Intergy EHR v9 Deep Dive
Meaningful Use Stage II
Confidential and Proprietary Information of Vitera
Healthcare Solutions, LLC. Presentations are for
informational purposes only.
1
GETTING THERE TOGETHER
• During this presentation, we will help you:
• Understand key objective changes with the MUII Final Rule
• Accurately capture and report data for MUII Objectives
• Apply role-based MUII workflows to your practice
2
2
OVERVIEW
● What Stage 2 Means to You
● Stage 1 Objective Changes
● Stage 2 Objectives
– Attesting with Intergy v9
● Appendix
– Stage 2 Objectives, detailed breakdown
3
3
WHAT STAGE 2 MEANS TO YOU
With Stage 2 the focus of Meaningful Use shifts from data capture to usability
● New Criteria
– Starting in 2014, providers participating in the EHR Incentive Programs who have met Stage 1 two or more
years will need to meet Stage 2 criteria
● Improving Patient Care
– Stage 2 includes new objectives to improve patient care through better clinical decision support, care
coordination and patient engagement
● Interoperability
– There is a greater emphasis on interoperability and patient engagement, with the latter requiring action on
the patient’s end in order for the objective to be met
4
4
Meaningful Use Stage II
STAGE 1 OBJECTIVES
5
5
STAGE 1 OBJECTIVE CHANGES
Stage 1 Objective
CPOE
Changes to Objective
• Change: Addition of an alternative measure
Effective Year
• Optional 2013+
• More than 30% of medication orders are recorded using CPOE
eRx
• Change: Additional exclusion
• Required 2013+
• Any EP who does not have a pharmacy within their organization and
there are no pharmacies that accept eRx within 10 miles of the EP’s
practice at the start of his/her EHR reporting period
Vital Signs
• Change: Age Limitations on Growth Charts and Blood Pressure increased
from 2 to 3
• Optional 2013
• Required 2014+
• Change: Splitting the EP exclusion so that BP and Height/Weight are
evaluated separately in terms of relevance to scope of practice
• More than 50% of all patients seen by the EP have BP (age 3+) and/or
height and weight (for all ages) recorded
Electronic Exchange
of Key Clinical
Information
• Requirement removed effective 2013
• Required 2013+
6
6
STAGE 1 OBJECTIVE CHANGES
Stage 1 Objective
Changes to Objective
Effective Year
Public Health
Objectives
• Change: Addition of "except where prohibited" to the objective
regulation text for the public health objectives under § 495.6
• Required 2013+
Report ambulatory
clinical quality
measures to
CMS or the States
• Change: Objective is incorporated directly into the definition of a
meaningful EHR user and eliminated as an objective because it is
redundant
• Required 2013+
Electronic Copy of
Health Information
(Stage 1 Core
Objective)
• Change: Replace these 2 objectives with the Stage 2 objective and one of • Required 2014+
the two Stage 2 measures
• New Objective: Provide patients the ability to view online, download
and transmit their health information within 4 business days of the
information being available to the EP.
Timely Electronic
Access to Health
Information (Stage 1 • New Measure: More than 50% of all are provided timely (within 4
Menu Set Objective)
business days after the information is available to the EP) online access
to their health information subject to the EP's discretion to withhold
certain information.
7
7
STAGE 1 OBJECTIVE CHANGES
Stage 1 Objective
Clinical Summaries
Changes to Objective
• Change: New IEHR workflow. Visit Summary must be provided in CCD
format and can no longer be generated as clinical correspondence.
Effective Year
• Required 2014+
• New Clinical Summary window on patient chart summary page. Provider
can provide the CCD as a printed document or electronically via portal
secure messaging or external media.
8
8
Meaningful Use Stage 2 Objectives
ATTESTING WITH INTERGY V9
9
9
MEANINGFUL USE STAGE 2 WITH INTERGY V9
Overview
●Patient Visit workflow
– Hands on Intergy
●Post Visit workflows
– Hands on Intergy
●Reporting workflow
– Hands on MU Dashboards
10
10
ACHIEVING MEANINGFUL USE WITH INTERGY
Patient
Visit
Post Visit
Reporting
11
11
PATIENT VISIT - REGISTRATION
Core 3 - Record demographics for >80% of patients including language, sex, race, ethnicity and DOB.
