TMG Meaningful Use
7/25/2012
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.
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?
- When I looked into this a year or so ago, reading the ~80 pages of densely packed legal terms, I gave up. It seemed too daunting. But now that I am revisiting this, it seems to not be too bad at all. I found that I am already doing most of the requirements.
- 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.
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)"
- Must meet 3 required core quality measures
- must also meet 3 of 38 possible additional quality measures
Q: Can you tell me more about the 15 "core" meaningful use measures? (all are required) They are as follows:
- CPOE -- Provider directly enters in orders source
- Implement drug-drug and drug-allergy interaction checks source
- Maintain and up-to-date problem list of current and active diagnoses source
- Generate and transmit permissible prescriptions electronically (eRx) source
- Maintain active medication list source
- Maintain active medication allergy list source
- Record required demographics source
- Record required vital signs source
- Record smoking status for patients aged 13 yrs and up source
- Report clinical quality measures to CMS source
- Implement 1 clinical decision support rule source
- Provide patients with an electronic copy of their health information source
- Provide clinical summaries for patients for each office visit (at least 50% of patients, within 3 days) source
- Perform at least 1 test of exchanging key clinical information with another entity electronically source
- Protect electronic health information source
Q: What about the 5 "menu" set of meaningful use objectives? (5 of 10 possible are required)
- Implement drug formulary checks source
- Incorporate lab results into EHR as structured data source
- Generate list of patients by specific conditions for quality improvement source
- Send patient reminders per patient preference source
- Provide patients with timely electronic access to their health information source
- Provide patient-specific education resources source
- Perform medication reconcilliation source
- Send summary care record to other providers source
- Submit data to immunization registries source
- Submit syndromic surveillance data source
Q: What about the required Clinical Quality Measures (CQM)?
- As above, providers must report 3 core CQM's
- NQF0013 – Hypertension: Blood Pressure Measurement
- NQF0028 – Preventive Care Screening Measure Pair:
- Tobacco Use Assessment
- Tobacco Cessation Intervention
- NQF0421 – Adult Weight Screening and Follow-up
- OR, 3 alternate core CQM's can be reported. These are to be used of unable to use 3 CQM
- NQF 0024 -- BMI for age 2-18
- NQF 0041 -- Influenza vaccination
- NQF 0038 -- Childhood immunization status
- An additional 3 from a list of 38 CQM's must be reported.