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                                                                                               Summary of Clinical Operations Workgroup Recommendations

                                                                                                                                                                                                                       Recommended
                                                                                                                                                                                                                    Directional Statement
           Subject Area                                 Recommended For Definitive 2011 Implementation                                         Recommended For Definitive 2013 Implementation                                                          Notes
                                                                                                                                                                                                                    Of Intent For 2013 or
                                                                                                                                                                                                                             2015


Each entry in this column is a subject Each entry in this column describes standards that are recommended within a subject           Each entry in this column describes standards that are recommended             Each entry in this
area that applies to one or more       area for one or more 2011 measures of meaningful use. Where multiple standards or             within a subject area for one or more 2011 measures of meaningful use.         column is a
2011 measures of meaningful use.       options are recommended, unless otherwise specified the standards are recommended             These are recommended as firm 2013 implementation requirements for             recommended
                                       only for the relevant use case scenarios specified by HITSP. These are recommended as         MU measures, as applicable. Each standard is recommended for the               statement of direction,
                                       firm 2011 implementation requirements for MU measures, as applicable. Each standard           purposes specified in the referenced implementation guidance. These            comprising guidance on
                                       is recommended for the purposes specified in the referenced implementation guidance.          standards are recommended to be documented immediately as 2013                 expected future
                                       This summary is not a complete list of included standards, for full details please refer to   requirements so that applicants for meaningful use of EHRs have sufficient     requirements. This
                                       the recommended implementation specifications.                                                time for implementation of the standards. This summary is not a complete       guidance is not intended
                                                                                                                                     list of included standards, for full details please refer to the recommended   as a firm implementation
                                                                                                                                     implementation specifications.                                                 requirement for 2013 or
                                                                                                                                                                                                                    2015.




Summary Records, Clinical Reports, HL7 CCD, or HL7 CDA templates, or HL7 2.5.1 messaging, as specified by HITSP             HL7 CCD or HL7 CDA templates or HL7 2.5.1 as specified by HITSP
Encounter Messages, Radiology       - or -
Messages, Allergies and Clinical   Allowable alternatives for 2011 and 2012:
Notes Content Exchange                 Unstructured documents with HL7 CDA header such as PDF or free text or images of
                                   documents with HL7 CDA header in certain cases such as encounter summaries, or,
                                   local or proprietary exchange such as other HL7 v2 implementations in certain cases such
                                   as radiology messages


Clinical Problem and Procedure        SNOMED CT as specified by HITSP                                                                SNOMED CT as specified by HITSP                                                SNOMED CT as
Vocabulary                            - or -                                                                                         - or -                                                                         specified by HITSP
                                      Allowable alternatives for 2011 and 2012:                                                      Allowable Alternatives for 2013
                                         ICD-9, and/or CPT-4, and/or Local codes                                                        ICD-10 as per HIPAA rules

                                      Problems and procedures specified in 2011 MU quality measures must be mappable to
                                      SNOMED CT or ICD-9 or CPT-4 as applicable for 2011 for quality reporting purposes.


Other Vocabulary for Clinical         HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII for allergies, as HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII
Reports, Encounter Messages,          specified by HITSP                                                                     for allergies, as specified by HITSP
Radiology Messages, Allergies and      - or -
Notes                                 Allowable alternatives for 2011 and 2012:
                                          Free text or local vocabulary in certain cases

Medication Prescriptions And Other    NCPDP Script 10.x for ambulatory and long term care messages, or HL7 2.51 for                  NCPDP Script 10.x for ambulatory and long term care messages, or HL7
Medication Content Exchange           inpatient messages, or HL7 CCD or HL7 CDA for documents, as specified by HITSP                 2.51 for inpatient messages, or CCD/CDA for documents, as specified by
                                       - or -                                                                                        HITSP
                                      Allowable alternatives for 2011 and 2012:
                                              Unstructured documents with HL7 CDA header in certain cases, e.g. medication
                                      history

Medication Vocabulary                 RxNorm as specified by HITSP                                                                   RxNorm as specified by HITSP                                                                              NDF-RT and SPL
                                       - or -                                                                                                                                                                                                  implementation TBD.
                                      Allowable alternatives for 2011 and 2012:                                                                                                                                                                RxTerms are expected
                                              Local and/or proprietary codes including NDC, FDB, and other codes for                                                                                                                           to be defined within
                                      prescriptions.                                                                                                                                                                                           RxNorm.

                                      Medications and medication allergies specified in MU quality measures must be mappable
                                      to RxNorm for 2011 for quality reporting purposes.




                                                                                                                          Page 1 of 32
                                                                                                           76b3bd5e-d791-4517-b2f6-9692ec2e5889.xls

Clinical Laboratory Content            HL7 2.5.1 results to ordering provider, and/or HL7 CDA for documents, as specified by    HL7 2.5.1 results to ordering provider, and/or HL7 CDA for documents, as
Exchange                               HITSP                                                                                    specified by HITSP
                                       - or -
                                       Allowable alternatives for 2011 and 2012:
                                          Local or proprietary exchange such as other HL7 v2 implementations

Clinical Laboratory Vocabulary         LOINC and UCUM and SNOMED CT and ancillary codes as specified by HITSP                   LOINC and UCUM and SNOMED CT and ancillary codes as specified by
                                       - or -                                                                                   HITSP
                                       Allowable alternatives for 2011 and 2012:
                                          Local and/or proprietary codes

Administrative Content Exchange:       HIPAA X12 4010A1, and NCPDP Telecommunications 5.1, and as constrained by CAQH HIPAA X12 5010 and NCPDP Telecommunications D.0 as per HIPAA
Eligibility, Benefits, and Referrals   CORE Phase I and Phase II                                                      rules, and as constrained by CAQH CORE Phase I and Phase II
                                       - or -
                                       Allowable alternatives for 2011 and 2012:
                                          HIPAA X12 5010 and NCPDP Script 10.x per HIPAA rules, and as constrained by
                                       CAQH CORE Phase I and Phase II
Administrative Vocabulary: Eligibility, HIPAA X12 4010A1, and NCPDP, and as constrained by CAQH CORE Phase I and                HIPAA X12 5010 and NCPDP D.0 as per HIPAA rules, and as constrained
Benefits, and Referrals                 Phase II                                                                                by CAQH CORE Phase I and Phase II
                                         - or -
                                        Allowable alternatives for 2011 and 2012:
                                            HIPAA X12 5010 and NCPDP Script 10.x per HIPAA rules, and as constrained by
                                        CAQH CORE Phase I and Phase II
Public Health, Immunization, and        HL7 CCD, or HL7 CDA templates, or HL7 2.3.1 for immunization queries and vaccination    HL7 CCD, or HL7 CDA templates, or HL7 2.3.1 for immunization queries
Other Population Care Content           updates, or HL7 2.5.1 messaging, as specified by HITSP                                  and vaccination updates,or HL7 2.5.1 messaging, as specified by HITSP
Exchange                                 - or -
                                        Allowable alternatives for 2011 and 2012:
                                            Unstructured documents with HL7 CDA header such as PDF or free text or images of
                                        documents with HL7 CDA header, or, local or proprietary exchange such as other HL7 v2
                                        implementations in certain cases as above

