Meaningful Use Stage One Final Rule

Core Set (15) and Menu Set (pick 5 of 10, include one population/public health measure) requirements

Meaningful Use - Core Set (15)
1. Record patient demographics (sex, race, ethnicity, date of birth, preferred language, and in the case of hospitals, date and preliminary cause of death in the event of mortality). More than 50% of patients' demographic data must be Recorded as structured data


 * Criteria for: Eligible Professionals
 * Section 170.304(c)-Record Demographics
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Record_Demographics_%28EP%29


 * Criteria for: Eligible Hospitals and CAHs
 * Section 170.306(b)-Record Demographics
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Record_Demographics_%28EH/CAH%29

2. Record vital signs and chart changes (height, weight, blood pressure, body mass index, growth charts for children). More than 50% of patients 2 years of age or older must have height, weight and blood pressure Recorded as structured data.


 * Criteria for: All Users
 * Section 170.302(e)-Record and Chart Vital Signs
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Record_and_Chart_Vital_Signs

3. Maintain up-to-date problem list of current and active diagnoses. More than 80% of patients must have at least one entry Recorded as structured data.


 * Criteria for: All Users
 * Section 170.302(b)-Maintain Up-To- Date Problem List
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Maintain_Up-To-_Date_Problem_List

4. Maintain an active medication list. More than 80% of patients have at least one entry Recorded as structured data.


 * Criteria for: All Users
 * Section 170.302(c)-Maintain Active Medication List
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Maintain_Active_Medication_List

5. Maintain an active medication Allergy list. More than 80% of patients have at least one entry Recorded as structured data.


 * Criteria for: All Users
 * Section 170.302(d)-Maintain Active Medication Allergy List
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Maintain_Active_Medication_Allergy_List

6. Record smoking status for patients 13 and older. More than 50% if patients age 13 or older have smoking status Recorded as structured data.


 * Criteria for: All Users
 * Section 170.302(g)-Smoking Status
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Smoking_Status

7. For professionals, provide patients with clinical summaries for each office visit; for hospitals provide an electronic copy of hospital discharge instructions upon request. Clinical summaries provided to patients for more than 50% of all visits within 3 business days. More than 50% of all patients who are discharged from an inpatient or ED of a hospital who request an electronic copy of their discharge instructions must be provided with it.


 * Criteria for: Eligible Professionals
 * Section 170.304(h)-Clinical Summaries
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Clinical_Summaries


 * Criteria for: Eligible Hospitals and CAHs
 * Section 170.306(e)-Electronic Copy of Discharge Information
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Electronic_Copy_of_Discharge_Information_%28EH/CAH%29

8. Upon request, provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication list, medication allergies, and for hospitals discharge summary and procedures). More than 50% of requesting patients must receive an electronic copy within 3 business days.


 * Criteria for: Eligible Professionals
 * Section 170.304(f)-Electronic Copy of Health Information
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Electronic_Copy_of_Health_Information_%28EP%29


 * Criteria for: Eligible Hospitals and CAHs
 * Section 170.306(d)-Electronic Copy of Health Information
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Electronic_Copy_of_Health_Information_%28EH/CAH%29

9. Generate and transmit permissible prescriptions electronically (does not apply to hospitals). More than 40% must be transmitted electronically using certified EHR technology.


 * Criteria for: Eligible Professionals
 * Section 170.304(b)-Electronically Exchange Prescription Information
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Electronically_Exchange_Prescription_Information

10. Computerized Provider Order Entry for Medication Orders. More than 30% of patients with at least one medication in their medication list must have at least one medication ordered through CPOE


 * Criteria for: Eligible Professionals
 * Section 170.304(a)-Computerized Provider Order Entry
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Computerized_Provider_Order_Entry_%28EP%29


 * Criteria for: Eligible Hospitals and CAHs
 * Section 170.306(a)-Computerized Provider Order Entry
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Computerized_Provider_Order_Entry_%28EH/CAH%29

11. Implement drug-drug and drug-Allergy interaction checks. Functionality must be enabled for these checks for the entire reporting period.


 * Criteria for: All Users
 * Section 170.302(a)-Drug-Drug, Drug-Allergy, Drug-Formulary Checks
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Drug-Drug_Drug-Allergy_Checks

12. Implement capability to electronically exchange key clinical information among providers and patient-authorized entities. Must perform at least one test of the EHR's capacity to electronically exchange information.


 * Criteria for: Eligible Professionals
 * Section 170.304(i)-Exchange Clinical Information and Patient Summary Record
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Capability_To_Exchange_Key_Clinical_Information_%28EP%29


 * Criteria for: Eligible Hospitals and CAHs
 * Section 170.306(f)-Exchange Clinical Information and Summary Record
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Capability_To_Exchange_Key_Clinical_Information_%28EH/CAH%29

13. Implement one clinical decision support rule and track compliance with that rule. One rule must be implemented.


 * Criteria for: Eligible Professionals
 * Section 170.304(e)-Clinical Decision Support
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Clinical_Decision_Support_%28EP%29


 * Criteria for: Eligible Hospitals and CAHs
 * Section 170.306(c)-Clinical Decision Support
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Clinical_Decision_Support_%28EH/CAH%29

14. Implement systems to protect privacy and security of patient data in the EHR. Must conduct or review a security risk analysis, implement security updates as necessary and correct identified security deficiencies.


