CORE 1 CORE 2 CORE 3 CORE 4 CORE 5 CORE 6 CORE 7 Meaningful Use Core Objectives Eligible Professionals (EP) must report on all Meaningful Use Core Objectives Computerized Physician Order Entry (CPOE) for Medication Orders Drug Interaction Checks Use CPOE for medication orders directly entered by any licensed health care professional who can enter orders in to the medical record per State, local and professional guidelines Implement drug-drug and drug-allergy interaction checks 30% More than 30% of medication orders created by the EP during the EHR Reporting Period are recorded using CPOE OR more than 30% of all unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE Yes / No The EP has enabled this functionality for the entire EHR Reporting Period Any EP who writes fewer than 100 prescriptions during the EHR Reporting Period Maintain Problem List e-prescribing (erx) Maintain an up-to-date problem list of current and active diagnoses Generate and transmit permissible prescriptions electronically (erx) 80% More than 80% of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data 40% More than 40% of all permissible prescriptions written by the EP are transmitted electronically using CEHRT Active Medication List Maintain active medication list 80% More than 80% of all unique patients seen by the EP have at least one (1) entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data Medication Allergy List Maintain active medication allergy list 80% More than 80% of all unique patients seen by the EP have at least one (1) entry (or an indication that the patient has no know medication allergies) recorded as structured data Record Demographics Record all of the following demographics: Preferred language Gender Race Ethnicity Date of Birth 50% More than 50% of all unique patients seen by the EP have demographics recorded as structured data Any EP who: Writes fewer than 100 prescriptions during the EHR Reporting Period Does not have a pharmacy within their organization and there is no pharmacies that accept electronic prescriptions within 10 miles of the EP s practice location at the start of the EHR Reporting Period
CORE 8 CORE 9 CORE 10 CORE 11 CORE 12 Record Vital Signs Record Smoking Status Record and chart changes in the following vital signs: Height Weight Blood Pressure (BP) Calculate and display Body Mass Index (BMI) Plot and display growth charts for children 2-20 years, including BMI Record smoking status for patients 13 years old or older 50% More than 50% of all unique patients seen by the EP during the EHR Reporting Period have BP (for patients 3+only) and height/length and weight (for all ages) recorded as structured data 50% More than 50% of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data Any EP who: Sees no patients 3 years or older is excluded from recording blood pressure 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 Believes that height and weight are relevant to their scope of practice, but blood pressure is not, is excluded from recording blood pressure Believes that blood pressure is relevant to their scope of practice, but height and weight are not, is excluded from recording height and weight Any EP who sees no patients 13 years or older Clinical Decision Support Rule Implement one (1) clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule Yes / No Implement one (1) clinical decision support rule Patient Electronic Access Clinical Summaries Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP Provide clinical summaries for patients for each office visit 50% More than 50% of all unique patients seen by the EP during the EHR Reporting Period are provided timely (available to the patient within four (4) business days after the information is available to the EP) online access to their health information 50% Clinical summaries provided to patients for more than 50% of all office visits within three (3) business days 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 office contact information may exclude both measures Conducts 50% or more of his/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 available from the FCC on the first day of the EHR Reporting Period may exclude only the second measure Any EP who has no office visits during the EHR Reporting Period
CORE 13 MENU 1 MENU 2 MENU 3 MENU 4 Protect Electronic Health Information Protect electronic health information created or maintained by the CEHRT through the implementation of appropriate technical capabilities Yes / No Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308(a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process Meaningful Use Menu Set Measures Eligible Professionals (EP) must report on 5 Meaningful Use Menu Set Objectives including one public health measure Drug Formulary Checks Implement drug formulary checks Yes / No / Exclusion The EP has enabled this functionality and has access to at least one (1) internal or external formulary for the entire EHR Reporting Period Any EP who writes fewer than 100 prescriptions during the EHR Reporting Period Incorporate Clinical Lab-test Results Incorporate clinical lab test results into the CEHRT as structured data 40% More than 40% of all clinical lab test results ordered by the EP during the EHR Reporting Period whose results are either in a positive/negative or numerical format are incorporated into the CEHRT as structured data An EP who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR Reporting Period Patient Lists Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach Yes / No Generate at least one (1) report listing patients of the EP with a specific condition Patient Reminders Send reminders to patients per patient preference for preventive / follow-up care 20% More than 20% of all patients 65 years or older or 5 years old or younger were sent appropriate reminder during the EHR Reporting Period An EP who has no patients 65 years old or older or 5 years old or younger with records maintained using the CEHRT