Public Health, Immunization, and       SNOMED CT, or HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary as             SNOMED CT, or HL7 CCD or HL7 CDA template vocabulary or HL7 v2             SNOMED CT, or HL7
Other Population Care Vocabulary       specified by HITSP                                                                       vocabulary as specified by HITSP                                           CCD or HL7 CDA
                                        - or -                                                                                   - or -                                                                    template vocabulary as
                                       Allowable alternatives for 2011 and 2012:                                                Allowable alternative for 2013                                             specified by HITSP
                                           ICD-9 or Free text or local vocabulary in certain cases as above                         ICD-10 in certain cases as above


Quality Measure Reporting Content      CMS PQRI Registry XML Specification                                                      CMS PQRI Registry XML Specification                                        HL7 QRDA as specified QRDA is expected to be
Exchange                               - or -                                                                                   - or -                                                                     by HITSP              defined within the CMS
                                       HL7 QRDA as specified by HITSP                                                           HL7 QRDA as specified by HITSP                                                                   PQRI specification in the
                                                                                                                                                                                                                                 future.


Reportable Laboratory Results To       HL7 2.5.1 reportable results to authorized public health agencies                        HL7 2.5.1 reportable results to authorized public health agencies          SNOMED CT, or HL7
Authorized Public Health Agencies                                                                                                                                                                          CCD or HL7 CDA
Content Exchange                                                                                                                                                                                           template vocabulary as
                                                                                                                                                                                                           specified by HITSP




                                                                                                                         Page 2 of 32
                                                                                                 Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                                                            Recommended Directional
Health Outcomes
                   2011 Measures               Subject Area                       Recommended For Definitive 2011 Implementation                                    Recommended For Definitive 2013 Implementation                           Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                                                                  2013 or 2015



                                       Each entry in this column is a   Each entry in this column describes standards that are recommended               Each entry in this column describes standards that are recommended                 Each entry in this column is a
                                       subject area that relates to     within a subject area for this measure of meaningful use. The first row for      within a subject area for this measure of meaningful use. The first row for        recommended statement of
                                       the MU measure. The first        each MU measure section in this column, tinted yellow, summarizes                each MU measure section in this column, tinted yellow, summarizes                  direction, comprising
                                       row for each MU measure          standards being recommended for the measure, and to list any applicable          standards being recommended for the measure, and to list any applicable            guidance on expected future
                                       section in this column, tinted   HITSP constructs which reference the detailed specifications for each            HITSP constructs which reference the detailed specifications for each              requirements. This guidance
                                       yellow, is used to summarize     standard. Each subsequent row in an MU measure section in this column,           standard. Each subsequent row in an MU measure section in this column,             is not intended as a firm
                                       standards being                  tinted blue, describes specific standards being recommended within the           tinted blue, describes specific standards being recommended within the             implementation requirement
                                       recommended for the              subject area. Each standard is recommended for the purposes specified in         subject area. Each standard is recommended for the purposes specified in           for 2013 or 2015.
                                       measure, and to list             the referenced implementation guidance. Where multiple standards or              the referenced implementation guidance. Where multiple standards or
                                       applicable HITSP constructs      options are recommended, unless otherwise specified the standards are            options are recommended, unless otherwise specified the standards are
                                       which reference the detailed     recommended only for the relevant use case scenarios specified by                recommended only for the relevant use case scenarios specified by
                                       specifications for each          HITSP. These are recommended as firm 2011 implementation                         HITSP. These are recommended as firm 2013 implementation
                                       standard.                        requirements for each MU measure, as applicable. This table is not a fully       requirements for each MU measure, as applicable. The standards
                                                                        comprehensive list of included standards, for full details please refer to the   recommended in this column are recommended to be documented
                                                                        most recent approved version of the recommended implementation                   immediately as 2013 requirements so that applicants for meaningful use of
                                                                        specifications.                                                                  EHRs have sufficient time for implementation of the standards. This table
                                                                                                                                                         is not a fully comprehensive list of included standards, for full details please
                                                                                                                                                         refer to the most recent approved version of the recommended
                                                                                                                                                         implementation specifications.



Improve care       · Implemented        Summary of                       When records are electronic, standards referenced within relevant                When records are electronic, standards referenced within relevant                 SNOMED CT to be required
coordination       ability to           Recommendations for the         sections of HITSP/C32 summary documents using HL7 continuity of care             sections of HITSP/C32 summary documents using HL7 continuity of care               as applicable in 2015
                   exchange health      measure                         document (CCD) and/or messaging, and vocabulary, specified in HITSP              document (CCD) and/or messaging, and vocabulary, specified in HITSP
                   information with                                     capabilities #117, 118, 119, 120, 126, 127, 137                                  capabilities #117, 118, 119, 126, 127, 137
                   external clinical
                   entity
                   (specifically
                   labs, care
                   summary and
                   medication lists)
                   [EP, IP]
                                                                                               Clinical Operations Workgroup Detailed Recommendations


Improve care        · Implemented
coordination        ability to                                                                                                                                                                                                Recommended Directional
Health Outcomes
                    exchange health
                    2011 Measures               Subject Area                      Recommended For Definitive 2011 Implementation                              Recommended For Definitive 2013 Implementation                   Statement Of Intent For
  Policy Priority
                    information with                                                                                                                                                                                                2013 or 2015
                    external clinical
                    entity
                    (specifically       Summary Records, Clinical       HL7 CCD, or HL7 CDA templates, or HL7 v2.5.1 messaging, and               HL7 CCD, or HL7 CDA templates, or HL7 v2.5.1 messaging, and
                    labs, care          Reports, Encounter              associated specifications, as documented in HITSP capabilities #117, 118, associated specifications, as documented in HITSP capabilities #117, 118,
                    summary and         Messages, Radiology             119, 126, 127, 137                                                        119, 126, 127, 137
                    medication lists)   Messages, Allergies and          - or -
                    [EP, IP]            Clinical Notes Content          Allowable alternatives for 2011 and 2012:
                                        Exchange                            Unstructured documents with HL7 CDA header such as PDF or free
                                                                        text or images of documents with HL7 CDA header as specified in HITSP
                                                                        capability #120, or, local or proprietary exchange such as other HL7 v2
                                                                        implementations where preexisting v2 lab result messages are used or in
                                                                        certain other cases to be specified by ONC guidance