Select this link to see
the full language for
the MU requirement
Intergy has been enhanced to
support multiple patient races
and to include additional
language codes
12
12
PATIENT VISIT - NURSE
Core 4 - Record Vitals for more than 80% of patients for BP (age 3+) or height/weight
• Age Limits on growth charts and BP increased from 2 to 3
• Splitting the EP exclusion so that BP and height/weight are evaluated separately in terms of relevance to
scope of practice
No enhancements were needed for
this measure
13
13
PATIENT VISIT - NURSE
Core 5 - Record Smoking Status for more than 80% of patients 13+
• New Statuses
• Increase threshold
.
Intergy has been enhanced to
include the additional smoking
statuses
Tip:
The additional smoking status
options will be automatically
available on forms that currently
use the smoking status dropdown
14
14
PATIENT VISIT - NURSE
Menu 4 - Record Family Hx for first degree relatives for more than 20% of patients.
• New Menu Objective
Encounter note forms and Visit
note templates can be used to
capture family history.
Tip:
Specific family prefixes must be
used to count towards the measure
(ie: paternal, maternal)
15
15
PATIENT VISIT - NURSE
Core 14 - Record Medication Reconciliation for more than 50% of patients who have been
transitioned into the care of the EP.
• Former menu objective
Intergy has been enhanced with a
new option on the Meds List for
‘Mark as Reconciled’. Selecting this
option will count towards the
numerator for the measure
Tips:
Adding a reported med while on an
encounter will auto-set the
reconciled flag for that encounter
Users must still indicate that the
patient has been transitioned into
EP’s care for counting in the
denominator
16
16
PATIENT VISIT - NURSE
Medication Reconciliation - Enhanced CCD Import
Enhanced CCD Import for clinical
information reconciliation
• Side-by-side comparison with
CCD and patient chart
• Consolidated view for
importing medications,
problems and allergies
• Data import based on industry
standard coding systems
(SNOMED, RxNorm), giving the
ability to import a CCDA from
any other practice
17
17
PATIENT VISIT - NURSE
Core 16 - Submit to Immunization Registries.
• Former menu objective
• Successful submission required, not just a test
• Exclusions exist based on Registry availability
Vitera will offer submission to State Registries through the
Vitera Clinical Exchange.
Enhanced Immunizations to allow
entry of Immunity as a reason to
not administer a vaccine
• Vaccine will show as Immune in
EHR
• Immunity will prevent recalls
for the vaccine from being
generated
18
18
PATIENT VISIT - NURSE
Immunization Administration Enhancements .
Additional Enhancements for
Immunizations:
New fields for: Admin Route,
Amount, and VIS Sheets
•
Route uses same default logic
as Site does
•
Amount is defaulted from setup
•
VIS sheets are defaulted based
on last VIS sheets used for the
vaccine
19
19
PATIENT VISIT - PROVIDER
Core 6 - 1) Implement 5 CDS interventions related to 4+ CQMs or high priority health condition
2) Enable and implement drug-drug and drug-allergy interaction checks
• Changed from 1 CDS rule to 5 CDS rules
Health Management can be used
to satisfy the first requirement.
Specific CQM data can be setup as
needed
Rx DUR can be used to satisfy the
second requirement.
Tip: the practice can manage which
DUR warnings appear in Practice
configuration
20
20
PATIENT VISIT - PROVIDER
Core 1 Record more than 60% of Meds, 30% of Labs and 30% Radiology Orders with CPOE.
– Now includes Lab and Radiology
– Threshold increase for medications
To count towards this measure,
Providers can either:
•
Enter the Orders themselves
or
•
A User who has been assigned
a “Scribe” User Role (in
Practice Maintenance) can
enter the Orders for the
provider
21
21
PATIENT VISIT - PROVIDER
Core 2 More than 50% of permissible Rx are queried for a formulary and transmitted electronically.
