TMG Meaningful Use
From VistApedia
Contents
- 1 Outpatient Meaningful Use for WorldVistA
- 1.1 Q: Where can I find the certification status of WorldVistA?
- 1.2 Q: There seems to be so many steps to be ready to attest meaningful use. It's overwhelming. Any overview sites?
- 1.3 Q: What's the bottom line? What do I have to do to be ready to attest meaningful use?
- 1.4 Q: Can you tell me more about the 15 "core" meaningful use measures? (all are required)
- 1.5 Q: What about the 5 "menu" set of meaningful use objectives? (5 of 10 possible are required)
- 1.6 Q: What about the required Clinical Quality Measures (CQM)?
Outpatient Meaningful Use for WorldVistA
Hello. My name is Kevin Toppenberg, MD. I am a primary care physician in Greeneville, TN. I have been active in the VistA community for at least 7 years, and have used VistA in my office during this time. I have decided to pursue meaningful use certification with VistA. This page will document my progress towards this, and record notes that I make to myself along the way. I hope this is helpful to others.
In CMS terminology, I am an "Eligible Provider" (EP), not a hospital. Also, I am going after Medicare (not Medicaid) certification. So my discussion below will be targeted accordingly.
NOTE: Other are welcome to make enhancements to this page
Q: Where can I find the certification status of WorldVistA?
- Go to CMS Certified Health IT Products
- Search for "WorldVistA" -- NOTE: the search engine on this page is flaky. I found that when I clicked the search button, it would return a list of ALL technology. But when I then simply clicked search AGAIN (with WorldVistA still in the search term box), then it would find it.
Q: There seems to be so many steps to be ready to attest meaningful use. It's overwhelming. Any overview sites?
- I recommend starting with this overview: CMS EHR Meaningful Use Overview. The information I am posting here is from this site.
- Alternatively, here are the slides from a CMS webinar presentation.
- Here is another CMS document (2010) document with similar detail.
- A very good presentation from IHS giving an overview of Meaningful Use can be found here
Q: What's the bottom line? What do I have to do to be ready to attest meaningful use?
- Meet 20 of 25 "Meaningful Use Objectives" source
- Must meet 15 "core" measures
- Must also meet 5 of 10 possible "menu" set measures
- Meet 6 of 41 "Clinical Quality Measures (CQM's)" source
- Must meet 3 required core quality measures
- must also meet 3 of 38 possible additional quality measures
- Attest to meeting requirements using Y/N answers and by supplying data from the Quality Measures package.
TODO SMH: Reference and write about the Quality Measures package.
Q: Can you tell me more about the 15 "core" meaningful use measures? (all are required)
(Detailed instructions on meeting these will be provided in more detail below.)
| Measure | Link to CMS Source | VISTA fulfillment | Attestation Type |
|---|---|---|---|
| CPOE -- Provider directly enters in orders | Source | Fulfillment | Rate > 30% |
| Implement drug-drug and drug-allergy interaction checks | Source | Fulfillment | Yes/No |
| Maintain an up-to-date problem list of current and active diagnoses | Source | Fullfillment | Rate > 80% |
| Generate and transmit permissible prescriptions electronically (eRx) | Source | not available | Rate > 40% |
| Maintain active medication list | Source | Fulfillment | Rate > 80% |
| Maintain active medication allergy list | Source | Fulfillment | Rate > 80% |
| Record required demographics | Source | Fulfillment | Rate > 50% |
| Record required vital signs | Source | Fulfillment | Rate > 50% |
| Record smoking status for patients aged 13 yrs and up | Source | Fulfillment | Rate > 50% |
| Report clinical quality measures to CMS | Source | Fulfillment | Yes/No (Measures are reportable rates however) |
| Implement 1 clinical decision support rule | Source | Fulfillment | Yes/No |
| Provide patients with an electronic copy of their health information | Source | Fulfillment | Rate > 50% |
| Provide clinical summaries for patients for each office visit within 3 days | Source | Fulfillment | Rate > 50% |
| Perform at least 1 test of exchanging key clinical information with another entity electronically | Source | Fulfillment | Yes/No |
| Protect electronic health information | Source | Yes/No |
| Measure | Link to CMS Source | VISTA fulfillment | Attestation Type |
|---|---|---|---|
| Implement drug formulary checks | Source | Fulfillment | Yes/No |
| Incorporate lab results into EHR as structured data | Source | Fulfillment | Rate > 40% |
| Generate list of patients by specific conditions for quality improvement | Source | Fulfillment | Yes/No |
| Send patient reminders per patient preference | Source | NOT DONE | NOT DONE |
| Provide patients with timely electronic access to their health information | Source | NOT DONE | NOT DONE |
| Provide patient-specific education resources | Source | Fulfillment | Rate > 10% |
| Perform medication reconcilliation | Source | Fulfillment | Rate > 50% |
| Send summary care record to other providers | Source | Fulfillment | Rate > 50% |
| Submit data to immunization registries | Source | Fulfillment | Yes/No |
| Submit syndromic surveillance data | Source | NOT DONE | NOT DONE |
Q: What about the required Clinical Quality Measures (CQM)?
- As above, providers must report 3 core CQM's
- Hypertension: Blood Pressure Measurement -- NQF0013: "Percentage of patient visits for patients aged 18 years and older with a diagnosis of hypertension who has been seen for at least 2 office visits, with blood pressure (BP) recorded." details details2
- Tobacco: Preventive Care Screening Measure Pair: details
- Tobacco Use Assessment
- Tobacco Cessation Intervention
- Adult Weight Screening and Follow-up details
- OR, 3 alternate core CQM's can be reported. These are to be used if unable to use 3 CQM
- An additional 3 from a list of 38 CQM's must be reported. source
- Diabetes: Hemoglobin A1c Poor Control details
- Diabetes: Low Density Lipoprotein (LDL) Management and Control -- details
- Diabetes: Blood Pressure Management details
- Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) details
- Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) details
- Pneumonia Vaccination Status for Older Adults details
- Breast Cancer Screening details
- Colorectal Cancer Screening details
- Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for Patients with CAD details
- Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) details
- Anti-depressant medication management: (a) Effective Acute Phase Treatment, (b)Effective Continuation Phase Treatment details
- Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation details
- Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy details
- Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care details
- Asthma Pharmacologic Therapy details
- Asthma Assessment details
- Appropriate Testing for Children with Pharyngitis details
- Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer details
- Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients details
- Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients details
- Smoking and Tobacco Use Cessation, Medical Assistance: a) Advising Smokers and Tobacco Users to Quit, b) Discussing Smoking and Tobacco Use Cessation Medications, c) Discussing Smoking and Tobacco # Use Cessation Strategies details
- Diabetes: Eye Exam details
- Diabetes: Urine Screening details
- Diabetes: Foot Exam details
- Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL-Cholesterol details
- Heart Failure (HF): Warfarin Therapy Patients with Atrial Fibrillation -- NQF 0084
- Ischemic Vascular Disease (IVD): Blood Pressure Management details
- Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic details
- Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a) Initiation, b) Engagement details
- Prenatal Care: Screening for Human Immunodeficiency Virus (HIV) -- NQF 0012
- Prenatal Care: Anti-D Immune Globulin -- NQF 0014
- Controlling High Blood Pressure details
- Cervical Cancer Screening details
- Chlamydia Screening for Women details
- Use of Appropriate Medications for Asthma details
- Low Back Pain: Use of Imaging Studies details
- Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control details
- Diabetes: Hemoglobin A1c Control (<8.0%) details