                                        Clinical Problem and            SNOMED CT as specified in HITSP capabilities #119, 126, 127, 129, 135       SNOMED CT as specified in HITSP capabilities #119,126, 127, 129, 135        SNOMED CT to be required
                                        Procedure Vocabulary            and 137.                                                                    and 137.                                                                    as applicable in 2015
                                                                         - or -                                                                      - or -
                                                                        Allowable alternatives for 2011 and 2012:                                   Allowable Alternatives for 2013 and 2014
                                                                            ICD-9, and/or CPT-4, and/or Local codes, except where specific codes        ICD-10 consistent with CMS final rule for ICD-10, except where specific
                                                                        are required for quality reporting                                          codes are required for quality reporting

                                        Other Vocabulary for Clinical   HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII        HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII
                                        Reports, Encounter              for allergies, as documented in HITSP capabilities #117, 118, 119, 126,     for allergies, as documented in HITSP capabilities #117, 118, 119, 126,
                                        Messages, Radiology             127, 137                                                                    127, 137
                                        Messages, Allergies and          - or -
                                        Notes                           Allowable alternatives for 2011 and 2012:
                                                                            Free text or local vocabulary in certain cases, except where specific
                                                                        codes are required for quality reporting.
                                                                                        Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                                       Recommended Directional
Health Outcomes
                   2011 Measures           Subject Area                    Recommended For Definitive 2011 Implementation                             Recommended For Definitive 2013 Implementation                    Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                                             2013 or 2015


                                   Medication Prescriptions And NCPDP Script 10.x for ambulatory and long term care messages, or HL7        NCPDP Script 10.x for ambulatory and long term care messages, or HL7
                                   Other Medication Content     v2.51 for inpatient messages, or HL7 CCD or HL7 CDA for documents,          v2.51 for inpatient messages, or HL7 CCD or HL7 CDA for documents,
                                   Exchange                     and associated specifications, as documented in HITSP capabilities #117,    and associated specifications, as documented in HITSP capabilities #117,
                                                                118, 119, 140                                                               118, 119, 140
                                                                 - or -
                                                                Allowable alternatives for 2011 and 2012:
                                                                        Unstructured documents with HL7 CDA header in certain cases as
                                                                documented in HITSP capability #120




                                   Medication Vocabulary         RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135       RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135
                                                                 and 140                                                                     and 140
                                                                  - or -
                                                                 Allowable alternatives for 2011 and 2012:
                                                                         Local and/or proprietary medication codes including NDC, FDB, and
                                                                 other codes, except where specific codes are required for quality reporting



                                   Clinical Laboratory Content   HL7 v2.5.1 results to ordering provider, and/or HL7 CDA for documents,   HL7 v2.5.1 results to ordering provider, and/or HL7 CDA for documents,
                                   Exchange                      and associated specifications, as documented in HITSP capabilities #119, and associated specifications, as documented in HITSP capabilities #119,
                                                                 126, 127 and 135                                                         126, 127 and 135
                                                                  - or -
                                                                 Allowable alternatives for 2011 and 2012:
                                                                     Local or proprietary exchange of clinical laboratory results where
                                                                 preexisting HL7 v2 lab result messages are used




                                   Clinical Laboratory           LOINC and UCUM and SNOMED CT and ancillary codes and associated            LOINC and UCUM and SNOMED CT and ancillary codes and associated
                                   Vocabulary                    specifications as documented in HITSP capabilities #119, 126, 127, 129,    specifications as documented in HITSP capabilities #119, 126, 127, 129,
                                                                 135, and 137                                                               135, and 137
                                                                  - or -
                                                                 Allowable alternatives for 2011 and 2012:
                                                                         Local and/or proprietary codes, except where specific codes are
                                                                 required for quality reporting
                                                                                               Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                                              Recommended Directional
Health Outcomes
                   2011 Measures                Subject Area                      Recommended For Definitive 2011 Implementation                              Recommended For Definitive 2013 Implementation                   Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                                                    2013 or 2015


                   · % of                Summary of                     Standards documented in HITSP capabilities #119, 120;                       Standards documented in HITSP capabilities #119                           SNOMED CT to be required
                   transitions in        Recommendations for the         Unstructured documents with HL7 CDA header such as PDF, free text or                                                                                 as applicable for 2015
                   care for which        measure                        images of documents with HL7 CDA header may be used for purposes of
                   summary care                                         2011 and 2012 reporting of measures
                   record is shared
                   (e.g., electronic,
                   paper, e-Fax)
                   [EP, IP]
                                        Summary Records, Clinical       HL7 CCD, or HL7 CDA templates, or HL7 v2.5.1 messaging, and               HL7 CCD, or HL7 CDA templates, or HL7 v2.5.1 messaging, and
                                        Reports, Encounter              associated specifications, as documented in HITSP capabilities #117, 118, associated specifications, as documented in HITSP capabilities #117, 118,
                                        Messages, Radiology             119, 126, 127, 137                                                        119, 126, 127, 137
                                        Messages, Allergies and          - or -
                                        Clinical Notes Content          Allowable alternatives for 2011 and 2012:
                                        Exchange                            Unstructured documents with HL7 CDA header such as PDF or free
                                                                        text or images of documents with HL7 CDA header as specified in HITSP
                                                                        capability #120, or, local or proprietary exchange such as other HL7 v2
                                                                        implementations where preexisting v2 lab result messages are used or in
                                                                        certain other cases to be specified by ONC guidance




                                        Clinical Problem and            SNOMED CT as specified in HITSP capabilities #119, 126, 127, 129, 135       SNOMED CT as specified n HITSP capabilities #119,126, 127, 129, 135         SNOMED CT to be required
                                        Procedure Vocabulary            and 137.                                                                    and 137.                                                                    as applicable in 2015
                                                                         - or -                                                                      - or -
                                                                        Allowable alternatives for 2011 and 2012:                                   Allowable Alternatives for 2013 and 2014
                                                                            ICD-9, and/or CPT-4, and/or Local codes, except where specific codes        ICD-10 consistent with CMS final rule for ICD-10, except where specific
                                                                        are required for quality reporting                                          codes are required for quality reporting


                                        Other Vocabulary for Clinical   HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII        HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII
                                        Reports, Encounter              for allergies, as documented in HITSP capabilities #117, 118, 119, 126,     for allergies, as documented in HITSP capabilities #117, 118, 119, 126,
                                        Messages, Radiology             127, 137                                                                    127, 137
                                        Messages, Allergies and          - or -
                                        Notes                           Allowable alternatives for 2011 and 2012:
                                                                            Free text or local vocabulary in certain cases, except where specific
                                                                        codes are required for quality reporting.
                                                                                            Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                                          Recommended Directional
Health Outcomes
                   2011 Measures              Subject Area                     Recommended For Definitive 2011 Implementation                             Recommended For Definitive 2013 Implementation                   Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                                                2013 or 2015


                                      Medication Vocabulary          RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135       RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135
                                                                     and 140                                                                     and 140
                                                                      - or -
                                                                     Allowable alternatives for 2011 and 2012:
                                                                             Local and/or proprietary medication codes including NDC, FDB, and
                                                                     other codes, except where specific codes are required for quality reporting



