’s scope of practice or patient population, the clinical decision support interventions must be related to high-priority health conditions.
AND
Measure 2: The EP has enabled and implemented the functionality for drug-drug and drug-allergy interaction checks for the entire reporting period.
For the second measure, any EP who writes fewer than 100 medication orders during the reporting period.
Source, CMS, ALL Stage 2 EHR Meaningful Use Specifi cation Sheets for Eligible Professionals, available at, http://www.cms.gov/Regulations-and-Guid- ance/Legislation/EHRIncentivePrograms/EducationalMaterials.html.
7 Patient Electronic Access The following health information must be made available:
1. Patient name.
2. Provider’s name and offi ce contact information.
3. Current and past proble list.
4. Procedures.
5. Laboratory test results.
6. Current medication list and medication history.
7. Current medication allergy list and medication allergy list history.
8. Vital signs.
9. Smoking status.
10. Demographic information.
11. Care plan fi eld(s), including goals and instructions.
AND
12. Any known care team members, including primary care provider of record unless information not available in CEHRT or restricted from disclosure.
Measure 1: More than 50% of all unique patients seen during the reporting period are provided timely (available to patient within four business days after the information is available to the EP) online access to their health information;
AND
Measure 2: More than 5% of all unique patients seen during the reporting period (or their authorized representatives) view, download or transmit to a third party their health information.
1. Any EP who neither orders nor creates any of the information listed for inclusion as part of both measures, except for
“patient name” and
“provider’s name and offi ce contact information,” may exclude both measures.
2. Any EP who conducts 50% or more of his or her patient
encounters in a county that does not have 50% or more of its housing units with 3Mbps broadband availability according to the latest
information available from the FCC on the fi rst day of the reporting period, may exclude only the second measure.
8 Clinical Summaries Provide clinical summaries for patients for each offi ce visit.
Clinical summaries are provided to patients or patient-authorized representatives within one business day for more than 50% of all offi ce visits.
Any EP who has no offi ce visits during the reporting period.
9 Protect Electronic Health Information
Protect electronic health information created or maintained by CEHRT through the implementation of appropriate technical capabilities.
Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308(a)(1), including addressing the encryption/
security of data stored in CEHRT in accordance with requirements under 45 CFR 164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identifi ed security defi ciencies as part of the risk management process.
No exclusion.
10 Clinical Lab-Test Results Incorporate clinical lab-test results into EHR as structured data.
More than 55% of all clinical lab test results ordered during the report- ing period that have results either in a positive/negative or numerical format, are incorporated in CERHT.
An EP who orders no lab tests that have
results in a positive/
negative or numeric format during the reporting period.
11 Patient Lists Generate lists of patients by specifi c conditions to use for quality improvement, reduction of disparities, research or outreach purposes.
Generate at least one report listing patients with a specifi c condition.
No exclusion.
EHR Incentive Program Stage 2 Objectives Summary • continued
Source, CMS, ALL Stage 2 EHR Meaningful Use Specifi cation Sheets for Eligible Professionals, available at, http://www.cms.gov/Regulations-and-Guid- ance/Legislation/EHRIncentivePrograms/EducationalMaterials.html.
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12 Preventive Care Use clinically relevant
information to identify patients who should receive reminders for preventive/follow-up care and send these patients the reminders, per patient preference.
More than 10% of all unique patients who have had two or more offi ce visits with the EP within the 24 months before the beginning of the reporting period were sent a reminder, per patient preference when available.
Any EP who had no offi ce visits in the 24 months before the reporting period.
13 Patient-Specifi c Education Resources
Use clinically relevant information from CEHRT to identify patient-specifi c
education resources and provide those resources to the patient.
More than 10% of all unique patients are provided patient-specifi c education resources identifi ed by the CEHRT.
Any EP who has no offi ce visits during the reporting period.
14 Medication
Reconciliation
The EP who receives a patient from another setting or provider of care, or believes an
encounter is relevant, should perform medication reconciliation.
Medication reconciliations are performed for more than 50% of transitions of care.
An EP who was not the recipient of any transitions of care during the reporting period.
15 Summary of Care The EP who transitions their patient to another setting of care or provider of care, or refers their patient to another provider of care, should provide a summary care record for each transition of care or referral.
Must satisfy all three Measures.
Measure 1: Summary of care records are provided for more than 50% of transitions of care and referrals;
AND
Measure 2: For more than 10% of transitions of care and referrals, a summary of care was either (a) electronically transmitted using CEHRT to a recipient or (b) received by a recipient via exchange facilitated by an organization that is a Nationwide Health Information Network (NwHIN) Exchange participant or in a manner that is consistent with the governance mechanism ONC establishes for the
AND
Measure 3: An EP must satisfy one of the following:
• Conducts one or more successful electronic
exchange of a summary of care document, as part of which is counted in Measure 2 (for EPs the measure at 495.6(j)(14) (ii)B with a recipient who has EHR technology developed/
designed by a diff erent EHR technology developer than the sender’s HER technology certifi ed to 45 CFR 170.314(b OR
• Conducts one or more successful test with the CMS-designated test EHR during the reporting period.
Any EP who transfers a patient to another setting or refers a patient to another provider less than100 times during the reporting period is excluded from all three measures.
Source, CMS, ALL Stage 2 EHR Meaningful Use Specifi cation Sheets for Eligible Professionals, available at, http://www.cms.gov/Regulations-and-Guid- ance/Legislation/EHRIncentivePrograms/EducationalMaterials.html.
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16 Immunization Registries Data Submission
Capability to submit electronic data to immunization registries or information systems and actual submission according to applicable law and practice.
Successful ongoing submission of electronic immunization data from CEHRT to an immunization registry or information system for the entire reporting period.
1. Any EP who does not administer any of the immunizations to any of the populations for which data is collected by their jurisdiction’s immunization registry or
information system during the reporting period; AND/OR 2. Any EP who operates
in a jurisdiction for which no
immunization registry or
information system is capable of accepting the specifi c standards required for CEHRT at the start of the reporting period; OR 3. Any EP who
operates in a jurisdiction where no immunization registry or
information provides information timely on capability to
receive
immunization data;
AND/OR
4. Any EP who operates in a jurisdiction for which no
immunization registry or
information system that is capable of accepting the specifi c standards required by CEHRT at the start of his or her reporting period can enroll additional EPs.
17 Use Secure Electronic Messaging
Use secure electronic messaging to communicate with patients on relevant health information.
A secure message was sent using the electronic messaging function of CEHRT by more than 5% of unique patients during the reporting period.
1. Any EP who has no offi ce visits during the reporting period; OR 2. Any EP who
conducts 50% or more of his or her patient encounters in a country that does not have 50% or more of its housing units with 3Mbps broadband
availability according to the latest
information available from the FCC on the fi rst day of the reporting period.
EHR Incentive Program Stage 2 Objectives Summary • continued
Source, CMS, ALL Stage 2 EHR Meaningful Use Specifi cation Sheets for Eligible Professionals, available at, http://www.cms.gov/
Regulations-and-Guidance/Legislation/EHRIncentivePrograms/EducationalMaterials.html. www.astro.org | 5