Source: http://www.scribd.com/doc/50882490/Meaningful-Use-EP-SCC-Ambulatory-Only-Grid
Timestamp: 2014-07-10 07:55:37
Document Index: 490855781

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P. 1Meaningful Use EP SCC Ambulatory Only GridMeaningful Use EP SCC Ambulatory Only GridRatings: (0)|Views: 1,362|Likes: 0Published by ONC for Health Information TechnologyIncludes only the EP objectives and measures and the standards and certification criteria for the ambulatory setting.Includes only the EP objectives and measures and the standards and certification criteria for the ambulatory setting.More info:Published by: ONC for Health Information Technology on Mar 16, 2011Copyright:Attribution Non-commercialAvailability:Read on Scribd mobile: iPhone, iPad and Android.download as PDF, TXT or read online from ScribdFlag for inappropriate content|Add to collectionSee moreSee lesshttp://www.scribd.com/doc/50882490/Meaningful-Use-EP-SCC-Ambulatory-Only-Grid02/03/2013pdftextoriginal **Unofficial Recitations of Portions of 42 CFR Part 495 and 45 CFR Part 170**
Note: MU measures may be subject to paragraph (c) of 495.6 and exclusions to measures may be subject to paragraph (a) (eligible professionals) of section 495.6.
42 CFR 495.6(d)-(e)
Stage 1 Objective Stage 1 Measure
C O R E S E T
§495.6(d)(1)(i) - Use CPOE formedication orders directly enteredby any licensed healthcareprofessional who can enter ordersinto the medical record per state,local and professional guidelines.§495.6(d)(1)(ii) - More than 30% of allunique patients with at least onemedication in their medication list seenby the EP have at least one medicationorder entered using CPOE.
§495.6(d)(1)(iii)
Exclusion: Any EP who writesfewer than 100 prescriptions during the EHRreporting period.
§170.304(a) -
Enable auser to electronically record, store, retrieve, and modify, at aminimum, the following order types:(2) Laboratory; and(3) Radiology/imaging.
[75 FR 44331-34] [75 FR 44624-25] §495.6(d)(2)(i) - Implement drug-drug and drug-allergy interactionchecks.§495.6(d)(2)(ii) - The EP has enabled thisfunctionality for the entire EHR reporting period.§170.302(a) -
Automatically and electronically generateand indicate in real-time, notifications at the point of carefor drug-drug and drug-allergy contraindications based onmedication list, medication allergy list, and computerizedprovider order entry (CPOE).
Provide certain users with the ability toadjust notifications provided for drug-drug and drug-allergy interaction checks.
[75 FR 44334-36] [75 FR 44600-03] §495.6(d)(3)(i) - Maintain an up-to-date problem list of current andactive diagnoses.§495.6(d)(3)(ii) - More than 80% of allunique patients seen by the EP have atleast one entry or an indication that noproblems are known for the patientrecorded as structured data.§170.302(c) -
(1) The standard specified in §170.207(a)(1); or
Enable a user to electronically record, modify, and retrieve a patient'sproblem list for longitudinal care in accordance with:(2) At a minimum, the version of the standard specified in§170.207(a)(2).
§170.207(a)(1) -
The code set specified at 45 CFR162.1002(a)(1) for the indicated conditions.
§170.207(a)(2) - IHTSDO SNOMED CT
July 2009version
[75 FR 44336-37] [75 FR 44603-04] §495.6(d)(4)(i) - Generate and transmit permissible prescriptionselectronically (eRx).§495.6(d)(4)(ii) - More than 40% of allpermissible prescriptions written by theEP are transmitted electronically using certified EHR technology.
§495.6(d)(4)(iii)
§170.304(b) -
(1) The standard specified in §170.205(b)(1) or§170.205(b)(2); and
Enable a user toelectronically generate and transmit prescriptions andprescription-related information in accordance with:(2) The standard specified in §170.207(d).
§170.205(b)(1) - NCPDP SCRIPT Version 8.1.
§170.205(b)(2) -
NCPDP SCRIPT Version 10.6.