                                      Clinical Laboratory            LOINC and UCUM and SNOMED CT and ancillary codes and associated            LOINC and UCUM and SNOMED CT and ancillary codes and associated
                                      Vocabulary                     specifications as documented in HITSP capabilities #119, 126, 127, 129,    specifications as documented in HITSP capabilities #119, 126, 127, 129,
                                                                     135, and 137                                                               135, and 137
                                                                      - or -
                                                                     Allowable alternatives for 2011 and 2012:
                                                                             Local and/or proprietary codes, except where specific codes are
                                                                     required for quality reporting

                                      Administrative Vocabulary:     ASC X12 v.4010A1 or v.5010 consistent with the timing in the CMS final     ASC X12 v.5010 consistent with CMS final rule for HIPAA administrative
                                      Eligibility, Benefits, and     rule for HIPAA administrative simplification, and as constrained by CAQH   simplification, and as constrained by CAQH CORE Phase I and Phase II,
                                      Referrals                      CORE Phase I and Phase II, and associated specifications, as               and associated specifications, as documented in HITSP capabilities 117,
                                                                     documented in HITSP capabilities 117, 118, 140 and 141                     118, 140 and 141




                                      Public Health, Immunization,   SNOMED CT, or RxNorm, or HL7 CCD or HL7 CDA template vocabulary            SNOMED CT, or RxNorm, or HL7 CCD or HL7 CDA template vocabulary
                                      and Other Population Care      or HL7 v2.5 or v2.5.1 vocabulary or associated specifications as           or HL7 v2.5 or v2.5.1 vocabulary or associated specifications as
                                      Vocabulary                     documented in HITSP capabilities #131, 132, 135, 137 and 139               documented in HITSP capabilities #131, 132, 135, 137 and 139
                                                                      - or -                                                                     - or -
                                                                     Allowable alternatives for 2011 and 2012:                                  Allowable alternatives for 2013 and 2014:
                                                                         ICD-9 or Free text or local vocabulary in certain cases except where       ICD-10 consistent with CMS final rule in certain cases except where
                                                                     specific codes are required for quality reporting                          specific codes are required for quality reporting




                   · Report 30-day     Summary of                     Standards referenced within HITSP capability #137                          Standards referenced within HITSP capability #137                         Standards referenced within
                   readmission rate    Recommendations for the                                                                                                                                                            HITSP capability #137
                   [IP]                measure: Admission,
                                       Discharge and Transfer
                                                                                             Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                                            Recommended Directional
Health Outcomes
                    2011 Measures
                    · Report 30-day            Subject Area                    Recommended For Definitive 2011 Implementation                             Recommended For Definitive 2013 Implementation                     Statement Of Intent For
 Policy Priority
                    readmission rate                                                                                                                                                                                              2013 or 2015
                    [IP]

                                        ADT messages                 Track and report admissions within a single facility using HL7 v2.5        Track and report admissions within affiliated and/or networked facilities   Track and report admissions
                                                                     encounter messaging and associated specifications as documented in         using HL7 v2.5 encounter messaging and associated specifications as         within affiliated and/or
                                                                     HITSP capability #137.                                                     documented by HITSP capability #137.                                        networked facilities using HL7
                                                                                                                                                                                                                            v2.5 encounter messaging
                                                                                                                                                                                                                            and associated specifications
                                                                                                                                                                                                                            as documented in HITSP
                                                                                                                                                                                                                            capability #137, in conjunction
                                                                                                                                                                                                                            with health information
                                                                                                                                                                                                                            exchange activities within and
                                                                                                                                                                                                                            across communities.




                   · % of encounters    Summary of
                   where med            Recommendations for the
                   reconciliation was   measure
                                        Medication Prescriptions And NCPDP Script 10.x for ambulatory and long term care messages, or HL7       NCPDP Script 10.x for ambulatory and long term care messages, or HL7
                   performed [EP, IP]
                                        Other Medication Content     v2.51 for inpatient messages, or HL7 CCD or HL7 CDA for documents,         v2.51 for inpatient messages, or HL7 CCD or HL7 CDA for documents,
                                        Exchange                     and associated specifications, as documented in HITSP capabilities #117,   and associated specifications, as documented in HITSP capabilities #117,
                                                                     118, 119, 140                                                              118, 119, 140
                                                                      - or -
                                                                     Allowable alternatives for 2011 and 2012:
                                                                             Unstructured documents with HL7 CDA header in certain cases as
                                                                     documented in HITSP capability #120




                                        Medication Vocabulary        RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135       RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135
                                                                     and 140                                                                     and 140
                                                                      - or -
                                                                     Allowable alternatives for 2011 and 2012:
                                                                             Local and/or proprietary medication codes including NDC, FDB, and
                                                                     other codes, except where specific codes are required for quality reporting
                                                                                            Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                                           Recommended Directional
Health Outcomes
                   2011 Measures             Subject Area                      Recommended For Definitive 2011 Implementation                              Recommended For Definitive 2013 Implementation                   Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                                                 2013 or 2015


Engage patients    · % of all         Summary of                     Standards documented in HITSP capabilities #119, 120;                       Standards documented in HITSP capabilities #119                           SNOMED CT to be required
and families       patients with      Recommendations for the         Unstructured documents with HL7 CDA header such as PDF, free text or                                                                                 as applicable for 2015
                   access to          measure                        images of documents with HL7 CDA header may be used for purposes of
                   personal health                                   2011 and 2012 reporting of measures
                   information
                   electronically
                   [EP, IP]

                                     Summary Records, Clinical       HL7 CCD, or HL7 CDA templates, or HL7 v2.5.1 messaging, and               HL7 CCD, or HL7 CDA templates, or HL7 v2.5.1 messaging, and
                                     Reports, Encounter              associated specifications, as documented in HITSP capabilities #117, 118, associated specifications, as documented in HITSP capabilities #117, 118,
                                     Messages, Radiology             119, 126, 127, 137                                                        119, 126, 127, 137
                                     Messages, Allergies and          - or -
                                     Clinical Notes Content          Allowable alternatives for 2011 and 2012:
                                     Exchange                            Unstructured documents with HL7 CDA header such as PDF or free
                                                                     text or images of documents with HL7 CDA header as specified in HITSP
                                                                     capability #120, or, local or proprietary exchange such as other HL7 v2
                                                                     implementations where preexisting v2 lab result messages are used or in
                                                                     certain other cases to be specified by ONC guidance




                                     Clinical Problem and            SNOMED CT as specified in HITSP capabilities #119, 126, 127, 129, 135       SNOMED CT as specified n HITSP capabilities #119,126, 127, 129, 135         SNOMED CT to be required
                                     Procedure Vocabulary            and 137.                                                                    and 137.                                                                    as applicable in 2015
                                                                      - or -                                                                      - or -
                                                                     Allowable alternatives for 2011 and 2012:                                   Allowable Alternatives for 2013 and 2014
                                                                         ICD-9, and/or CPT-4, and/or Local codes, except where specific codes        ICD-10 consistent with CMS final rule for ICD-10, except where specific
                                                                     are required for quality reporting                                          codes are required for quality reporting