• Threshold increase
• New Exclusion - Does not have a pharmacy within organization and no pharmacies that accept e-Rx within
10 miles of the EP's practice location
EHR has been enhanced to perform
a formulary check for Rx Renewals
and Rx Authorizations
Tip: If using RxHub formulary, no
patient setup is required to perform
formulary checking.
22
22
PATIENT VISIT - PROVIDER
Core 13 - Patient Education is provided to more than 10% of unique patients.
• Former menu objective
Intergy EHR has been enhanced to
include right click access to patient
education from problems, meds
and labs
• Uses NIH’s Medline Plus as
default website
• Automated capture in MU
numerator when using this
option
Can also continue to use Forms to
access education and indicate
education was given
23
23
PATIENT VISIT - PROVIDER
Supporting - Problem based Care Plan
Intergy EHR has been enhanced to
allow Problem based Care Plan
entry.
•
New Page on Problem screen to
enter Care Plan
•
Full history is saved when the
Care Plan is changed
•
Care Plans can be inserted into
the Encounter Note and Visit
note, and the CCDA
•
Multiple options to Cite Care
Plans into notes
•
Quick Text for Care Plans are
stored at the Problem type
level (ie: ICD code or Finding ID)
24
24
PATIENT VISIT - PROVIDER
Supporting – Personal Quick Text
Intergy has been enhanced to
support User level Quick Text
•
This is now available in ALL
Places where quick text is used.
•
The system will remember the
“shared” and “personal” quick
text checkboxes for each type of
quick text
•
Quick Text security is confined
to Shared Quick Text.
25
25
PATIENT VISIT - PROVIDER
Menu 2 More than 30% of Visits contain an Electronic Note signed by the provider.
• The electronic note is text searchable and may contain drawings and other content
• New menu objective
The following types of documents
will count for the measure:
•
Encounter Note – signed by
the provider
•
Visit Note – signed by the
provider
•
Transcription Docs – approved
by the provider
26
26
PATIENT VISIT - PROVIDER
Core 8 - Clinical Summaries are provided within one day for more than 50% of patient visits.
• Now required to generate Clinical Summary in the CCDA format.
Intergy has been enhanced to
provide a one click workflow for
meeting this measure.
There is a new option on the
patient summary page to Print the
Clinical Summary. This option will
generate a CCD with all required
sections.
If the patient is registered for
secure messaging, then a Send
option also displays
Once the summary has been
generated, the area will turn green
to indicate it has been done.
27
27
PATIENT VISIT - PROVIDER
Core 15 1) Generate a Referral Summary for more than 50% of transitions of care.
2) Electronically send >10% of referral summaries.
⁃ electronically transmitted using CEHRT to a recipient or
⁃ where the recipient receives the summary of care record via exchange facilitated by an organization
that is a NwHIN Exchange participant or in a manner that is consistent with NwHIN standards.
3) An EP must satisfy one of the following criteria:
⁃ Conducts one or more successful electronic exchanges of a summary of care document, with a
recipient who has EHR technology from a different EHR technology developer than the sender's
EHR technology.
⁃ Conducts one or more successful tests with the CMS designated test EHR during the EHR reporting
period.
Exclusion: Any EP who transfers a patient to another setting or refers a patient to another provider
less than 100 times during the EHR reporting period is excluded from all three measures.
Referral Summaries also require CCDA technology.
Intergy workflow for Referral Summaries is similar to that for Visit Summaries
28
28
PATIENT VISIT - PROVIDER
Clinical Summary and Referral Summary - Generate Exchange Documents
Enhanced CCD generation screen
• Document type will default
based on recipient
• Sections will default for each
document type based on MU
requirements
• Sections can be changed
for a single visit or
permanently.
• Send option is available if
patient is registered for secure
messaging, or if sending to
Referring Provider.
29
29
ACHIEVING MEANINGFUL USE WITH INTERGY
Patient
Visit
Post Visit
Reporting
30
30
AFTER PATIENT VISIT
Core 7
•
•
•
•
1) More than 50% of patients are provided timely online access to their info
2) More than 5% of patients view, download or transmit their info.
