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Stage 2 Meaningful Use Checklist

Author Name Patrick Ouellette   |   Date September 20, 2012   |   Tagged , , , , ,
The first Stage 2 Meaningful Use reporting period is Jan. 1, 2014, but it wouldn’t hurt to get a rundown of what you’re going to be up against at that time. Eligible professionals (EPs) will have to meet 17 core objectives and 3 of 6 menu objectives. Eligible hospitals will have to hit 16 core objectives and 3 of 6 menu objectives.
Note that all providers are required to report on CQMs in order to demonstrate meaningful use. Beginning in 2014, all providers regardless of their stage of meaningful use will report on CQMs in the same way.
- EPs must report on 9 out of 64 total CQMs.
- Eligible hospitals and critical access hospitals (CAHs) must report on 16 out of 29 total CQMs.
In addition, all providers must select CQMs from at least 3 of the 6 key health care policy domains recommended by the Department of Health and Human Services’ National Quality Strategy:
- Patient and Family Engagement
- Patient Safety
- Care Coordination
- Population and Public Health
- Efficient Use of Healthcare Resources
- Clinical Processes/Effectiveness
Beginning with Stage 2, CMS is creating a separate place for these measures that puts them on par with core and menu objectives. Read the complete list of Stage 2 clinical quality measures for eligible professionals here.
EPs can electronically report CQMs either individually or as a group using the following methods:
- Physician Quality Reporting System (PQRS): Electronic submission of samples of patient-level data. EPs can also report as group using the PQRS GPRO tool. EPs that are beyond the first year of demonstrating meaningful use who electronically report using this PQRS option will meet both their EHR Incentive Program and PQRS reporting requirements.
- CMS Portal: Electronic submission of aggregate-level data.
Before even thinking about Stage 2 requirements, you should know the retained Stage 1 Menu Measures:
- CPOE
- Demographics
- Vitals
- Smoking Status
- Structured Labs*
- Patient Lists*
- Preventive Reminders*
- Clinical Summary
- Patient Education*
- Medication Reconciliation*
- Immunizations*
- Syndromic Surveillance
- Security Analysis
*Former Stage 1 menu measures that are now core measures in Stage 2
And these measures were consolidated:
eRx
- eRx, Drug Formulary*
Interventions
-Clinical Decision Support, Drug/Drug, Drug/Allergy
Patient Access
- Timely Access*, E-Copy of Health Information
Summary of Care
- Summary of Care*, Problems, Medications, Medication Allergies, Exchange Clinical Information
*Former Stage 1 menu measures that are now core measures in Stage 2
These are the Stage 2 Core and Menu Objectives for EPs:
Core (all 17 required)
1. Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders (More than 60 percent of medication, 30 percent of laboratory, and 30 percent of radiology orders created by the EP during the EHR reporting period are recorded using CPOE)
2. Generate and transmit permissible prescriptions electronically (eRx) (More than 50 percent of all permissible prescriptions written by the EP)
3. Record demographic information (More than 80 percent of all unique patients seen by the EP have demographics recorded as structured data)
4. Record and chart changes in vital signs (More than 80 percent of all unique patients seen by the EP have blood pressure (for patients age 3 and over only) and height and weight (for all ages) recorded as structured data)
5. Record smoking status for patients 13 years old or older (More than 80 percent of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data)
6. Use clinical decision support to improve performance on high-priority health conditions (1. Implement 5 clinical decision support interventions related to 4 or more clinical quality measures, if applicable, at a relevant point in patient care for the entire EHR reporting period and 2. The EP, eligible hospital, or CAH has enabled the functionality for drug and drug-allergy interaction checks for the entire EHR reporting period.)
7. Provide patients the ability to view online, download and transmit their health information (1. More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timely (available to the patient within 4 business days after the information is available to the EP) online access to their health information and 2. More than 5 percent of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download, or transmit to a third party their health information.)
8. Provide clinical summaries for patients for each office visit (Clinical summaries provided to patients within one business day for more than 50 percent of office visits)
9. Protect electronic health information created or maintained by the Certified EHR Technology (Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1), including addressing the encryption/security of data at rest and implement security updates as necessary and correct identified security deficiencies as part of its risk management process)
10. Incorporate clinical lab-test results into Certified EHR Technology (More than 55 percent of all clinical lab tests results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in Certified EHR Technology as structured data)
11. Generate lists of patients by specific conditions to use for quality improvement, reduction of  disparities, research, or outreach (At least one report)
12. Use clinically relevant information to identify patients who should receive reminders for  preventive/follow-up care
13. Use certified EHR technology to identify patient-specific education resources (More than 10 percent of unique patients)
14. Perform medication reconciliation (The EP performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP)
15. Provide summary of care record for each transition of care or referral (1. The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50% of transitions of care and referrals 2. The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record either a) electronically transmitted to a recipient using CEHRT or b) where the recipient receives the summary of care record via exchange facilitated by an organization that is a NwHIN Exchange participant or is validated through an ONC‑established governance mechanism to facilitate exchange for 10% of transitions and referrals3. The EP who transitions or refers their patient to another setting of care or provider of care must either a) conduct one or more successful electronic exchanges of a summary of care record with a recipient using technology that was designed by a different EHR developer than the sender’s, or b) conduct one or more successful tests with the CMS-designated test EHR during the EHR reporting period.)
