Meaningful Use Stage 2 Requirements

Stage 2 of the meaningful use program requires that eligible professionals (EPs) satisfy 17 core objectives (Table A below) and three of six menu objectives (Table B below).

Table A: Core Objectives

NUMBER OBJECTIVE MEASUREMENT
1 Use computerized physician order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. More than 60% of medication, 30% of laboratory, and 30% of radiology orders created by the EP during the EHR reporting period are recorded using CPOE.
2 Generate and transmit permissible prescriptions electronically (eRx). More than 50% of all permissible prescriptions, or all prescriptions, written by the EP are queried for a drug formulary and transmitted electronically using certified EHR technology.
3 Record all of the following demographics:
a. preferred language;
b. gender;
c. race;
d. ethnicity; and
e. date of birth.
More than 80% of all unique patients seen by the EP have demographics recorded as structured data.
4 Record and chart changes in the following vital signs:
a. height (no age limit);
b. weight (no age limit);
c. blood pressure (ages 3+);
d. calculate and display body mass index (BMI); and
e. plot and display growth charts for children 0-20 years, including BMI.
More than 80% 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.
5 Record smoking status for patients 13 years old or older. More than 80% of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data.
6 Use clinical decision support to improve performance on high-priority health conditions. (1) Implement five clinical decision support interventions related to four or more clinical quality measures, if applicable, at a relevant point in patient care for the entire EHR reporting period. Absent four clinical quality measures related to an EP’s scope of practice or patient population, the clinical decision support interventions must be related to high-priority health conditions. (2) Enable the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period.
7 Provide patients the ability to view online, download, and transmit their health information within four business days of the information being available to the EP. (1) More than 50% of all unique patients seen by the EP during the EHR reporting period are provided timely (available to the patient within four business days after the information is available to the EP) online access to their health information, with the ability to view, download, and transmit to a third party. (2) More than 5% of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download, or transmit to a third party their health information.
8 Provide clinical summaries for patients for each office visit. Clinical summaries provided to patients or patient-authorized representatives within one business day for more than 50% of all office visits.
9 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 in accordance with the requirements under 45 CFR 164.308(a)(1), including addressing the encryption/security of data stored in the certified EHR technology in accordance with requirements under 45 CFR 164.12(a)(2) (iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the provider’s risk management process for EPs.
10 Incorporate clinical lab test results into certified EHR technology as structured data. More than 55% 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.
11 Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach. Generate at least one report listing patients of the EP with a specific condition.
12 Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care and send these patients the reminders, per patient preference. More than 10% of all unique patients who have had two or more office visits with the EP within the 24 months before the beginning of the EHR reporting period were sent a reminder, per patient preference when available.
13 Use clinically relevant information from certified EHR technology to identify patient-specific education resources and provide those resources to the patient. Patient-specific resources identified by certified EHR technology are provided to patients for more than 10% of all unique patients with office visits seen by the EP during the EHR reporting period.
14 The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform 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.
15 The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral. (1) 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. (2) 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 10% of such transitions and referrals either: (a) electronically transmitted using certified EHR technology to a recipient, or (b) where the recipient receives the summary of care record via exchange facilitated by an organization that is an eHealth Exchange (formerly known as NwHIN Exchange) participant or in a manner that is consistent with the governance mechanism ONC establishes for the eHealth Exchange. (3) An EP must also satisfy one of the following criteria: (A) Conduct one or more successful electronic exchanges of a summary of care document, as part of which is counted in “measure 2″ with a recipient who has EHR technology that was developed/designed by a different EHR technology developer than the sender’s EHR technology certified to 45 CFR 170.314(b)(2). (B) Conducts one or more successful tests with the CMS designated test EHR during the EHR reporting period.
16 Capability to submit electronic data to immunization registries or immunization information systems, except where prohibited, and in accordance with applicable law and practice. Successful ongoing submission of electronic immunization data from certified EHR technology to an immunization registry or immunization information system for the entire EHR reporting period.
17 Use secure electronic messaging to communicate with patients on relevant health information. A secure message was sent using the electronic messaging function of certified EHR technology by more than 5% of unique patients (or their authorized representatives) seen by the EP during the EHR reporting period.

Table B: Menu Objectives

NUMBER OBJECTIVE MEASUREMENT
1 Capability to submit electronic syndromic surveillance data to public health agencies, except where prohibited, and in accordance with applicable law and practice. Successful ongoing submission of electronic syndromic surveillance data from certified EHR technology to a public health agency for the entire EHR reporting period.
2 Record electronic notes in patient records. 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 EHR reporting period. The text of the electronic note must be text searchable and may contain drawings and other content.
3 Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through certified EHR technology. 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 certified EHR technology.
4 Record patient family history as structured data. 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.
5 Capability to identify and report cancer cases data to a public health central cancer registry, except where prohibited, and in accordance with applicable law and practice. Successful ongoing submission of cancer case information from certified EHR technology to a public health central cancer registry for the entire EHR reporting period.
6 Capability to identify and report specific cases to a specialized registry (other than a cancer registry), except where prohibited, and in accordance with applicable law and practice. Successful ongoing submission of specific case information from certified EHR technology to a specialized registry for the entire EHR reporting period.