§170.207(d) -
Any source vocabulary that isincluded in RxNorm, a standardizednomenclature for clinical drugs produced by theUnited States National Library of Medicine.
[75 FR 44337-38] [75 FR 44625-27] §495.6(d)(5)(i) - Maintain activemedication list.§495.6(d)(5)(ii) - More than 80% of allunique patients seen by the EP have atleast one entry (or an indication that thepatient is not currently prescribed anymedication) recorded as structured data.§170.302(d) -
Enable a user toelectronically record, modify, and retrieve a patient's activemedication list as well as medication history for longitudinalcare.
[75 FR 44338-39] [75 FR 44604] §495.6(d)(6)(i) - Maintain activemedication allergy list.§495.6(d)(6)(ii) - More than 80% of allunique patients seen by the EP have atleast one entry (or an indication that thepatient has no known medicationallergies) recorded as structured data.§170.302(e) -
Enable auser to electronically record, modify, and retrieve a patient'sactive medication allergy list as well as medication allergyhistory for longitudinal care.
[75 FR 44339-40] [75 FR 44605] **Unofficial Recitations of Portions of 42 CFR Part 495 and 45 CFR Part 170**
§495.6(d)(7)(i) - Record all of thefollowing demographics:(A) Preferred language.(B) Gender.(C) Race.(D) Ethnicity.(E) Date of birth.§495.6(d)(7)(ii) - More than 50% of allunique patients seen by the EP havedemographics recorded as structureddata.§170.304(c) -
Enable a user toelectronically record, modify, and retrieve patientdemographic data including preferred language, gender, race,ethnicity, and date of birth. Enable race and ethnicity to berecorded in accordance with the standard specified at§170.207(f).
§170.207(f) - The OMB Standards for Maintaining,Collecting, and Presenting Federal Data on Raceand Ethnicity, Statistical Policy Directive No. 15,October 30, 1997.
[75 FR 44340-42] [75 FR 44627] §495.6(d)(8)(i) - Record and chartchanges in the following vital signs:(A) Height.(B) Weight.(C) Blood pressure.(D) Calculate and display bodymass index (BMI).(E) Plot and display growth chartsfor children 2–20 years,including BMI.§495.6(d)(8)(ii) - For more than 50% of allunique patients age 2 and over seen by the EP, height, weight and blood pressureare recorded as structured data.
§495.6(d)(8)(iii)
Exclusion: Any EP who either seeno patients 2 years or older, or who believes thatall three vital signs of height, weight, and bloodpressure of their patients have no relevance totheir scope of practice.
§170.302(f) -
Enable a user to electronically record, modify,and retrieve a patient's vital signs including, at a minimum,height, weight, and blood pressure.
Automatically calculate anddisplay body mass index (BMI) based on a patient's heightand weight.(3)
Plot and electronicallydisplay, upon request, growth charts for patients 2–20years old.
[75 FR 44342-43] [75 FR 44605-06] §495.6(d)(9)(i) - Record smoking status for patients 13 years old orolder.§495.6(d)(9)(ii) - More than 50% of allunique patients 13 years old or olderseen by the EP have smoking statusrecorded as structured data.
§495.6(d)(9)(iii) - Exclusion: Any EP who sees nopatients 13 years or older.
§170.302(g) -
Enable a user to electronicallyrecord, modify, and retrieve the smoking status of a patient.Smoking status types must include: current every day smoker;current some day smoker; former smoker; never smoker;smoker, current status unknown; and unknown if eversmoked.
[75 FR 44344-45] [75 FR 44606-07] §495.6(d)(10)(i) - Report ambulatoryclinical quality measures to CMS or,in the case of Medicaid EPs, theStates.
§495.6(d)(10)(ii) - Subject to paragraph (c) of this section, successfully report to CMS (or, in the case of Medicaid EPs, the States)ambulatory clinical quality measures selectedby CMS in the manner specified by CMS (or in the case of Medicaid EPs, the States).[Preamble Reference]
For 2011, provide aggregate numerator,denominator, and exclusions throughattestation as required by CMS or State.
For 2012, electronically submit theclinical quality measures as required byCMS or State.
