EHR Incentive Program Stage 2 Objectives Summary CORE OBJECTIVES (You must meet all objectives unless exclusion applies.) TARGETING CANCER CARE 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. 2 eprescribing (erx) Generate and transmit permissible prescriptions electronically (erx). 3 Record Demographics Record ALL of the following demographics: 1. Preferred Language, 2. Gender, 3. Race, 4. Ethnicity 5. Date of Birth. More than 60% of medication, 30% of laboratory and 30% of radiology orders are recorded using CPOE. More than 50% of all permissible prescriptions, or all prescriptions, are queried for a drug formulary and transmitted electronically using CEHRT. Demographics are recorded for more than 80% of all unique patients. Any EP who writes fewer than 100 medication, radiology or laboratory orders during the 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 there are no pharmacies that accept electronic prescriptions within 10 miles of the EP s practice location at the start of the www.astro.org 1
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. 5 Record Smoking Status Record smoking status for patients 13 years old or older. 6 Clinical Decision Support Implement clinical decision support to improve performance on high-priority health conditions. 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. Smoking status is recorded for more than 80% of all unique patients 13 years old or older. Measure 1: Implement five clinical decision support interventions related to four or more CQMs at a relevant point in patient care for the entire If four or less of the five 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. Measure 2: The EP has enabled and implemented the functionality for drug-drug and drug-allergy interaction checks for the entire 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. Any EP who sees no patients 13 years old or older. For the second measure, any EP who writes fewer than 100 medication orders period. www.astro.org 2
7 Patient Electronic Access The following health information must be made available: 1. Patient name. 2. Provider s name and office 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 field(s), including goals and instructions. 12. Any known care team members, including primary care provider of record unless information not available in CEHRT or restricted from disclosure. 8 Clinical Summaries Provide clinical summaries for patients for each office visit. 9 Protect Electronic Health Information Protect electronic health information created or maintained by CEHRT through the implementation of appropriate technical capabilities. 10 Clinical Lab-Test Results Incorporate clinical lab-test results into EHR as structured data. 11 Patient Lists Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach purposes. 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; 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. Clinical summaries are provided to patients or patient-authorized representatives within one business day for more than 50% of all office visits. 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 identified security deficiencies as part of the risk management process. More than 55% of all clinical lab test results ordered period that have results either in a positive/negative or numerical format, are incorporated in CERHT. Generate at least one report listing patients with a specific condition. 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 office 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 first day of the reporting period, may exclude only the second measure. Any EP who has no An EP who orders no lab tests that have results in a positive/ negative or numeric format during the www.astro.org 3
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. 13 Patient-Specific Education Resources 14 Medication Reconciliation Use clinically relevant information from CEHRT to identify patient-specific education resources and provide those resources to the patient. The EP who receives a patient from another setting or provider of care, or believes an encounter is relevant, should perform medication reconciliation. 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. More than 10% of all unique patients who have had two or more office visits with the EP within the 24 months before the beginning of the reporting period were sent a reminder, per patient preference when available. More than 10% of all unique patients are provided patient-specific education resources identified by the CEHRT. Medication reconciliations are performed for more than 50% of transitions of care. Must satisfy all three Measures. Measure 1: Summary of care records are provided for more than 50% of transitions of care and referrals; 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 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 different EHR technology developer than the sender s HER technology certified to 45 CFR 170.314(b OR Conducts one or more successful test with the CMS-designated test EHR during the Any EP who had no office visits in the 24 months before the Any EP who has no An EP who was not the recipient of any transitions of care 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. www.astro.org 4
16 Immunization Registries Data Submission 17 Use Secure Electronic Messaging Capability to submit electronic data to registries or information systems and actual submission according to applicable law and practice. Use secure electronic messaging to communicate with patients on relevant health information. Successful ongoing submission of electronic data from CEHRT to an registry or information system for the entire A secure message was sent using the electronic messaging function of CEHRT by more than 5% of unique patients during the Source, CMS, ALL Stage 2 EHR Meaningful Use Specification Sheets for Eligible Professionals, available at, http://www.cms.gov/ Regulations-and-Guidance/Legislation/EHRIncentivePrograms/EducationalMaterials.html. 1. Any EP who does not administer any of the s to any of the populations for which data is collected by their jurisdiction s information system period; /OR 2. Any EP who operates in a jurisdiction for which no information system is capable of accepting the specific standards required for CEHRT at the start of the reporting period; OR 3. Any EP who operates in a jurisdiction where no information provides information timely on capability to receive data; /OR 4. Any EP who operates in a jurisdiction for which no information system that is capable of accepting the specific standards required by CEHRT at the start of his or her reporting period can enroll additional EPs. 1. Any EP who has no 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 first day of the www.astro.org 5