Meaningful Use (WG6)

Discussion of How VistA Meets, or Can Meet,
Meaningful Use, Stage 1
45 CFR Part 170

Official document published in the Federal Register

CMS Topical Web Site

Background discussion

• The texts discusses EHR's as being Certified. It is not yet clear how this certification status will be awarded.
• The criteria herein are just for Stage 1 (beginning 2011). Further criteria are likely to be unveiled as the program progresses.
• Stage 2 will begin in 2013; Stage 3 in 2015
• Professionals must not only adopt/install a certified EHR, but must also demonstrate meaningful use. Thus just have a system capable of the features below will not be sufficient. They must be implemented and used.

All-in-one vs. Composite systems

Details from 45 CFR Part 170 describe the ability of a eligible system to be constructed from modules, and thus VistA doesn't have to meet all of the meaningful use criteria by itself.

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Possible $ Bonus amounts

Up to $65k, maximum amount available under Medicaid

Up to $44k, maximum amount available under Medicare

Listing of Criteria for Stage 1 of Meaningful Use

Use Computerised Provider Order Entry (CPOE)

Enable a user to electronically record, store, retrieve and manage, at a minimum, the following order types:

• 1. Medications
  2. Laboratory
  3. Radiology/Imaging
  4. Provider referrals

VistA Status

[x ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Implement drug-drug, drug-allergy, drug-formulary checks

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOWMED CT

VistA Status

[x] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Generage and transmit permissible prescriptions electronically (eRx)

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Maintain active medication list

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Maintain active medication allergy list

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Record demographics

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Record and chart changes in vital signs

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Record smoking status for patients 13 yrs old or older

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Incomporate clinical lab-test results into EHR as structured data

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities and outreach

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Report quality measures to CMS or the States

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Send reminders to patients per patient preference for preventative/followup care

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Implement 5 clinical decision support rules

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Check insurance eligibility electronically frompublic and private payers

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Submit claims electronically to public and private payers

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Provide patients with an electronic copy of their health information upon request

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Provide patients with an electronic copy of their discharge instructions and procedures at time of discharge, upon request

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Provide patients with timely electronic access to their health information (including lab results, problem lists, medication lists, allergies) within 96 hours of the information being available to the eligible professional

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Provide clinical summaries for patients for each office visit

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Capability to exchange key clinical information among providers of care and patient authorized entities electronically.

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Provide summary care records for each transition of care and referral

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Perform medication reconciliation at relevant encounters and each transition of care

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Capability to submit electronic data to immunization registries and actual submission where required and accepted.

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Capability to provide electronic submission of reportable lab results (as required by state or local law) to public health agencies and actual submission where is can be received

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.

VistA Status

[ ] Ready Now; [ ] Minor Work; [ ] Major Work <Please edit>

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