                                     Other Vocabulary for Clinical   HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII        HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII
                                     Reports, Encounter              for allergies, as documented in HITSP capabilities #117, 118, 119, 126,     for allergies, as documented in HITSP capabilities #117, 118, 119, 126,
                                     Messages, Radiology             127, 137                                                                    127, 137
                                     Messages, Allergies and          - or -
                                     Notes                           Allowable alternatives for 2011 and 2012:
                                                                         Free text or local vocabulary in certain cases, except where specific
                                                                     codes are required for quality reporting.
                                                                                            Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                                          Recommended Directional
Health Outcomes
                   2011 Measures                Subject Area                   Recommended For Definitive 2011 Implementation                             Recommended For Definitive 2013 Implementation                   Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                                                2013 or 2015


                                        Medication Vocabulary        RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135       RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135
                                                                     and 140                                                                     and 140
                                                                      - or -
                                                                     Allowable alternatives for 2011 and 2012:
                                                                             Local and/or proprietary medication codes including NDC, FDB, and
                                                                     other codes, except where specific codes are required for quality reporting



                                        Clinical Laboratory          LOINC and UCUM and SNOMED CT and ancillary codes and associated            LOINC and UCUM and SNOMED CT and ancillary codes and associated
                                        Vocabulary                   specifications as documented in HITSP capabilities #119, 126, 127, 129,    specifications as documented in HITSP capabilities #119, 126, 127, 129,
                                                                     135, and 137                                                               135, and 137
                                                                      - or -
                                                                     Allowable alternatives for 2011 and 2012:
                                                                             Local and/or proprietary codes, except where specific codes are
                                                                     required for quality reporting

                                        Administrative Vocabulary:   ASC X12 v.4010A1 or v.5010 consistent with the timing of CMS final rule    ASC X12 v.5010 consistent with CMS final rule for HIPAA administrative
                                        Eligibility, Benefits, and   for HIPAA administrative simplification, and as constrained by CAQH        simplification, and as constrained by CAQH CORE Phase I and Phase II,
                                        Referrals                    CORE Phase I and Phase II, and associated specifications, as               and associated specifications, as documented in HITSP capabilities 117,
                                                                     documented in HITSP capabilities 117, 118, 140 and 141                     118, 140 and 141




                   · % of all                                        TBD                                                                        TBD                                                                       TBD
                   patients with
                   access to patient-
                   specific
                   educational

                   · % of                Summary of                  Standards documented in HITSP capabilities #119, 120;                      Standards documented in HITSP capabilities #119                           SNOMED CT to be required
                   encounters for        Recommendations for the      Unstructured documents with HL7 CDA header such as PDF, free text or                                                                                as applicable for 2015
                   which clinical        measure                     images of documents with HL7 CDA header may be used for purposes of
                   summaries were                                    2011 and 2012 reporting of measures
                   provided [EP]
                                                                                           Clinical Operations Workgroup Detailed Recommendations
                   · % of
                   encounters for
                   which clinical
                   summaries were                                                                                                                                                                                         Recommended Directional
Health Outcomes
                   2011 Measures
                   provided [EP]            Subject Area                      Recommended For Definitive 2011 Implementation                              Recommended For Definitive 2013 Implementation                   Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                                                2013 or 2015


                                    Summary Records, Clinical       HL7 CCD, or HL7 CDA templates, or HL7 v2.5.1 messaging, and               HL7 CCD, or HL7 CDA templates, or HL7 v2.5.1 messaging, and
                                    Reports, Encounter              associated specifications, as documented in HITSP capabilities #117, 118, associated specifications, as documented in HITSP capabilities #117, 118,
                                    Messages, Radiology             119, 126, 127, 137                                                        119, 126, 127, 137
                                    Messages, Allergies and          - or -
                                    Clinical Notes Content          Allowable alternatives for 2011 and 2012:
                                    Exchange                            Unstructured documents with HL7 CDA header such as PDF or free
                                                                    text or images of documents with HL7 CDA header as specified in HITSP
                                                                    capability #120, or, local or proprietary exchange such as other HL7 v2
                                                                    implementations where preexisting v2 lab result messages are used or in
                                                                    certain other cases to be specified by ONC guidance




                                    Clinical Problem and            SNOMED CT as specified in HITSP capabilities #119, 126, 127, 129, 135       SNOMED CT as specified n HITSP capabilities #119,126, 127, 129, 135         SNOMED CT to be required
                                    Procedure Vocabulary            and 137.                                                                    and 137.                                                                    as applicable in 2015
                                                                     - or -                                                                      - or -
                                                                    Allowable alternatives for 2011 and 2012:                                   Allowable Alternatives for 2013 and 2014
                                                                        ICD-9, and/or CPT-4, and/or Local codes, except where specific codes        ICD-10 consistent with CMS final rule for ICD-10, except where specific
                                                                    are required for quality reporting                                          codes are required for quality reporting


                                    Other Vocabulary for Clinical   HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII        HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII
                                    Reports, Encounter              for allergies, as documented in HITSP capabilities #117, 118, 119, 126,     for allergies, as documented in HITSP capabilities #117, 118, 119, 126,
                                    Messages, Radiology             127, 137                                                                    127, 137
                                    Messages, Allergies and          - or -
                                    Notes                           Allowable alternatives for 2011 and 2012:
                                                                        Free text or local vocabulary in certain cases, except where specific
                                                                    codes are required for quality reporting.




                                    Medication Vocabulary           RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135       RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135
                                                                    and 140                                                                     and 140
                                                                     - or -
                                                                    Allowable alternatives for 2011 and 2012:
                                                                            Local and/or proprietary medication codes including NDC, FDB, and
                                                                    other codes, except where specific codes are required for quality reporting
                                                                                           Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                                          Recommended Directional
Health Outcomes
                    2011 Measures            Subject Area                     Recommended For Definitive 2011 Implementation                             Recommended For Definitive 2013 Implementation                    Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                                                2013 or 2015


                                     Clinical Laboratory            LOINC and UCUM and SNOMED CT and ancillary codes and associated            LOINC and UCUM and SNOMED CT and ancillary codes and associated
                                     Vocabulary                     specifications as documented in HITSP capabilities #119, 126, 127, 129,    specifications as documented in HITSP capabilities #119, 126, 127, 129,
                                                                    135, and 137                                                               135, and 137
                                                                     - or -
                                                                    Allowable alternatives for 2011 and 2012:
                                                                            Local and/or proprietary codes, except where specific codes are
                                                                    required for quality reporting


