• Stage 1 Meaningful Use Checklist

    Author | Date June 20, 2012
    Download the complete checklist here.  As announced recently, there are more than 100,000 EHR users and a good portion of those have achieved Meaningful Use Stage 1 already and are focusing on preparing for Stage 2. But not everyone has accomplished Stage 1, including many small practices. Here’s a checklist to look over when prepping and organizing for meaningful use. Remember, the last day to prove meaningful use over a 90-day period and receive full incentive funds from the government is October 3!
    1. Establish your meaningful use team
    A. Define site manager responsibilities, pick manager
    B. Ensure everyone on the team is informed about meaningful use news and updates from CMS
    2. Decide who’s going to help you achieve meaningful use
    A. If you’re a small practice, there are plenty of regional extension centers (RECs) that can help you get up to speed.
    B. There are also vendors such as MBTC that offer training programs along with their EHR systems.
    3. Complete a meaningful use readiness assessment and form an action plan to fill in any holes from the assessment
    4. Determine EHR Incentive Program eligibility. From there, decide if you’ll be able to use EHR in a meaningful manner and electronic exchange of health information to improve quality of health care
    5. Review Meaningful Use Stage 1 requirements for eligible professionals. Start with ensuring you are able to provide the 15 core objectives:
    1. Computerized provider order entry (CPOE)
    2. E-Prescribing (eRx)
    3. Report ambulatory clinical quality measures to CMS/States
    4. Implement one clinical decision support rule
    5. Provide patients with an electronic copy of their health information, upon request
    6. Provide clinical summaries for patients for each office visit
    7. Drug-drug and drug-allergy interaction checks
    8. Record demographics
    9. Maintain an up-to-date problem list of current and active diagnoses
    10. Maintain active medication list
    11. Maintain active medication allergy list
    12. Record and chart changes in vital signs
    13. Record smoking status for patients 13 years or older
    14. Capability to exchange key clinical information among providers of care and patient- authorized entities electronically
    15. Protect electronic health information
    *Note that hospitals must complete these 14 core objectives:
    1. Computerized provider order entry (CPOE)
    2. Drug-drug and drug-allergy interaction checks
    3. Record demographics
    4. Implement one clinical decision support rule
    5. Maintain up-to-date problem list of current and active diagnoses
    6. Maintain active medication list
    7. Maintain active medication allergy list
    8. Record and chart changes in vital signs
    9. Record smoking status for patients 13 years or older
    10. Report hospital clinical quality measures to CMS or States
    11. Provide patients with an electronic copy of their health information, upon request
    12. Provide patients with an electronic copy of their discharge instructions at time of
    discharge, upon request
    13. Capability to exchange key clinical information among providers of care and patientauthorized entities electronically
    14. Protect electronic health information
     6. Pick five objectives out of 10 from menu set (you may defer five of 10)
    1. Drug-formulary checks
    2. Record advanced directives for patients 65 years or older
    3. Incorporate clinical lab test results as structured data
    4. Generate lists of patients by specific conditions
    5. Use certified EHR technology to identify patient-specific education resources
    and provide to patient, if appropriate
    6. Medication reconciliation
    7. Summary of care record for each transition of care/referrals
    8. Capability to submit electronic data to immunization registries/systems*
    9. Capability to provide electronic submission of reportable lab results to public
    health agencies*
    10. Capability to provide electronic syndromic surveillance data to public health
    agencies*
    * At least 1 public health objective must be selected.
    7. Choose Clinical Quality Measures
    Track the 3 required core Clinical Quality Measures (CQMs):
    1. Hypertension: Blood Pressure Measurement
    2. Preventive Care and Screening Measure Pair: a) Tobacco Use Assessment, b) Tobacco Cessation Intervention
    3.  Adult Weight Screening and Follow-Up
    Or pick three of the 38 alternatives below on patients:
    1. Diabetes: Hemoglobin A1c Poor Control
    2. Diabetes: Low Density Lipoprotein (LDL) Management and Control
    3. Diabetes: Blood Pressure Management
    4. Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
    5. Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI)
    6. Pneumonia Vaccination Status for Older Adults
    7. Breast Cancer Screening
    8. Colorectal Cancer Screening
    9. Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for Patients with CAD
    10. Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)
    11. Anti-depressant medication management: (a) Effective Acute Phase Treatment, (b)Effective Continuation Phase Treatment
    12. Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation
    13. Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
    14. Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
    15. Asthma Pharmacologic Therapy
    16. Asthma Assessment
    17. Appropriate Testing for Children with Pharyngitis
    18. Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer
    19. Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients
    20. 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
    21. Diabetes: Eye Exam
    22. Diabetes: Urine Screening
    24. Diabetes: Foot Exam
    25. Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL-Cholesterol
    26. Heart Failure (HF): Warfarin Therapy Patients with Atrial Fibrillation
    27. Ischemic Vascular Disease (IVD): Blood Pressure Management
    28. Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic
    29. Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a) Initiation, b) Engagement
    30. Prenatal Care: Screening for Human Immunodeficiency Virus (HIV)
    31. Prenatal Care: Anti-D Immune Globulin
    32. Controlling High Blood Pressure
    33. Cervical Cancer Screening
    34. Chlamydia Screening for Women
    35. Use of Appropriate Medications for Asthma
    36. Low Back Pain: Use of Imaging Studies
    37. Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control
    38. Diabetes: Hemoglobin A1c Control (<8.0%)
    8. Be sure you’ve met all objectives, such as 80% of patients must have records in the certified EHR technology. Apply for CMS Meaningful Use funding.
    9. Demonstrate meaningful use achievement over 90 days
    10. Check out Stage 2 news and make sure that Stage 1 decisions won’t affect any future plans.

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