16. Submit electronic data to immunization registries
17. Use secure electronic messaging to communicate with patients on relevant health information (5 percent of unique patients)
Menu objectives (need to report on 3 of 6)
1. Submit electronic syndromic surveillance data to public health agencies for an entire reporting period
2. Record electronic notes in patient records (Enter at least one electronic progress note created, edited and signed by an EP for more than 30 percent of unique patients)
3. Imaging results accessible through CEHRT (More than 10 percent of all scans and tests whose result is an image ordered by the EP for patients seen during the EHR reporting period are incorporated into or accessible through Certified EHR Technology)
4. Record patient family health history (More than 20 percent of all unique patients seen by the EP during the EHR reporting period have a structured data entry)
5. Identify and report cancer cases to a State cancer registry for the entire reporting period.
6. Identify and report specific cases to a specialized registry (other than a cancer registry) for the entire reporting period.
These are the 16 Stage 2 Core and Menu Objectives for Eligible Hospitals (EHs) and CAHs:
Core (all 16 required)
1. Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders (More than 60 percent of medication, 30 percent of laboratory, and 30 percent of radiology orders created by authorized providers of the eligible hospital’s or CAH’s inpatient or emergency department.)
2. Record demographic information (More than 80 percent of all unique patients admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data)
3. Record and chart changes in vital signs (80 percent)
4. Record smoking status for patients 13 years old or older (80 percent)
5. Use clinical decision support to improve performance on high-priority health conditions (1. Implement 5 clinical decision support interventions related to 4 or more clinical quality measures, if applicable, at a relevant point in patient care for the entire EHR reporting period. 2. The eligible hospital or CAH has enabled the functionality for drug and drug-allergy interaction checks for the entire EHR reporting period)
6. Provide patients the ability to view online, download and transmit their health information within 36 hours after discharge. (More than 50% of all unique patients discharged from the inpatient or emergency departments of the eligible hospital or CAH (POS 21 or 23) during the EHR reporting period are provided timely (available to the patient within 36 hours after discharge from the hospital.) online access to their health information 2. More than 5% of all unique patients discharged from the inpatient or emergency departments of the eligible hospital or CAH (POS 21 or 23) during the EHR reporting period (or their authorized representatives) view, download, or transmit to a third party their health information.)
7. Protect electronic health information created or maintained by the Certified EHR Technology (Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1), including addressing the encryption/security of data at rest and implement security updates as necessary and correct identified security deficiencies as part of its risk management process)
8. Incorporate clinical lab-test results into Certified EHR Technology (More than 55 percent of all clinical lab tests results ordered by authorized providers of the eligible hospital or CAH for patients admitted to its inpatient or emergency department)
9. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach (At least one)
10. Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate (More than 10 percent of unique patients)
11. Perform medication reconciliation (The eligible hospital or CAH performs medication reconciliation for more than 50% of transitions of care in which the patient is admitted to the eligible hospital’s or CAH’s inpatient or emergency department.)
12. Provide summary of care record for each transition of care or referral (1. The eligible hospital, or CAH that transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50% of transitions of care and referrals 2. The eligible hospital or CAH that transitions or refers their patient to another setting of care or provider of care provides a summary of care record either a) electronically transmitted to a recipient using CEHRT or b) where the recipient receives the summary of care record via exchange facilitated by an organization that is a NwHIN Exchange participant or is validated through an ONC‑established governance mechanism to facilitate exchange for 10% of transitions and referrals)
13. Submit electronic data to immunization registries for the entire reporting period.
14. Submit electronic data on  reportable lab results to public health agencies for the entire reporting period.
15. Submit electronic syndromic surveillance data to public health agencies for the entire reporting period.
16. Automatically track medications with an electronic medication administration record (eMAR) (More than 10% of medication orders created by authorized providers of the eligible hospital’s or CAH’s inpatient or emergency department)
Menu objectives (need to report on 3 of 6)
1. Record whether a patient 65 years old or older has an advance directive (More than 50 percent)
2. Record electronic notes in patient records (Enter at least one electronic progress note created, edited and signed by an EP for more than 30 percent of unique patients.)
3. Imaging results accessible through CEHRT (More than 10 percent of all scans and tests whose result is an image ordered by an authorized provider of the eligible hospital or CAH for patients admitted to its inpatient or emergency department.)
4. Record patient family health history (More than 20 percent)
5. Generate and transmit permissible discharge prescriptions electronically (eRx) (More than 10 percent)
6. Provide structured electronic lab results to ambulatory providers (More than 20 percent)
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