                                     Administrative Vocabulary:     ASC X12 v.4010A1 or v.5010 consistent with the timing of the CMS final     ASC X12 v.5010 consistent with CMS final rule for HIPAA administrative
                                     Eligibility, Benefits, and     rule for HIPAA administrative simplification, and as constrained by CAQH   simplification, and as constrained by CAQH CORE Phase I and Phase II,
                                     Referrals                      CORE Phase I and Phase II, and associated specifications, as               and associated specifications, as documented in HITSP capabilities 117,
                                                                    documented in HITSP capabilities 117, 118, 140 and 141                     118, 140 and 141




Improve            · Report up-to-    Summary of                    Standards documented in HITSP capabilities #117, 118, 119, 120, 131,       Standards documented in HITSP capabilities #117, 118, 119, 120, 131,       TBD
population and     date status for    Recommendations for the       132, 133, 135, 137, 139 and 140                                            132, 133, 135, 137, 139 and 140
public health      childhood          measure
                   immunizations     Medication Prescriptions And   NCPDP Script 10.x for ambulatory and long term care messages, or HL7       NCPDP Script 10.x for ambulatory and long term care messages, or HL7
                   [EP]7             Other Medication Content       v2.51 for inpatient messages, or HL7 CCD or HL7 CDA for documents,         v2.51 for inpatient messages, or HL7 CCD or HL7 CDA for documents,
                                     Exchange                       and associated specifications, as documented in HITSP capabilities #117,   and associated specifications, as documented in HITSP capabilities #117,
                                                                    118, 119, 140                                                              118, 119, 140
                                                                     - or -
                                                                    Allowable alternatives for 2011 and 2012:
                                                                            Unstructured documents with HL7 CDA header in certain cases as
                                                                    documented in HITSP capability #120

                                     Medication Vocabulary          RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135       RxNorm as specified by HITSP in capabilities #117, 118, 119, 129, 135
                                                                    and 140                                                                     and 140
                                                                     - or -
                                                                    Allowable alternatives for 2011 and 2012:
                                                                            Local and/or proprietary medication codes including NDC, FDB, and
                                                                    other codes, except where specific codes are required for quality reporting
                   immunizations
                   [EP]7




                                                                                           Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                                         Recommended Directional
Health Outcomes
                    2011 Measures            Subject Area                     Recommended For Definitive 2011 Implementation                             Recommended For Definitive 2013 Implementation                   Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                                               2013 or 2015


                                     Public Health, Immunization,   HL7 CCD, or HL7 CDA templates, or HL7 v2.3.1, for immunization queries     HL7 CCD, or HL7 CDA templates, or HL7 v2.3.1, for immunization queries
                                     and Other Population Care      and vaccination updates, or HL7 v2.5.1 messaging, and associated           and vaccination updates, or HL7 v2.5.1 messaging, and associated
                                     Content Exchange               specifications, as documented in HITSP capability #117, 118, 119, 131,     specifications, as documented in HITSP capability #117, 118, 119, 131,
                                                                    132, 133, 135, 137, and 139                                                132, 133, 135, 137, and 139.
                                                                     - or -
                                                                    Allowable alternatives for 2011 and 2012:
                                                                        Unstructured documents with HL7 CDA header such as PDF or free
                                                                    text or images of documents with HL7 CDA header as documented in
                                                                    HITSP capability #120, or, local or proprietary exchange such as other
                                                                    HL7 v2 implementations where preexisting v2 lab result messages are
                                                                    used or in certain other cases to be specified by ONC guidance




                                     Public Health, Immunization,   SNOMED CT, or RxNorm, or HL7 CCD or HL7 CDA template vocabulary            SNOMED CT, or RxNorm, or HL7 CCD or HL7 CDA template vocabulary
                                     and Other Population Care      or HL7 v2.5 or v2.5.1 vocabulary or associated specifications as           or HL7 v2.5 or v2.5.1 vocabulary or associated specifications as
                                     Vocabulary                     documented in HITSP capabilities #131, 132, 135, 137 and 139               documented in HITSP capabilities #131, 132, 135, 137 and 139
                                                                     - or -                                                                     - or -
                                                                    Allowable alternatives for 2011 and 2012:                                  Allowable alternatives for 2013 and 2014:
                                                                        ICD-9 or Free text or local vocabulary in certain cases except where       ICD-10 consistent with CMS final rule in certain cases except where
                                                                    specific codes are required for quality reporting                          specific codes are required for quality reporting




                    · % reportable Summary of                       Standards documented in HITSP capabilities #117, 118, 119, 126, 127,       Standards documented in HITSP capabilities #117, 118, 119, 126, 127,      Additional specifications of
                    lab results         Recommendations for the     131, 132, 133, 135, 137 and 139                                            131, 132, 133, 135, 137 and 139                                           HL7 v2.5.1 and HL7 CDA lab
                    submitted           measure                                                                                                                                                                          results expected to be
                    electronically [IP]                                                                                                                                                                                  recommended for 2013 or
                                                                                                                                                                                                                         2015 implementation, when
                                     Clinical Laboratory Content    HL7 v2.5.1 results to ordering provider, and/or HL7 CDA for documents,   HL7 v2.5.1 results to ordering provider, and/or HL7 CDA for documents,
                                     Exchange                       and associated specifications, as documented in HITSP capabilities #119, and associated specifications, as documented in HITSP capabilities #119,
                                                                    126, 127 and 135                                                         126, 127 and 135
                                                                     - or -
                                                                    Allowable alternatives for 2011 and 2012:
                                                                        Local or proprietary exchange of clinical laboratory results where
                                                                    preexisting HL7 v2 lab result messages are used
                      · % reportable
                      lab results
                      submitted
                      electronically [IP]


                                                                                                   Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                                                Recommended Directional
Health Outcomes
                      2011 Measures                 Subject Area                     Recommended For Definitive 2011 Implementation                             Recommended For Definitive 2013 Implementation                   Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                                                      2013 or 2015


                                            Clinical Laboratory            LOINC and UCUM and SNOMED CT and ancillary codes and associated            LOINC and UCUM and SNOMED CT and ancillary codes and associated
                                            Vocabulary                     specifications as documented in HITSP capabilities #119, 126, 127, 129,    specifications as documented in HITSP capabilities #119, 126, 127, 129,
                                                                           135, and 137                                                               135, and 137
                                                                            - or -
                                                                           Allowable alternatives for 2011 and 2012:
                                                                                   Local and/or proprietary codes, except where specific codes are
                                                                           required for quality reporting

                                            Public Health, Immunization,   HL7 CCD, or HL7 CDA templates, or HL7 v2.3.1, for immunization queries     HL7 CCD, or HL7 CDA templates, or HL7 v2.3.1, for immunization queries
                                            and Other Population Care      and vaccination updates, or HL7 v2.5.1 messaging, and associated           and vaccination updates, or HL7 v2.5.1 messaging, and associated
                                            Content Exchange               specifications, as documented in HITSP capability #117, 118, 119, 131,     specifications, as documented in HITSP capability #117, 118, 119, 131,
                                                                           132, 133, 135, 137, and 139                                                132, 133, 135, 137, and 139.
                                                                            - or -
                                                                           Allowable alternatives for 2011 and 2012:
                                                                               Unstructured documents with HL7 CDA header such as PDF or free
                                                                           text or images of documents with HL7 CDA header as documented in
                                                                           HITSP capability #120, or, local or proprietary exchange such as other
                                                                           HL7 v2 implementations where preexisting v2 lab result messages are
                                                                           used or in certain other cases to be specified by ONC guidance