§170.304(j) -
(i) Electronically calculate all of the core clinical measuresspecified by CMS for eligible professionals.(ii) Electronically calculate, at a minimum, three clinicalquality measures specified by CMS for eligibleprofessionals, in addition to those clinical quality measuresspecified in paragraph (1)(i).(2)
Enable a user to electronically submitcalculated clinical quality measures in accordance with thestandard and implementation specifications specified in§170.205(f).
§170.205(f) - CMS PQRI 2009 Registry XMLSpecification.
PQRIMeasure Specifications Manual for Claims andRegistry.
[75 FR 44348] [75 FR 44610-12] §495.6(d)(11)(i) - Implement oneclinical decision support rulesrelevant to specialty or high clinicalpriority along with the ability to track compliance with that rule.§495.6(d)(11)(ii) -
Implement one clinicaldecision support rule.§170.304(e) -
Implement automated, electronic clinicaldecision support rules (in addition to drug-drug and drug-allergy contraindication checking) based on the dataelements included in: problem list; medication list;demographics; and laboratory test results.
Automatically and electronically generateand indicate in real-time, notifications and caresuggestions based upon clinical decision support rules.
[75 FR 44350-51] [75 FR 44628-29] **Unofficial Recitations of Portions of 42 CFR Part 495 and 45 CFR Part 170**
§495.6(d)(12)(i) -
Provide patientswith an electronic copy of theirhealth information (including diagnostics test results, problemlist, medication lists, medicationallergies), upon request.§495.6(d)(12)(ii) -
More than 50% of allpatients who request an electronic copyof their health information are provided itwithin 3 business days.
§495.6(d)(12)(iii)
Exclusion: Any EP that has norequests from patients or their agents for anelectronic copy of patient health informationduring the EHR reporting period.
§170.304(f) -
Enable auser to create an electronic copy of a patient’s clinicalinformation, including, at a minimum, diagnostic test results,problem list, medication list, and medication allergy list in:(2) On electronic media or through some other electronicmeans in accordance with:(i) The standard (and applicable implementationspecifications) specified in §170.205(a)(1) or§170.205(a)(2); and(ii) For the following data elements the applicable standardmust be used:(A)
The standard specified in §170.207(a)(1)or, at a minimum, the version of the standard specifiedin §170.207(a)(2);(B)
At a minimum, the version of the standard specified in §170.207(c); and(C)
The standard specified in §170.207(d).
§170.205(a)(1) - HL7
CDA Release 2, CCD.
HITSP SummaryDocuments Using HL7 CCD ComponentHITSP/C32.
§170.205(a)(2) -
ASTM E2369 StandardSpecification for Continuity of Care Record andAdjunct to ASTM E2369.
§170.207(a)(1) - The code set specified at 45 CFR162.1002(a)(1) for the indicated conditions.
July 2009version.
§170.207(c) - LOINC
version 2.27, when suchcodes were received within an electronic transaction from a laboratory.
§170.207(d) - Any source vocabulary that isincluded in RxNorm, a standardizednomenclature for clinical drugs produced by theUnited States National Library of Medicine.
[75 FR 44353-55] [75 FR 44629-30] §495.6(d)(13)(i) - Provide clinicalsummaries for patients for eachoffice visit.§495.6(d)(13)(ii) - Clinical summariesprovided to patients for more than 50%of all office visits within 3 business days.
§495.6(d)(13)(iii)
Exclusion: Any EP who has nooffice visits during the EHR reporting period.
§170.304(h) -
Enable a user to provideclinical summaries to patients for each office visit thatinclude, at a minimum, diagnostic test results, problem list,medication list, and medication allergy list. If the clinicalsummary is provided electronically it must be:(2) Provided on electronic media or through some otherelectronic means in accordance with:(i) The standard (and applicable implementationspecifications) specified in §170.205(a)(1) or§170.205(a)(2); and(ii) For the following data elements the applicable standardmust be used:(A)
The standard specified in §170.207(a)(1)or, at a minimum, the version of the standardspecified in §170.207(a)(2);(B)
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