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For Eligible Providers (EP) to receive Medicare and Medicaid Stimulus Funds a certified EMR system has to be used and each EP must be able to report that the requirements of Meaningful Use have been met. These requirements are outlined, below (in the left column) and consist of 15 Core Requirements that are mandatory and 10 Menu items, from ‘/ which 5 must be chosen. The #10 Core Item mandates that 6 Clinical Quality Measures (CQM) must be chosen and eligible professionals will be required to report ambulatory clinical quality measures (CQMs) to CMS or the States. The method for choosing the 6 CQM’s is outlined below, in the right column. Meaningful Use Eligible Providers (EP) Clinical Quality Measures Core and Menu Requirements Ambulatory/Outpatient Core, Alternate and Additional The 15 Core Requirements An EP must report on a total of 6 CQM’s consisting of the following: The first 3 measures must come from the Core and/or Alternate CQM lists. It is preferred that 1. Use of CPOE for orders directly entered by authorizing provider (for example, MD, DO, the first 3 come from the Core CQM list, but if any of the 3 Core measures do not RN, PA, NP) More than 30% of all unique patients with at least one medication in their apply to an EP’s practice, then the EP can select and report on one or more of the 3 medication list seen by EP have at least one medication order entered using CPOE Alternate CQM’s. The remaining 3 are then chosen from the 38 options on the 2. Implement drug-drug, drug-allergy checks Additional List. 3. Maintain an up-to-date problem list of current and active diagnoses. More than 80% of all unique patients seen by the EP have at least one entry or an indication that no 3 Core CQM’s problems are known. (To be done by a Provider) 1. Hypertension: Blood Pressure Measurement 4. Generate and transmit permissible prescriptions electronically (eRx). More than 40% 2. Preventive Care and Screening Measure Pair: a) Tobacco Use Assessment, and b) of all permissible prescriptions written by EP are transmitted electronically Tobacco Cessation Intervention 3. Adult Weight Screening and Follow-up 5. Maintain active medication list. More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed 3 Alternate CQM’s any medication) 1. Weight Assessment and Counseling for Children and Adolescents 6. Maintain active medication allergy list. More than 80% of all unique patients seen by 2. Preventive Care and Screening: Influenza Immunization for Patients 50 years old or older the EP have at least one entry (or an indication that the patient has no known 3. Childhood Immunization Status medication allergies) 7. Record all of the following demographics: More than 50% of all unique patients seen 38 Additional CQM’s by the EP Preferred language, Gender, Race, Ethnicity, Date of Birth 1. Asthma assessment 8. Record and chart changes in the following vital signs: Height). Weight, Blood Pressure, 2. Appropriate Testing for Children with Pharyngitis Calculate and display body mass index, Plot and display growth charts for children 2 - 3. Initiation and Engagement of Alcohol and Other Drug Dependence Treatment 20 years, including BMI. For more than 50% of all unique patients age 2 and over 4. Prenatal Screening for Human Immunodeficiency Virus (HIV) seen by the EP, height, weight and blood pressure are recorded as structured data. 5. Prenatal Anti-D Immune Globulin Exclusion: Any EP who either see no patients 2 years and older, or who believes that 6. Controlling High Blood Pressure all three vital signs of height, weight and blood pressure of their patients have no 7. Preventive Care and Screening: Advising Smokers to Quit relevance to their scope of practice. 8. Preventive Care and Screening: Screening Mammography 9. Cervical Cancer Screening 9. Record smoking status for patients 13 years old or older. More than 50% of all unique 10. Chlamydia screening in women patients 13 years old or older seen by the EP 11. Preventive Care and Screening: Colorectal Cancer Screening 12. Use of appropriate medications for people with asthma 10. Report ambulatory clinical quality measures to CMS or, in the case of 13. Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Medicaid EPs, the states. Subject to paragraph (c) of this section, successfully Years and Older report to CMS (or, in case of Medicaid EPs, the States) ambulatory clinical quality 14. Asthma: Pharmacologic Therapy measures selected by CMS in the manner specified by CMS (or in the case of Medicaid 15. Low back pain: use of imaging studies EPs, the States). [Preamble Reference] For 2011, provide aggregate numerator, 16. Diabetes Mellitus: Dilated Eye Exam in Diabetic Patient 17. Diabetes Mellitus: Foot Exam denominator, and exclusions through attestation as required by CMS or State. 18. Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus * For 2012, electronically submit the clinical quality measures as required by 19. Diabetes: Blood Pressure Management CMS or State 20. Diabetes Mellitus: Urine Screening for Microalbumin or Medical Attention for Nephropathy in Diabetic Patients 11. Implement one clinical decision support rules relevant to specialty or high clinical 21. Diabetes Mellitus: Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus priority along with the ability to track compliance with that rule. 22. Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for 12. Provide patients with an electronic copy of their health information (including Patients with CAD diagnostics test results, problem list, medication lists, medication allergies), upon 23. Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 24. Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients request. More than 50% of all patients who request an electronic copy of their health with Prior Myocardial Infarction (MI) information are provided it within 3 business days. Exclusion: Any EP that has no 25. Ischemic Vascular Disease (IVD): Blood Pressure Management requests from patients or their agents for an electronic copy of patient health 26. Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL-Cholesterol information during the EHR reporting period. 27. Ischemic Vascular Disease (IVD): Complete 13. Provide clinical summaries for patients for each office visit. Clinical summaries Lipid Panel and LDL Control provided to patients for more than 50% of all office visits within 3 business days. 28. Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Exclusion: Any EP who has no office visits during the EHR reporting period. Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) 29. Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction) 14. Capability to exchange key clinical information (for example, problem list, medication 30. Heart Failure: Warfarin Therapy for Patients with Atrial Fibrillation list, medication allergies, and diagnostic test results), among providers of care and 31. Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation patient authorized entities electronically. 1 Test 32. Diabetic Retinopathy: Documentation of Presence or Absence of Macular 15. Protect electronic health information created or maintained by the certified EHR Edema and Level of Severity of Retinopathy technology through the implementation of appropriate technical capabilities. 33. Diabetic Retinopathy: Communication with the Physician Managing On-going Diabetes Care The Menu Items (there are 10, these are the 5 for MUSC) 34. Major Depressive Disorder (MDD): Antidepressant Medication During 1. Drug-formulary checking - Implement drug-formulary checks. Exclusion: Any EP who Acute Phase for Patients with MDD writes fewer than 100 prescriptions during the EHR reporting period 35. Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients 2. Incorporate clinical lab-test results into EHR as structured data. More than 40% of all 36. Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/ clinical lab tests results ordered by the EP during the EHR reporting period whose Progesterone Receptor (ER/PR) Positive Breast Cancer 37. Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low-Risk results are either in a positive/negative or numerical format are incorporated in ProstateCancer Patients certified EHR technology as structured data. Exclusion: Any EP who orders no lab 38. Diabetes: Hemoglobin A1c Control (<8.0%) tests whose results are either in a positive/negative or numeric format during the EHR reporting period 3. Generate lists of patients by specific condition to use for quality improvement, reduction of disparities, and outreach. Generate at least one report listing patients of Red Indicates an Action that is taken in the clinic the EP with a specific condition. 4. Capability to submit electronic data to immunization registries or immunization Yellow Indicates the CQM’s that will be available at Go-Live (Note: the information systems and actual submission according to applicable law and practice CQM’s have specific parameters regarding ages, visit types & other Exclusion: An EP who administers no immunizations during the EHR reporting period metrics that can be reviewed on the SharePoint site: Implementation or where no immunization registry has the capacity to receive the information Project Documentation>Meaningful Use> Epic Documents>Meaningful electronically. Use Quality Measure Tracker. 5. Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice.
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