                                            Public Health, Immunization,   SNOMED CT, or RxNorm, or HL7 CCD or HL7 CDA template vocabulary            SNOMED CT, or RxNorm, or HL7 CCD or HL7 CDA template vocabulary
                                            and Other Population Care      or HL7 v2.5 or v2.5.1 vocabulary or associated specifications as           or HL7 v2.5 or v2.5.1 vocabulary or associated specifications as
                                            Vocabulary                     documented in HITSP capabilities #131, 132, 135, 137 and 139               documented in HITSP capabilities #131, 132, 135, 137 and 139
                                                                            - or -                                                                     - or -
                                                                           Allowable alternatives for 2011 and 2012:                                  Allowable alternatives for 2013 and 2014:
                                                                               ICD-9 or Free text or local vocabulary in certain cases except where       ICD-10 consistent with CMS final rule in certain cases except where
                                                                           specific codes are required for quality reporting                          specific codes are required for quality reporting




Improve quality,      · Report quality Quality measure reporting to        CMS PQRI Registry XML specification                                        CMS PQRI Registry XML specification                                       HL7 QRDA and associated
safety, efficiency,   measures to      CMS                                  - or -                                                                     - or -                                                                   specifications as documented
and reduce            CMS including:                                       HL7 QRDA and associated specifications as documented in HITSP              HL7 QRDA and associated specifications as documented in HITSP             in HITSP capability #129 and
health disparities                                                         capability #129 and 130                                                    capability #129 and 130                                                   130
                        o % diabetics                                       - see recommendations in separate matrix of quality data elements. -       - see recommendations in separate matrix of quality data elements. -
                        with A1c under
                        control [EP]
                                                                                Clinical Operations Workgroup Detailed Recommendations
Improve quality,
safety, efficiency,
and reduce
health disparities                                                                                                                                                                                     Recommended Directional
Health Outcomes
                      2011 Measures       Subject Area            Recommended For Definitive 2011 Implementation                         Recommended For Definitive 2013 Implementation                 Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                             2013 or 2015


                        o%                               - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                        hypertensive
                        patients with
                        BP under
                        control [EP]
                        o % of                           - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                        patients with
                        LDL under
                        control [EP]
                        o % of                           - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                        smokers
                        offered
                        smoking
                        cessation
                        counseling
                        [EP, IP]
                      · % of patients                    - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                      with recorded
                      BMI [EP]
                      · % eligible                       - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                      surgical patients
                      who receive
                      VTE prophylaxis
                      [IP]
                      · % of orders                      - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                      (for medications,
                      lab tests,
                      procedures,
                      radiology, and
                      referrals)
                      entered directly
                      by physicians
                      through CPOE

                      · Use of high-                     - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                      risk medications
                      (Re: Beers
                      criteria) in the
                      elderly
                                                                              Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                     Recommended Directional
Health Outcomes
                   2011 Measures        Subject Area            Recommended For Definitive 2011 Implementation                         Recommended For Definitive 2013 Implementation                 Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                           2013 or 2015


                   · % of patients                     - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                   over 50 with
                   annual
                   colorectal
                   cancer
                   screenings [EP]

                   · % of females                      - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                   over 50
                   receiving annual
                   mammogram
                   [EP]

                   · % patients at                     - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                   high-risk for
                   cardiac events
                   on aspirin
                   prophylaxis [EP]

                   · % of patients                     - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                   who received flu
                   vaccine [EP]
                   · % lab results                     - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                   incorporated into
                   EHR in coded
                   format [EP, IP]

                   · Stratify                          - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                   reports by
                   gender,
                   insurance type,
                   primary
                   language, race
                   ethnicity [EP, IP]
                                                                             Clinical Operations Workgroup Detailed Recommendations



                                                                                                                                                                                                    Recommended Directional
Health Outcomes
                   2011 Measures       Subject Area            Recommended For Definitive 2011 Implementation                         Recommended For Definitive 2013 Implementation                 Statement Of Intent For
 Policy Priority
                                                                                                                                                                                                          2013 or 2015


                   · % of all                         - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                   medications,
                   entered into
                   EHR as generic,
                   when generic
                   options exist in
                   the relevant drug
                   class [EP, IP]

                   · % of orders                      - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                   for high-cost
                   imaging services
                   with specific
                   structured
                   indications
                   recorded [EP,
                   IP]

                   · % claims                         - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                   submitted
                   electronically to
                   all payers [EP,
                   IP]
                   · % patient                        - see recommendations in separate matrix of quality data elements. -   - see recommendations in separate matrix of quality data elements. -
                   encounters with
                   insurance
                   eligibility
                   confirmed [EP,
                   IP]

Ensure adequate    · Full                             N/A for Clinical Operations Workgroup                                  N/A for Clinical Operations Workgroup                                  N/A for Clinical Operations
privacy and        compliance with                                                                                                                                                                  Workgroup
security           HIPAA Privacy
protections for    and Security
personal health    Rules
information
                                                                            Clinical Operations Workgroup Detailed Recommendations



EnsureOutcomes                                                                                                                                                                    Recommended Directional
Health adequate
privacy and         2011 Measures      Subject Area            Recommended For Definitive 2011 Implementation                    Recommended For Definitive 2013 Implementation    Statement Of Intent For
  Policy Priority
security                                                                                                                                                                                2013 or 2015
protections for
personal health
information         · Conduct or                      N/A for Clinical Operations Workgroup                             N/A for Clinical Operations Workgroup                     N/A for Clinical Operations
                    update a                                                                                                                                                      Workgroup
                    security risk
                    assessment and
                    implement
                    security updates
                    as necessary
            Subject Area


Summary Records, Clinical Reports,
Encounter Messages, Radiology
Messages, Allergies and Clinical
Notes Content Exchange



Clinical Problem and Procedure
Vocabulary



Other Vocabulary for Clinical
Reports, Encounter Messages,
Radiology Messages, Allergies and
Notes

Medication Prescriptions And Other
Medication Content Exchange




Medication Vocabulary




Clinical Laboratory Content
Exchange




Clinical Laboratory Vocabulary




Administrative Content Exchange:
Eligibility, Benefits, and Referrals



Administrative Vocabulary: Eligibility,
Benefits, and Referrals
Public Health, Immunization, and
Other Population Care Content
Exchange




Public Health, Immunization, and
Other Population Care Vocabulary
                                                                                        Summary of Clinical Operations Wo


