Stage 1 Objectives

Stage 1 of Meaningful Use lays a foundation for healthcare providers using EMR / EHR technology. There will be future rulings to define the requirements for Stage 2, slated for 2013, and Stage 3, slated for 2015.

For Stage 1, eligible professionals are required to meet 15 core objectives and 5 out of 10 menu set objectives. With each objective, there is a measure that defines the minimum usage for meeting each objective. With each new stage of meaningful use, the thresholds will increase along with the addition of new objectives.

Below are three lists containing the core and menu objectives plus the clinical quality measures. The lists include the requirement, definition of the requirement to be met, and the feature in FlexMedical that satisfies the requirement.

Core Objectives

Eligibile Professionals must meet all 15 Core Objectives.

	Core Objectives	Measure	Solution
1	Computerized physician order entry (CPOE) of medications	More than 30% of unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE	Prescriptions
2	Generate and transmit permissible prescriptions electronically (eRx)	More than 40% of all permissible prescriptions written by the EP are transmitted electronically	ePrescribing
3	Report a total of 6 ambulatory clinical quality measures to CMS (Medicare EHR Incentive Program) or States (Medicaid EHR Incentive Program)	For 2011, provide aggregate numerator, denominator, and exclusions through attestation as discussed in section II(A)(3) of this final rule For 2012, electronically submit the clinical quality measures as discussed in section II(A)(3) of this final rule	Clinical Quality Measures
4	Implement one clinical decision support rule	Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance for that rule	Health Maintenance
5	Provide patients with an electronic copy of their health information, upon request	More than 50% of all patients of the EP who request an electronic copy of their health information are provided it within three business days	CCR Support
6	Provide clinical summaries for patient for each office visit	Clinical summaries provided to patients for more than 50% of all office visits within three business days	Plan Summary Report
7	Drug-drug and drug-allergy interaction checks	The EP has enabled this functionality for the entire EHR reporting period	Interaction Checking
8	Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, gender, race, ethnicity, and date of birth	More than 50% of all unique patients seen by the EP have demographics recorded as structured data	Demographics
9	Maintain an up-to-date problem list of current and active diagnoses based on ICD–9–CM or SNOMED CT®	More than 80% of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data	Problem List
10	Maintain the patient’s active medication list	More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data	Medication List
11	Maintain the patient’s active medication allergy list	More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data	Allergy List
12	Record and chart changes in vital signs: height, weight, blood pressure; Calculate and display BMI; Plot and display growth charts for children 2–20 years, including BMI	For more than 50% of all unique patients age 2 and over seen by the EP, the height, weight and blood pressure are recorded as structured data	Vitals Growth Charts
13	Record smoking status for patients 13 years old or older	More than 50% of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data	Smoking Status
14	Capability to exchange key clinical information among providers of care and patient-authorized entities electronically	Performed at least one test to electronically exchange key clinical information	Health Information Exchange
15	Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities	Conduct or review a security risk analysis per 45 CFR 164.308 (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process	Security

Menu Set Objectives

There are 10 Menu Set Objectives. Eligibile Professionals must meet 5 with at least 1 public health objective selected.

	Core Objectives	Measure	Solution
1	Drug-formulary checks	The EP has enabled this functionality and has access to at least one internal or external drug formulary for the entire EHR reporting period	Drug Formularies
2	Document clinical lab test results as structured data	More than 40% of all clinical lab test results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data	Lab Results
3	Generate lists of patients by specific conditions	Generate at least one report listing patients of the EP with a specific condition	Patients By Diagnsosis Data Mining
4	Send reminders to patients per patient preference for preventive/follow-up care	More than 20% of all unique patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period	Health Maintenance
5	Provide patients with timely electronic access to their health information	More than 10% of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP’s discretion to withhold certain information	Patient Portal
6	Use certified EHR technology to identify patient-specific education resources and provide to patient	More than 10% of all unique patients seen by the EP are provided patient-specific education resources	Patient Education
7	Medication reconciliation	The EP performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP	Medication List
8	Summary of care record for each transition of care/referrals	The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50% of transitions of care and referrals	Outgoing Referrals
9	Capability to submit electronic data to immunization registries/systems (public health objective)	Performed at least one test to submit electronic data to immunization registries and follow up submission if the test is successful where accepted and required	Immunization List Report
10	Capability to provide electronic syndromic surveillance data to public health agencies (public health objective)	Performed at least one test to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful where accepted and required	Health Information Exchange

Clinical Quality Measures

Core Measures (reporting on all three required)
NQF0421	Adult Weight Screening and Follow up
NQF0028	Preventive Care and Screening Measure Pair: Tobacco Use Assessment and Tobacco Cessation Intervention
NQF0013	Hypertension: Blood Pressure Measurement
Alternative Core Measures (substitute one for every Core Measure where denominator is 0)
NQF0024	Weight Assessment and Counseling for Children and Adolescents
NQF0041	Preventive Care and Screening: Influenza Immunization for Patients 50 Years Old or Older
NQF0038	Childhood Immunization Status
FlexMedical is Certified for These Additional Measures
NQF0059	Diabetes Control: Hemoglobin A1c >9.0%
NQF0064	Diabetes Control: LDL < 100mg/dl
NQF0575	Diabetes Control: Hemoglobin A1c <8.0%