If you’ve ever tried to read the Department of Health and Human Services’ requirements for meaningful use, I’m sure you understand why so many people are struggling to keep up; if you’re like me, you probably had to stop to take an aspirin after 10 minutes or so. Actually, if you managed to navigate the agency website to even find the list of meaningful use requirements within 10 minutes, my hat is off to you – it took me 30.
After all of that searching, it seemed a waste not to write them down and translate them from “government speak” into English to save everyone else some time.
(If you’re completely lost and have no idea what “meaningful use” is, you’re probably not in healthcare and you’re definitely not alone. Hang with me – I’ll be back with another blog post soon to explain meaningful use and electronic health records for dummies.)
For everyone else, let’s plow ahead.
For hospitals, the DHHS has created a checklist of 14 requirements that must be met to achieve the first stage of “meaningful use.” In addition, it has another list of 10 choice objectives and the hospital must meet at least five of them.
The 14 requirements (hospitals must meet all of these) are:
- Use computerized provider order entry (CPOE) for prescriptions.
- Check for drug-drug and drug-allergy interactions.
- Maintain an up-to-date problem list of diagnoses.
- Maintain an active medication list.
- Maintain an active medication allergy list.
- Record demographics on date of birth, language, gender, race, ethnicity, and date and preliminary cause of death.
- Record and chart changes in height, weight, blood pressure and BMI. In children 2-20, growth charts must also be plotted.
- Record whether each patient (age 13 and up) smokes.
- Report hospital clinical quality measures (a separate list of requirements) to government authorities.
- Implement one clinical decision support rule related to a high priority hospital condition along with the ability to track compliance with that rule. (This means identifying a serious problem, creating a way to solve it and tracking your success. An example could include reducing preventable readmissions to the hospital).
- Provide patients with an electronic copy of their health information (diagnostic test results, problem list, medication lists, medication allergies, discharge summary and procedures) upon request.
- Provide patients with an electronic copy of their discharge instructions at the time of discharge, upon request.
- Have the ability to exchange information (such as medications, allergies and test results) electronically with other doctors and facilities.
- Protect electronic health information and patient privacy.
The 10 choice objectives (hospitals must meet five of these) are:
- Implement drug formulary checks. (A drug formulary is a list of prescription drugs preferred by your health plan. Checking this list helps ensure you’re not paying extra for an expensive drug when a cheaper one will treat your condition just as well.)
- Record advance directives for patients 65 years or older.
- Incorporate test results as “structured data” so it can be searched, collected and reported automatically by computer systems.
- Generate lists of patients by specific conditions to use for research, outreach, reduction of disparities and quality improvement.
- Use EHRs to provide the appropriate education and resources to patients.
- When a patient is transferred from another doctor or hospital, perform medication reconciliation to make sure all of the patient’s drugs are listed and are correct.
- When a patient is transferred to another doctor or hospital, provide a summary of the patient’s care.
- Be able to submit immunization records electronically to the appropriate government agencies.
- Be able to submit reportable lab results electronically to the appropriate government agencies. (State and local governments specify which lab results are reportable in each location. For example, in some states, doctors must report positive HIV tests.)
- Be able to submit “syndromic surveillance” data electronically to public health agencies. (Syndromic surveillance means doctors and health agencies monitor patient symptoms so they’ll know if there’s an outbreak of disease.)
For those of you who just can’t get enough federal guidelines, you can download a ZIP file containing lots of details about each specific requirement here: Lots of regulation details.
There’s a whole separate (but similar) set of requirements for doctors but you’ll have to click this link to get to them. Hey, DHHS makes you click 12 links to find them — I’m only making you hit one.
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