                 Recommended For Definitive 2011 Implementation


HL7 CCD, or HL7 CDA templates, or HL7 2.5.1 messaging, as specified by HITSP
 - or -
Allowable alternatives for 2011 and 2012:
    Unstructured documents with HL7 CDA header such as PDF or free text or images of
documents with HL7 CDA header, or, local or proprietary exchange such as other HL7 v2
implementations in certain cases

SNOMED CT as specified by HITSP
- or -
Allowable alternatives for 2011 and 2012:
    ICD-9, and/or CPT-4, and/or Local codes
HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII for allergies, as
specified by HITSP
 - or -
Allowable alternatives for 2011 and 2012:
    Free text or local vocabulary in certain cases
NCPDP Script 10.x for ambulatory and long term care messages, or HL7 2.51 for inpatient
messages, or HL7 CCD or HL7 CDA for documents, as specified by HITSP
 - or -
Allowable alternatives for 2011 and 2012:
        Unstructured documents with HL7 CDA header in certain cases
RxNorm as specified by HITSP
- or -
Allowable alternatives for 2011 and 2012:
       Local and/or proprietary codes including NDC, FDB, and other codes

HL7 2.5.1 results to ordering provider, and/or HL7 CDA for documents, as specified by
HITSP
- or -
Allowable alternatives for 2011 and 2012:
    Local or proprietary exchange such as other HL7 v2 implementations

LOINC and UCUM and SNOMED CT and ancillary codes as specified by HITSP
 - or -
Allowable alternatives for 2011 and 2012:
    Local and/or proprietary codes

HIPAA X12 4010A1
- or -
Allowable alternatives for 2011 and 2012:
    HIPAA X12 5010 per regulatory rule
HIPAA Administrative Simplification, and/or CAQH CORE, as specified by HITSP
HL7 CCD, or HL7 CDA templates, or HL7 2.3.1 for immunization queries and vaccination
updates, or HL7 2.5.1 messaging, as specified by HITSP
 - or -
Allowable alternatives for 2011 and 2012:
    Unstructured documents with HL7 CDA header such as PDF or free text or images of
documents with HL7 CDA header, or, local or proprietary exchange such as other HL7 v2
implementations in certain cases

SNOMED CT, or HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary as
specified by HITSP
 - or -
Allowable alternatives for 2011 and 2012:
    ICD-9 or Free text or local vocabulary in certain cases




                                                                                        Medication Vocabulary


                                                                                        Clinical Laboratory Vocabulary
Summary of Clinical Operations Workgroup Recommendations


              Subject Area


  Summary Records, Clinical Reports,
  Encounter Messages, Radiology
  Messages, Allergies and Clinical
  Notes Content Exchange



  Clinical Problem and Procedure
  Vocabulary



  Other Vocabulary for Clinical
  Reports, Encounter Messages,
  Radiology Messages, Allergies and
  Notes

  Medication Prescriptions And Other
  Medication Content Exchange




  Medication Vocabulary




  Clinical Laboratory Content
  Exchange




  Clinical Laboratory Vocabulary




  Administrative Content Exchange:
  Eligibility, Benefits, and Referrals



  Administrative Vocabulary: Eligibility,
  Benefits, and Referrals
Public Health, Immunization, and
Other Population Care Content
Exchange




Public Health, Immunization, and
Other Population Care Vocabulary




Summary Records, Clinical Reports,
Encounter Messages, Radiology
Messages, Allergies and Clinical
Notes Content Exchange

Clinical Problem and Procedure
Vocabulary


Other Vocabulary for Clinical
Reports, Encounter Messages,
Radiology Messages, Allergies and
Notes
Medication Prescriptions And Other
Medication Content Exchange

Medication Vocabulary
Clinical Laboratory Content
Exchange
Clinical Laboratory Vocabulary

Administrative Content Exchange:
Eligibility, Benefits, and Referrals
Administrative Vocabulary: Eligibility,
Benefits, and Referrals
Public Health, Immunization, and
Other Population Care Content
Exchange
Public Health, Immunization, and
Other Population Care Vocabulary
Public Health, Immunization, and
Other Population Care Vocabulary
ations Workgroup Recommendations


                    Recommended For Definitive 2013 Implementation


          HL7 CCD or HL7 CDA templates or HL7 2.5.1 as specified by HITSP




          SNOMED CT as specified by HITSP
          - or -
          Allowable Alternatives for 2013
              ICD-10
          HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII
          for allergies, as specified by HITSP




          NCPDP Script 10.x for ambulatory and long term care messages, or HL7
          2.51 for inpatient messages, or CCD/CDA for documents, as specified by
          HITSP



          RxNorm as specified by HITSP




          HL7 2.5.1 results to ordering provider, and/or HL7 CDA for documents, as
          specified by HITSP




          LOINC and UCUM and SNOMED CT and ancillary codes as specified by
          HITSP



          HIPAA X12 5010




          HIPAA Administrative Simplification, and/or CAQH CORE, as specified by
          HITSP
HL7 CCD, or HL7 CDA templates, or HL7 2.3.1 for immunization queries
and vaccination updates,or HL7 2.5.1 messaging, as specified by HITSP




SNOMED CT, or HL7 CCD or HL7 CDA template vocabulary or HL7 v2
vocabulary as specified by HITSP
 - or -
Allowable alternative for 2013
    ICD-10 in certain cases




HL7 CCD or HL7 CDA templates or HL7 2.5.1 as specified by HITSP




SNOMED CT as specified by HITSP
 - or -
Allowable Alternatives for 2013
    ICD-10
HL7 CCD or HL7 CDA template vocabulary or HL7 v2 vocabulary, or UNII
for allergies, as specified by HITSP


NCPDP Script 10.x for ambulatory and long term care messages, or HL7
2.51 for inpatient messages, or CCD/CDA for documents, as specified by
HITSP
RxNorm as specified by HITSP
HL7 2.5.1 results to ordering provider, and/or HL7 CDA for documents, as
specified by HITSP
LOINC and UCUM and SNOMED CT and ancillary codes as specified by
HITSP
HIPAA X12 5010

HIPAA Administrative Simplification, and/or CAQH CORE, as specified by
HITSP
HL7 CCD, or HL7 CDA templates, or HL7 2.3.1 for immunization queries
and vaccination updates,or HL7 2.5.1 messaging, as specified by HITSP

SNOMED CT, or HL7 CCD or HL7 CDA template vocabulary or HL7 v2
vocabulary as specified by HITSP
 - or -
Allowable alternative for 2013
ICD-10 in certain cases
   Recommended Directional
 Statement Of Intent For 2013 or   Standards Gaps       Notes
             2015




SNOMED CT as specified by HITSP




                                                    NDF-RT and SPL
                                                    implementation
                                                    TBD
SNOMED CT, or HL7 CCD or HL7
CDA template vocabulary as
specified by HITSP

								
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