Former menu objective
Consolidated patient electronic info request with timely access
New exclusion
Threshold increase
Practice portal has been enhanced
to support Download and Transmit
options.
•
These options are available to
the patient when viewing their
clinical summary
•
When download or sent, the
CCD will be delivered in both
XML and a Viewable format.
Tip: Once a patient has been given
a PIN letter for the portal, they
have access to the portal and will
meet the first requirement.
31
31
AFTER PATIENT VISIT
Supporting – Practice Portal Report
Intergy has been enhanced to include
a New Report to let you manage
Practice Portal patients
Report is based on appointments, so
you can discover the Portal status of
patients either before or after their
visit.
32
32
AFTER PATIENT VISIT
Core 11 Generate at least 1 report listing patients with a specific condition.
• Former menu objective
Using the Practice Analytics’ Patient
Care Conditions list will satisfy this
requirement.
In addition you can export the list of
patients that are generated from this
screen for Posting Recalls.
To create recalls using this method:
• Generate the list for the
condition(s) desired,
• Export to Excel (the XL button).
• From Excel, save the file as a CSV
file.
• Import the file in Intergy
33
33
AFTER PATIENT VISIT
Core 12 More than 10% of patients with 2+ visits within 24 months before reporting period were
sent a Reminder (recall) per patient preference.
• Former menu objective
Intergy has been enhanced to allow
posting of recalls from a file.
• This option is intended to work
with files exported from Practice
Analytics
• A single recall reason will be used
for all recalls posted.
• All other options on the screen
work the same as with the other
modes
34
34
AFTER PATIENT VISIT
Core 17 A secure message was sent using the electronic messaging function of CEHRT by more than
5% of unique patients (or their authorized representatives) seen by the EP
• New Objective
Most Secure messages sent by the
patient are counted towards the
measure.
The following are NOT counted:
Appointment Requests
New Patient Request
Billing and Payment messages
35
35
AFTER PATIENT VISIT
Menu 1 - Capability to submit Electronic Syndromic Surveillance data.
• New Objective
Intergy has been enhanced to include
a New Report to let you create
Syndromic Surveillance files for
submission.
•
The Report is based on signed
encounter/visit notes.
•
Will report on selected
assessments via the ICD code.
•
HL7 2.5.1 Compliant
36
36
AFTER PATIENT VISIT
Core 10 More than 55 % of Lab Orders contain structured results.
Lab Orders Groups are counted as a
single entry for the denominator for
Labs
If the Lab Order has at least one Lab
Result linked to a Test or Favorite, the
Lab Order will be counted in the
Numerator
Tip: Manually entered results will be
counted as structured data
37
37
AFTER PATIENT VISIT
Menu 3 More than 10% of all tests whose result is one or more images ordered by the EP during the
EHR reporting period are accessible through CEHRT.
Radiology Order Groups are counted
for the denominator.
If the Order Group has at least one
Image linked to the Order, the
Radiology Order Group will be
counted in the Numerator
Tip: For proper counting, Order
Types can be changed in Practice
Analytics if needed.
38
38
ACHIEVING MEANINGFUL USE WITH INTERGY
Patient
Visit
Post Visit
Reporting
39
39
REPORTING
Meaningful Use Dashboard Enhancements
The Meaningful Use
Dashboards have been
enhanced to include the
2014 MU Measures for both
Stage 1 and Stage 2
To toggle between Stage 1
and Stage 2, select the
appropriate tab in the middle
of the screen.
Some measures have two
requirements. If multiple
requirements exist, a
dropdown will display for
selection
40
40
REPORTING
Dashboard Auditing Enhancements
The Dashboards have
been Enhanced to allow a
scorecard to be saved for
future review
Once the Scorecard is
prepared, select the
Export Audit Scorecard
and the Save Audit
Scorecard buttons.
(both options must be
selected to generate the
Audit)
When you want to review
Scorecards later, you can
select the Audit Scorecard
History option, and select
a file to review.