MENU 5 MENU 6 MENU 7 MENU 8 MENU 9 Patient-specific Education Use the CEHRT to identify patient-specific education resources and provide those resources to the patient if appropriate 10% More than 10% of all unique patients seen by the EP are provided patient-specific education resources Medication Reconciliation The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation 50% The EP performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP An EP who was not the recipient of any transitions of care during the EHR Reporting Period Summary Care Record 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 summary care record for each transition of care or referral 50% The EP 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% of transitions of care and referrals An EP who neither transfers a patient to another setting nor refers a patient to another provider during the EHR Reporting Period Immunization Registries Data Submission (public health) Syndromic Surveillance Data Submission (public health) Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice Yes / No / Exclusion Yes / No / Exclusion Performed at least one (1) test of the CEHRT 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 submits such information has the capacity to receive the information electronically), except where prohibited Performed at least one (1) test of the CEHRT 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 submits such information has the capacity to receive the information electronically) except where prohibited An EP who administers no immunizations during the EHR Reporting Period, where no immunization registry has the capacity to receive the information electronically, or where it is prohibited An EP who does not collect any reportable syndromic information on their patients during the EHR Reporting Period, does not submit such information to any public health agency that has the capacity to receive the information electronically, or if it is prohibited
Clinical Quality Measures NQF# CMS ID# Measure / CQM Title National Quality NQF# CMS ID# Measure / CQM Title National Quality Eligible Professionals (EP) must report on 9 CQMs in 3 of the National Quality s 0002 146 0004 137 Appropriate Testing for Children with Pharyngitis Initiation and of Alcohol and Other Drug Dependence Treatment 0018 165 Controlling High Blood Pressure 0022 156 0024 155 0028 138 Use of High-risk Medication in the Elderly Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 0031 125 Breast Cancer Screening 0032 124 Cervical Cancer Screening Efficient use of Healthcare 0104 161 0105 128 0108 136 Patient Safety 0110 169 Population / Public Health 0384 157 Population / Public Health 0385 141 0387 140 0389 129 Major Depressive Disorder (MDD): Suicide Risk Assessment Anti-depressant Medication Management ADHD: Follow-up Care for Children Prescribed Attention- Deficit/Hyperactivity Disorder (ADHD) Medication Bipolar Disorder and Major Depression: Appraisal for Alcohol or Chemical Substance Abuse Oncology: Medical and Radiation Pain Intensity Quantified Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor / Progesterone Receptor (ER/PR) Positive Breast Cancer Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients Efficient Use of Healthcare 0033 153 Chlamydia Screening for Women Population / Public Health 0403 62 HIV/AIDS: Medical Visit 0034 130 Colorectal Cancer Screening HIV/AIDS: Pneumocystis Jiroveci 0405 52 Pneumonia (PCP) Prophylaxis 0036 126 Use of Appropriate Medications for HIV/AIDS: RNA Control for Patients with TBD 77 Asthma HIV 0038 117 Childhood Immunization Status Population / Public Health 0418 2 Preventive Care and Screening for Clinical Depression and Follow-up Plan Population / Public Health 0041 147 Preventive Care and Screening: Documentation of Current Medications Population / Public Health 0419 68 Influenza Immunization in the Medical Record Patient Safety 0043 127 Preventive Care and Screening: Body Pneumonia Vaccination Status for 0421 69 Mass Index (BMI) Screening and Followup Older Adults Population / Public Health 0052 166 Cataracts: Complications Within 30 Days Use of Imaging Studies for Low Back Efficient Use of Healthcare 0564 132 Following Cataract Surgery Requiring Pain Additional Surgical Procedures Patient Safety 0055 131 Diabetes: Eye Exam 0565 133 Cataracts: 20/40 or Better Visual Acuity
NQF# CMS ID# Measure / CQM Title National Quality NQF# CMS ID# Measure / CQM Title National Quality 0056 123 Diabetes: Foot Exam 0059 122 0060 148 Diabetes: Hemoglobin A1c Poor Control Hemoglobin A1c Test for Pediatric Patients 0062 134 Diabetes: Urine Protein Screening 0064 163 0068 164 0069 154 0070 145 0075 182 0081 135 0083 144 0086 143 0088 167 0089 142 Diabetes: Low Density Lipoprotein (LDL) Management Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic Appropriate Treatment for Children with Upper Respiratory Infection (URI) Coronary Artery Disease (CAD): Betablocker Therapy Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <40%) Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) Heart Failure (HF): Beta-blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) Primary Open Angel Glaucoma (POAG): Optic Nerve Evaluation Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care Efficient Use of Healthcare 0608 158 Within 90 Days Following Cataract Surgery Pregnant Women That Had HBsAg Testing 0710 159 Depression Remission at Twelve Months 0712 160 Depression Utilization of the PHQ-9 Tool TBD 75 1365 177 Children Who Have Dental Decay or Cavities Child and Adolescent Major Depressive Disorder: Suicide Risk Assessment Patient Safety 1401 82 Maternal Depression Screening Population / Public Health TBD 74 TBD 61 TBD 64 Primary Cares Prevention Intervention as Offered by Primary Care Providers, including Dentists Preventive Care and Screening: Cholesterol Fasting Low Density Lipoprotein (LDL) Test Performed Preventive Care and Screening: Risk- Stratified Cholesterol Fasting Low Density Lipoprotein (LDL-C) TBD 149 Dementia: Cognitive Assessment TBD 65 TBD 50 TBD 66 TBD 56 0101 139 Falls: Screening for Future Fall Risk Patient Safety TBD 90 Hypertension: Improvement In Blood Pressure Closing the Referral Loop: Receipt of Specialist Report Functional Status Assessment for Knee Replacement Functional Status Assessment for Hip Replacement Functional Status Assessment for Complex Chronic Conditions Care Coordination