View source for Meaningful Use (WG6)

'''Discussion of How VistA Meets, or Can Meet, <BR>Meaningful Use, Stage 1<BR> ''45 CFR Part 170'''''

Final Rule
* Standards and Certification Criteria Final Rule http://edocket.access.gpo.gov/2010/pdf/2010-17210.pdf [PDF - 390 kb] <br>U.S. Department of Health & Human Services (Published on July 28, 2010)

Interim final rule documents (superseded by Final rule documents)
* [http://edocket.access.gpo.gov/2010/pdf/E9-31216.pdf Official document published in the Federal Register]
* http://edocket.access.gpo.gov/2010/E9-31216.htm (HTML version of Official Document published in the Federal Register)
* [[E9-31216 | VistApedia copy of Official Document]]
* [http://www.cms.hhs.gov/Recovery/11_HealthIT.asp CMS Topical Web Site]

=Background discussion=
* The texts discusses EHR's as being '''Certified'''.  It is not yet clear how this certification status will be awarded.
* The criteria herein are just for Stage 1 (beginning 2011).  Further criteria are likely to be unveiled as the program progresses.
* Stage 2 will begin in 2013; Stage 3 in 2015
* Professionals must not only adopt/install a certified EHR, but must also demonstrate meaningful use.  Thus just have a system capable of the features below will not be sufficient. They must be implemented and used.

=All-in-one vs. Composite systems=


Details from 45 CFR Part 170 describe the ability of a eligible system to be constructed from modules, and thus VistA doesn't have to meet all of the meaningful use criteria by itself.''

[[MU-CompositeSystems|Discussion/Details Page]]

=Possible $ Bonus amounts=

[https://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=9810&p_created=1245700431&p_sid=GYgNF3Tj&p_accessibility=0&p_redirect=&p_lva=&p_sp=cF9zcmNoPSZwX3NvcnRfYnk9JnBfZ3JpZHNvcnQ9JnBfcm93X2NudD0yNCwyNCZwX3Byb2RzPTIxLDI2LDEwNTgmcF9jYXRzPSZwX3B2PTMuMTA1OCZwX2N2PSZwX3NlYXJjaF90eXBlPWFuc3dlcnMuc2VhcmNoX25sJnBfcGFnZT0x&p_li=&p_topview=1 Up to $65k, maximum amount available under Medicaid]

[https://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=9811&p_created=1245700559&p_sid=ENVCG3Tj&p_accessibility=0&p_redirect=&p_lva=&p_sp=cF9zcmNoPSZwX3NvcnRfYnk9JnBfZ3JpZHNvcnQ9JnBfcm93X2NudD0yNCwyNCZwX3Byb2RzPTIxLDI2LDEwNTgmcF9jYXRzPSZwX3B2PTMuMTA1OCZwX2N2PSZwX3NlYXJjaF90eXBlPWFuc3dlcnMuc2VhcmNoX25sJnBfcGFnZT0x&p_li=&p_topview=1 Up to $44k, maximum amount available under Medicare]

=Listing of Criteria for Stage 1 of Meaningful Use=

==1. Use Computerised Provider Order Entry (CPOE)==
; VistA Status: [ ] '''Ready Now'''; [ ] Minor Work; [X] Moderate Work  [ ] Major Work depending upon which item. Elements of this are handled in other Meaningful use items. 
; [[MU-CPOE|Discussion/Details Page]]

==2. Implement drug-drug, drug-[[allergy~|Allergy]], drug-formulary checks==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [X] Major Work <Please edit> 
; [[MU-RxCheck|Discussion/Details Page]]

==3. Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOWMED CT==
; VistA Status: [x] '''Ready Now'''; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-ProbList|Discussion/Details Page]]

==4. Generage and transmit permissible prescriptions electronically (eRx)==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ X] Major Work <Please edit> 
; [[MU-ERx|Discussion/Details Page]]

==5. Maintain active medication list==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [X] Major Work <Please edit> 
; [[MU-MedList|Discussion/Details Page]]

==6. Maintain active medication [[allergy~|Allergy]] list==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work [X] To be determined <Please edit> 
; [[MU-AllergyList|Discussion/Details Page]]

==7. [[Record~|Record]] demographics==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work [X] To Be Determined <Please edit> 
; [[MU-Demographics|Discussion/Details Page]]

==8. [[Record~|Record]] and chart changes in vital signs==
; VistA Status: [ ] Ready Now; [X] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-Vitals|Discussion/Details Page]]

==9. [[Record~|Record]] smoking status for patients 13 yrs old or older==
; VistA Status: [ ] Ready Now; [X] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-SmokeStatus|Discussion/Details Page]]

==10. Incomporate clinical lab-test results into EHR as structured data==
; VistA Status: [] '''Ready Now'''; [ ] Minor Work;  [ ] Major Work [X] Depends upon specific requirements which are not yet available <Please edit> 
; [[MU-LabIntegrate|Discussion/Details Page]]

==11. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities and outreach==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-PtLists|Discussion/Details Page]]

==12. Report quality measures to CMS or the States==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [X] Major Work <Please edit> 
; [[MU-ReportQuality|Discussion/Details Page]]

==13. Send reminders to patients per patient preference for preventative/followup care==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-PtReminders|Discussion/Details Page]]

==14. Implement 5 clinical decision support rules==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-SupportRules|Discussion/Details Page]]

==15. Check insurance eligibility electronically from public and private payers==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-eInsurElig|Discussion/Details Page]]

==16. Submit claims electronically to public and private payers==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-eClaims|Discussion/Details Page]]

==17. Provide patients with an electronic copy of their health information upon request==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-eCopyInfo|Discussion/Details Page]]

==18. Provide patients with an electronic copy of their discharge instructions and procedures at time of discharge, upon request==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-Discharge|Discussion/Details Page]]

==19. Provide patients with timely electronic access to their health information (including lab results, problem lists, medication lists, allergies) within 96 hours of the information being available to the eligible professional==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-eAccess|Discussion/Details Page]]

==20. Provide clinical summaries for patients for each office visit==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-Summaries|Discussion/Details Page]]

==21. Capability to exchange key clinical information among providers of care and patient authorized entities electronically.==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-eExchange|Discussion/Details Page]]

==22. Provide summary care [[record~|Record]]s for each transition of care and referral==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-TransSummary|Discussion/Details Page]]

==23. Perform medication reconciliation at relevant encounters and each transition of care==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-eMedRec|Discussion/Details Page]]

==24. Capability to submit electronic data to immunization registries and actual submission where required and accepted.==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-ImmReg|Discussion/Details Page]]

==25. Capability to provide electronic submission of reportable lab results (as required by state or local law) to public health agencies and actual submission where is can be received HOSPITALS ONLY==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-eSubReportable|Discussion/Details Page]]

==26. Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-eSyndromic|Discussion/Details Page]]

==27. Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.==
; VistA Status: [ ] Ready Now; [ ] Minor Work;  [ ] Major Work <Please edit> 
; [[MU-Security|Discussion/Details Page]]