41
41
REPORTING
Dashboard Auditing Enhancements
42
42
REPORTING
Dashboard CQM Enhancements
The CQM Dashboard has
been enhanced to allow
creation of a file for
submission to CMS.
Select the measures for the
Scorecard and the provider
the score card is for, then
select Prepare Scorecard
Submission
43
43
REPORTING
Dashboard CQM Enhancements
These screens will walk you through the process
of creating the score card.
On the third screen, enter the file name to save
the CQM Scorecard under.
44
44
Appendix
STAGE 2 OBJECTIVES
45
45
STAGE 2 CORE OBJECTIVES
Core
Objective
1. CPOE
Measure
• More than 60% of medication, 30% of laboratory, and 30% of
radiology orders are created using CPOE
Exclusion
• Any EP who writes fewer than 100 medication, radiology, or
laboratory orders during the EHR reporting period.
2. e-Prescribing
(eRx)
• More than 50% of Rx are queried for a drug formulary and
transmitted electronically
Change from Stage 1
• Order-centric
• Inclusion of lab and
radiology
• Threshold increase from
more than 30% for
medications
• Threshold increase from
more than 40%
• New Exclusion
Exclusion:
• Any EP who:
• (1) Writes fewer than 100 permissible prescriptions during
the EHR reporting period.
• (2) Does not have a pharmacy within their organization and
there are no pharmacies that accept electronic
prescriptions within 10 miles of the EP's practice location
at the start of his/her EHR reporting period.
46
46
STAGE 2 CORE OBJECTIVES
Core Objective
3. Record
Demographics
Measure
• More than 80% of all unique patients seen by the EP have the
following demographics recorded: Language, Sex, Race, Ethnicity,
DOB
Change from Stage 1
• Threshold Increase
from more than 50%
• No Exclusion
4. Record Vital
Signs
• More than 80 percent of all unique patients seen by the EP have
blood pressure (for patients age 3 and over only) and/or height
and weight (for all ages) recorded as structured data.
• Threshold Increase
from more than 50%
Exclusion
• Any EP who:
• (1) Sees no patients 3 years or older is excluded from
recording blood pressure.
• (2) Believes that all 3 vital signs of height/length, weight,
and blood pressure have no relevance to their scope of
practice is excluded from recording them.
• (3) Believes that height/length and weight are relevant to
their scope of practice, but blood pressure is not, is excluded
from recording blood pressure.
• (4) Believes that blood pressure is relevant to their scope of
practice, but height/length and weight are not, is excluded
from recording height/length and weight.
47
47
STAGE 2 CORE OBJECTIVES
Core Objective
5. Record Smoking
Status
Measure
• More than 80% of all unique patients 13+ seen by the EP have
smoking status recorded
Exclusion
• Any EP that neither sees nor admits any patients 13 years old
or older.
6. Clinical Decision
Support Rule
• Measure 1: Implement 5 CDS interventions related to 4 or
more CQMs. Absent 4 CQMs related to an EP’s scope of
practice or patient population, the CDS interventions must be
related to high-priority health conditions.
• Measure 2: The EP has enabled and implemented the
functionality for drug-drug and drug-allergy interaction checks
Exclusion
• For the second measure, any EP who writes fewer than 100
medication orders during the EHR reporting period.
Change from Stage 1
• 2 new statuses
• Threshold increase from
more than 50%
• 1 rule attestation
increased to 5 rules
• Consolidated drugdrug/drug-allergy
objective into a measure
for this objective
• New Audit options
48
48
STAGE 2 CORE OBJECTIVES
Core
Objective
7. Patient
Electronic
Access
Measure
Change from Stage 1
• Measure 1: More than 50% of all unique patients seen are provided
• Former menu objective
timely (within 4 business days after the information is available to the
• Consolidated patient
EP) online access to their health information subject to the EP's
discretion to withhold certain information.
electronic info request
with timely access
• Measure 2: More than 5% of all patients seen(or their authorized
• Patient accountability
representatives) view, download, or transmit to a third party their
health information.
