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Meaningful-use Requirement

Stage one of meaningful use include a core objective that users be able to record demographic information, including preferred language, gender, race, ethnicity, date of birth, and date and preliminary cause of death in the event of mortality in the eligible hospital. Stage one includes a corresponding core measure that more than 50% of all unique patients seen by the eligible professional (EP) or admitted to the eligible hospital (EH) have demographics as recorded structured data.

Here is the precise wording about these core objectives from the Federal Register, Vol. 75, No. 8, Wednesday, January 13, 2010, Rules and Regulations:

"C. Standards, Implementation Specifications, and Certification Criteria Processes Before and After the HITECH Act . . .

"2. HITECH Act Requirements for the Adoption of Standards, Implementation Specifications, and Certification Criteria . . .

"Once the National Coordinator accepts a recommendation for the priority order of standards, implementation specifications, and certification criteria, such priorities will be communicated to the HIT Standards Committee to guide its work. The HIT Policy Committee is charged with making recommendations in at least the following eight areas as specified in section 3002(b)(2)(B) of the PHSA: . . .

"(7) The use of electronic systems to ensure the comprehensive collection of patient demographic data, including, at a minimum, race, ethnicity, primary language, and gender information;

". . .

"TABLE 1—CERTIFICATION CRITERIA . . .

Proposed meaningful use Stage 1 objectives: Record demographics [4] [5]

"Certification criteria to support the achievement of meaningful use Stage 1 by eligible professionals: Enable a user to electronically record, modify, and retrieve patient demographic data in- cluding preferred language, insurance type, gender, race, ethnicity, and date of birth.

"Certification criteria to support the achievement of meaningful use Stage 1 by eligible hospital: Enable a user to electronically record, modify, and retrieve patient demographic data in- cluding preferred language, insurance type, gender, race, ethnicity, date of birth, and date and cause of death in the event of mortality.'

"[4] For eligible professionals the full proposed meaningful use Stage 1 objective is: 'record demographics: preferred language, insurance type, gender, race, ethnicity, date of birth.'

"[5] For eligible hospitals the full proposed meaningful use Stage 1 objective is: 'record demographics: preferred language, insurance type, gender, race, ethnicity, date of birth, date and cause of death in the event of mortality.'

". . .

"§ 170.304 Specific certification criteria for Complete EHRs or EHR Modules designed for an ambulatory setting.

"The Secretary adopts the following certification criteria for Complete EHRs or EHR Modules designed to be used in an ambulatory setting. Complete EHRs or EHR Modules must include the capability to perform the following functions electronically and in accordance with all applicable standards and implementation specifications adopted in this part: . . .

"(c) Record demographics. Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, insurance type, gender, race, ethnicity, and date of birth.

". . .

"§ 170.306 Specific certification criteria for Complete EHRs or EHR Modules designed for an inpatient setting.

"The Secretary adopts the following certification criteria for Complete EHRs or EHR Modules designed to be used in an inpatient setting. Complete EHRs or EHR Modules must include the capability to perform the following functions electronically and in accordance with all applicable standards and implementation specifications adopted in this part: . . .

"(b) Record demographics. Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, insurance type, gender, race, ethnicity, date of birth, and date and cause of death in the event of mortality."

Prior to WorldVistA EHR 2.0, VISTA did not include anything like a preferred language field attached to patients, nor did it include the necessary options to set or modify it. This part of the project was about resolving this deficiency to help WorldVistA EHR 2.0 become a certified EHR hospitals could use to meet meaningful use stage one.