 * Criteria for: All Users
 * Section 170.302(o)-Access Control
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Access_Control


 * Criteria for: All Users
 * Section 170.302(p)-Emergency Access
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Emergency_Access


 * Criteria for: All Users
 * Section 170.302(q)-Automatic Log-Off
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Automatic_Log-Off


 * Criteria for: All Users
 * Section 170.302(r)-Audit Log
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Audit_Log


 * Criteria for: All Users
 * Section 170.302(s)-Integrity
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Integrity


 * Criteria for: All Users
 * Section 170.302(t)-Authentication
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Authentication


 * Criteria for: All Users
 * Section 170.302(u)-Encryption
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Encryption

15. Report Clinical Quality Measures to CMS or the states. For 2011 provide aggregate numerator and denominator through attestation. For 2012, electronically submit measures.


 * Criteria for: Eligible Hospitals and CAHs
 * Section 170.302(i)-Report Quality Measures
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Report_Quality_Measures_%28EH/CAH%29


 * Criteria for: Eligible Professionals
 * Section 170.302(i)-Report Quality Measures
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Report_Quality_Measures_%28EP%29

Meaningful Use - Menu Set (Pick 5 of 10)
1. Implement drug formulary checks. Drug formulary check system must be implemented and access at least one internal or external drug formulary during the reporting period.


 * Criteria for: All Users
 * Section 170.302(a)-Drug-Drug, Drug-Allergy, Drug-Formulary Checks
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Drug-Formulary_Checks

2. Incorporate clinical laboratory test results into EHRs as structured data. More than 40% of clinical laboratory test results are in positive/negative or numerical format and are incorporated into EHRs as structured data


 * Criteria for: All Users
 * Section 170.302(g)-Incorporate Laboratory Test Results
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Incorporate_Laboratory_Test_Results

3. Generate lists of patients by specific conditions for use for quality improvement, reduction of disparities, research or outreach. Must generate one listing of patients with a specific condition


 * Criteria for: All Users
 * Section 170.302(h)-Generate Patient Lists
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Generate_Patient_Lists

4. Use EHR technology to identify patient-specific education resources and provide those to the patient as appropriate. More than 10% of patients are provided patient specific education resources


 * Criteria for: All Users
 * Section N/A - Patient-specific Education Resources
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Patient-specific_Education_Resources

5. Perform Medication reconciliation between care settings. Medication reconciliation must be performed for more than 50% of transitions of care.


 * Criteria for: All Users
 * Section 170.302(l)-Medication Reconciliation
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Medication_Reconciliation

6. Provide summary of care Record for patients referred or transitioned to another provider or setting. Summary of care Record must be provided for more than 50% of patient transitions or referrals


 * Criteria for: Eligible Professionals
 * Section 170.304(i)-Exchange Clinical Information and Patient Summary Record
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Provide_Summary_Of_Care_Record_%28EP%29


 * Criteria for: Eligible Hospitals and CAHs
 * Section 170.306(f)-Exchange Clinical Information and Summary Record
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Provide_Summary_Of_Care_Record_%28EH/CAH%29

7. Submission of electronic immunization data to immunization registries or immunization information systems. Must perform at least one test of data submission and follow-up submission (where registries can accept electronic submissions)


 * Criteria for: All Users
 * Section 170.302(m)-Submission to Immunization Registries
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Submission_to_Immunization_Registries

8. Submission of electronic syndromic surveillance data to public health agencies. Must perform at least one test of data submission and xe submission (where public health agencies can accept electronic data)


 * Criteria for: All Users
 * Section 170.302(n)-Public Health Surveillance
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Public_Health_Surveillance

For hospitals - 9 & 10
9. Record advanced directives for patients 65 years or older. More than 50% of patients aged 65 or older must have an indication of an advanced directive status Recorded.


 * Criteria for: Eligible Hospitals and CAHs

Section N/A - Advance Directives
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Advance_Directives

10. Submission of electronic data on reportable laboratory results to public health agencies. Perform at least one test of data submission and follow-up submission (where public health agencies can accept electronic data)


 * Criteria for: Eligible Hospitals and CAHs
 * Section 170.306(g)-Reportable Lab Results
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Reportable_Lab_Results_%28EH/CAH%29

For professionals - 9 & 10
9. Send reminders to patients (per patient preference) for preventative and follow-up care. More than 20% of patients aged 65 or older or age 5 or younger must be sent appropriate reminders.


 * Criteria for: Eligible Professionals
 * Section 170.304(d)-Generate Patient Reminder List
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Generate_Patient_Reminder_List

10. Provide patients with timely electronic access to their health information (including laboratory results, problem list, medication list, medication allergies). More than 10% of patients must be provided with electronic access to information within 4 days of its being updated in the EHR.


 * Criteria for: Eligible Professionals
 * Section 170.304(g)-Timely Access
 * http://vistapedia.net/index.php?title=MU_Stage1_Final_Rule_-_Timely_Access

Core Set
1. Provide patients an electronic copy of their ambulatory, ED or inpatient summary of care record 2. Transmit prescriptions 3. Capability to exchange key clinical information among care providers and patient authorized entities 4. Report clinical quality measures

Menu Set
5. Incorporate clinical lab tests results into EHRs as structured data 6. Provide summary of care Record for patients referred or transition to another provider or setting 7. Capability to submit data to immunization registries, provide syndromic surveillance and lab data to public health agencies Another issue not in this PPT: The date, time, patient identification, and user identification must be Recorded when electronic health information is created, modified, accessed, or deleted; and an indication of which Action(s) occurred and by whom must also be Recorded

Approved Test Procedures
Each wiki pages described on this page contains a link to the NIST testing requirement specific to meaningful use criteria. Below is a link to the NIST page that lists all of the test procedure documents on one page: http://healthcare.nist.gov/use_testing/effective_requirements.html (updated to reflect V1.1 and v1.2 documents)