• New exclusion
Exclusion
• Any EP who:
• New IEHR workflow
• (1) Neither orders nor creates any of the information listed for
inclusion as part of both measures, except for "Patient name"
and "Provider's name and office contact information, may
exclude both measures.
• (2) Conducts 50 percent or more of his or her patient
encounters in a county that does not have 50 percent or more
of its housing units with 3Mbps broadband availability
according to the latest information available from the FCC on
the first day of the EHR reporting period may exclude only the
second Measure
49
49
STAGE 2 CORE OBJECTIVES
Core
Objective
8. Clinical
Summaries
Measure
• Clinical summaries provided to patients within one business day for
more than 50% of office visits.
Change from Stage 1
• Must provide CCD
• New IEHR workflow
Exclusion
• Any EP who has no office visits during the EHR reporting period.
9. Protect
Electronic
Health
Information
• Conduct or review a security risk analysis, implement security
updates as necessary and correct identified security deficiencies
10. Clinical
Lab-Test
Results
• More than 55% of all lab tests ordered are linked to structured results • Threshold increase from
more than 40%
Exclusion
• Any EP who orders no lab tests where results are either in a
• PA logic change
positive/negative affirmation or numeric format during the EHR
reporting period.
Unchanged
• No Exclusion
50
50
STAGE 2 CORE OBJECTIVES
Core Objective
Measure
Changes from Stage 1
11. Patient Lists
• Generate at least one report listing patients of the EP
with a specific condition.
• No Exclusion
• Former menu objective
12. Preventive
Care
• More than 10% of all unique patients who have had 2 or
more office visits with the EP 2 years during or prior to
the reporting period were sent a reminder, per patient
preference when available.
• Former menu objective
Exclusion
• Any EP who has had no office visits in the 24 months
before the EHR reporting period.
13. PatientSpecific
Education
Resources
• No age thresholds
• Can utilize Batch Recall Posting
• New IEHR workflow
• Patient-specific education resources are provided for
more than 10% of all unique patients with office visits
seen by the EP
• Former menu objective
Exclusion
• Any EP who has no office visits during the EHR reporting
period.
• New IEHR workflow
• Infobutton standard
51
51
STAGE 2 CORE OBJECTIVES
Core Objective
14. Medication
Reconciliation
Measure
• The EP who performs medication reconciliation for more than
50% of transitions of care in which the patient is transitioned
into the care of the EP.
Exclusion
• Any EP who was not the recipient of any transitions of care
during the EHR reporting period.
Change from Stage 1
• Former menu objective
• PA logic update-automated
numerator capture
• New IEHR workflow
52
52
STAGE 2 CORE OBJECTIVES
Core Objective
15. Summary of
Care
Measure
• Measure 1: Provide a summary of care record for more than 50% of
transitions of care and referrals.
• Measure 2: Provide a summary of care record for more than 10% of
transitions of care and referrals either:
(a) electronically transmitted using CEHRT to a recipient or
(b) where the recipient receives the summary of care record via
exchange facilitated by an organization that is a NwHIN Exchange
participant or in a manner that is consistent with NwHIN standards.
Change from Stage 1
• Former menu objective
• New electronic measure
• New measure requiring
receipt
• New IEHR workflow
• Measure 3: An EP must satisfy one of the following criteria:
(a)Conducts one or more successful electronic exchanges of a
summary of care document, with a recipient who has EHR
technology from a different EHR technology developer than the
sender's EHR technology.
(b)Conducts one or more successful tests with the CMS designated
test EHR during the EHR reporting period.
Exclusion
• Any EP who transfers a patient to another setting or refers a
patient to another provider less than 100 times during the EHR
reporting period is excluded from all three measures.
53
53
STAGE 2 CORE OBJECTIVES
Core Objective
16. Immunization
Registries Data
Submission
Measure
• Successful ongoing submission of electronic immunization data
from CEHRT to an immunization registry or immunization
information system for the entire EHR reporting period.
