TMG Meaningful Use

= 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: This page was originally created by Kevin Toppenberg, whose namespace is TMG. Enhancements have been made to this page, to include more general information for those seeking to attest to Meaningful Use Stage One in an outpatient setting.

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 seem to be so many steps involved in getting ready for Stage One attestation. 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?
(TO-DO SMH: Reference and write about the Quality Measures package.)
 * 1) Meet 20 of 25 "Meaningful Use Objectives" source
 * 2) * Must meet 15 "core" measures
 * 3) * Must also meet 5 of 10 possible "menu" set measures
 * 4) Meet 6 of 41 "Clinical Quality Measures (CQM's)" source
 * 5) * Must meet 3 required core quality measures
 * 6) * must also meet 3 of 38 possible additional quality measures
 * 7) Attest to meeting requirements using Y/N answers and by supplying data from 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. Detailed instructions on reporting can be found here: Quality Measures package documentation.

Q: What about the required Clinical Quality Measures (CQM)?
You must report the 3 core measures. If any of the 3 core measures are reported with zero values for the denominator, you are required to pick an alternate core measure to report in addition, even if these yield zero. For example if: NQF 0028 & NQF 0421 are 0; report 2 measures from the alternate core measures.

In addition to the core/alternate core measures, you need to report an additional 3 measures from the additional list of 38 CQMs.

Click here for a list of all measures afrom the CMS website along with the instructions just above.

NB: If you see the numerator and denomiator logic filled out, it means that the measure is fully supported in the Quality Measurement Package. If they are not there, then they are unsupported; you may still report on them, but you will have to do extra work on your end to make them work.

Alternate Core Measures
If you reported 0 for all 3 core measures, you must report on all 3 alternate core measures even if you will report zeroes for all 6 measures.

Additional Core Measures
An additional 3 from a list of 38 CQM's must be reported. Only the first three are supported by the Quality Measures package right now. If you need to add more, get in contact with George Lilly or Sam Habiel.