OpenEMR Certification Stage II Meaningful Use

Overview

Project page for OpenEMR Certification Stage II Meaningful Use, which is due in 2014:

• What's going on: http://www.hitechanswers.net/ehr-adoption-2/meaningful-use/
• Stage 2 Final Rule: Standards and Certification Article
• Stage 2 CMS Final Rule
• Stage 2 ONC Final Rule
• Stage 2 NPRM Proposed Rule

Completion Barometer

Stage 2 MU Completion Barometer

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Certification Criteria

Clinical (170.314(a))

a1. Computerized provider order entry

a2. Drug-drug, drug-allergy interaction checks

a3. Demographics

a4. Vital signs, body mass index, and growth charts

a5. Problem list

a6. Medication list

a7. Medication allergy list

a8. Clinical decision support

a9. Electronic notes

a10. Drug-formulary checks

a11. Smoking status

a12. Image results

a13. Family health history

a14. Patient list creation

a15. Patient-specific education resources

Care Coordination (170.314(b))

b1. Transitions of care – receive, display, and incorporate transition of care/referral summaries

b2. Transitions of care – create and transmit transition of care/referral summaries

b3. Electronic prescribing

b4. Clinical information reconciliation

b5. Incorporate lab tests and values/results

Clinical Quality Measures (170.314(c))

c1. Clinical Quality Measures

c2. Clinical Quality Measures

c3. Clinical Quality Measures

Analysis of Proposed Guidelines

Difference(s) from Stage 1

Improving quality, safety, efficiency, and reducing health disparities

Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed healthcare professional who can enter licensed healthcare professional who can enter orders into the medical record per State, local and professional guidelines to create the first record of the order.

More than 60 percent of medication, laboratory, and radiology orders created by the EP or authorized providers of the eligible hospital's or CAH's inpatient or emergency department (POS 21 or 23) during the EHR reporting period are recorded using CPOE.

• Adds laboratory & radiology
• Increased from 30% to 60%
• Requirement is based on number of orders, not number of patients.

Generate and transmit permissible prescriptions electronically (eRx)

More than 65 percent of all permissible prescriptions written by the EP are compared to at least one drug formulary and transmitted electronically using Certified EHR Technology.

• Increased from 40% to 65%.
• Includes formulary check which formerly was part of menu set

Record the following demographics

• Preferred language
• Gender
• Race
• Ethnicity
• Date of birth

More than 80 percent of all unique patients seen by the EP have demographics recorded as structured data

• Increased from 50% to 80%.

Record and chart changes in vital signs:

• Height/length
• Weight
• Blood pressure (age 3 and over)
• Calculate and display BMI
• Plot and display growth charts for patients 0-20 years, including BMI

More than 80 percent of all unique patients seen by the EP have blood pressure (for patients age 3 and over only) and height/length and weight (for all ages) recorded as structured data

• Increased from 50% to 80%.
• Changed from age 2 and over to age 3 and over.

Record smoking status for patients 13 years old or older More than 80% of all unique patients 13 years old or older seen by the have smoking status recorded as structured data

• Increased from 50% to 80%.

Use clinical decision support to improve performance on high-priority health conditions

1. Implement 5 clinical decision support interventions related to 5 or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period.
2. The EP has enabled and implemented the functionality for drug-drug and drug-allergy interaction checks for the entre EHR reporting period.

• Increased from implementing one rule to five.
• Must be related to five quality measures for entire reporting period.
• Incorporates drug-drug/drug-allergy checks (formerly standalone requirement).

Incorporate clinical lab-test results into Certified EHR Technology as structured data

More than 55 percent of all clinical lab tests results ordered by the EP 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

• Formerly menu set item.
• Increased from 40% to 55%.

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

Generate at least one report listing patients of the EP, eligible hospital or CAH with a specific condition.

• Formerly menu set item.

Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care

More than 10 percent of all unique patients who have had an office visit with the EP within the 24 months prior to the beginning of the EHR reporting period were sent a reminder, per patient preference

• Formerly menu set item.
• Eliminated age parameters; changed to “unique patients who have had an office visit”

Engage patients and families in their health care

Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP.

1. More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timely (within 4 business days after the information is available to the EP) online access to their health information subject to the EP's discretion to withhold certain information
2. More than 10 percent of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download , or transmit to a third party their health information

• Formerly menu set item.
• More specific
• Increased from 10% to 50%
• Added requirement for patients to “view, download or transmit” information.