Change from Stage 1
• Former menu objective
• Successful submission
required, not just a
test
Exclusion
• Any EP that meets one or more of the following criteria may be
• New IEHR workflow
excluded from this objective:
• (1) the EP does not administer any of the immunizations to
any of the populations for which data is collected by their
jurisdiction's immunization registry or information system
during the EHR reporting period;
• (2) the EP operates in a jurisdiction for which no
immunization registry or information system is capable of
accepting the specific standards required for CEHRT at the
start of their EHR reporting period;
• (3) the EP operates in a jurisdiction where no immunization
registry or information system provides information timely
on capability to receive immunization data; or
• (4) the EP operates in a jurisdiction for which no
immunization registry or information system that is capable
of accepting the specific standards required by CEHRT at
the start of their EHR reporting period can enroll additional
EPs.
54
54
STAGE 2 CORE OBJECTIVES
Core Objective
17. Use Secure
Electronic Messaging
Measure
• A secure message was sent using the electronic
messaging function of CEHRT by more than 5% of
unique patients (or their authorized representatives)
seen by the EP
Change from Stage 1
• New objective
Exclusion
• Any EP who has no office visits during the EHR reporting
period, or any EP who conducts 50 percent or more of
his or her patient encounters in a county that does not
have 50 percent or more of its housing units with 3Mbps
broadband availability according to the latest
information available from the FCC on the first day of
the EHR reporting period.
55
55
STAGE 2 MENU OBJECTIVES
Starting in 2014 exclusions claimed for menu objectives will no longer count towards the
number of menu objectives needed
Menu Objective
1. Syndromic
Surveillance Data
Submission
Measure
Change from Stage 1
• Successful ongoing submission of electronic syndromic
• Successful
surveillance data from CEHRT to a public health agency for
submission required,
the entire EHR reporting period.
not just a test
Exclusion
• Any EP that meets one or more of the following criteria may
• New IEHR workflow
be excluded from this objective:
• (1) the EP is not in a category of providers that collect
ambulatory syndromic surveillance information
• (2) the EP operates in a jurisdiction for which no public
health agency is capable of receiving electronic
syndromic surveillance data in the standards required
by CEHRT at the start of their reporting period;
• (3) the EP operates in a jurisdiction where no public
health agency provides information timely on capability
to receive syndromic surveillance data; or
• (4) the EP operates in a jurisdiction for which no public
health agency that is capable of accepting the specific
standards required by CEHRT at the start of their EHR
reporting period can enroll additional EPs.
56
56
STAGE 2 MENU OBJECTIVES
Menu Objective
2. Electronic Notes
Measure
• Enter at least one electronic progress note created, edited
and signed by an EP for more than 30% of unique patients
with at least one office visit during the reporting period.
Change from Stage 1
• New objective
• New IEHR workflow
• The text of the electronic note must be text searchable and
may contain drawings and other content
• No exclusion.
3. Imaging Results
• More than 10% of all tests whose result is one or more
images ordered by the EP during the EHR reporting period
are accessible through CEHRT.
• New objective
• New IEHR workflow
Exclusion
• Any EP who orders less than 100 tests whose result is an
image during the EHR reporting period; or any EP who has no
access to electronic imaging results at the start of the EHR
reporting period.
57
57
STAGE 2 MENU OBJECTIVES
Menu Objective
4. Family Health
History
Measure
• More than 20% of all unique patients seen by the EP during
the EHR reporting period have a structured data entry for
one or more first-degree relatives.
Change from Stage 1
• New objective
Exclusion
• Any EP who has no office visits during the EHR reporting
period.
5. Report Cancer
Cases
• This is an optional criterion which we will not be certified to
and is not required to be considered a complete certified
EHR.
• New objective
6. Report Specific
Cases
• Capability to submit to a registry “other than a cancer or
immunization registry.”
• New objective
• The specialized registry cannot be duplicative of any of the
other registries included in other meaningful use objectives
and measures.
• EPs will attest YES/NO to successfully submitting specific case
information from their CEHRT to a specialized registry for the
entire reporting period.
58
58