Which 2015 Meaningful Use Objectives Have Changed?

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CMS recently released changes to Meaningful Use for 2015 that will directly impact you and your practice. Have you had the chance to read all 196 pages of the final rule to find out what has changed? Don’t worry, ChartLogic has and we’re here to simplify the process for you.

One of the main changes will be eliminating the term “Stage 1” for eligible providers (EP). Now, providers will attest for Stage 2 or Modified Stage 2, which contains alternate measures that more closely resemble the previous Stage 1 requirements.

They now refer to any provider that has attested less than 2 times as “Scheduled for Stage 1.” These providers attest to Modified Stage 2, while all other providers will continue attesting for Meaningful Use Stage 2.

The Menu and Core measures have been compiled into 10 objectives with 1-3 measures each objective. This change impacts 9 out of the 10 Objectives by reducing or removing the requirements for the measures within. See below for a breakdown of each Objective that was affected.

To assist providers who may have already started working on Meaningful Use in 2015, there are alternate exclusions and specifications within individual objectives for providers who were previously scheduled to be in Stage 1 of meaningful use. These include:

• Allowing providers who were previously scheduled to be in a Stage 1 EHR reporting period for 2015 to use a lower threshold for certain measures.
• Allowing providers to exclude for Stage 2 measures in 2015 for which there is no Stage 1 equivalent.

– CMS

Attestation Period

The attestation reporting period has changed from 1 quarter or 1 year, to any 90 day period. CMS will only accept attestation submissions on start date of 1/4/2016. The current deadline is February 29, 2016, but is subject to change.

We recommend that you access the attestation page, using your PCOS logins, as soon as possible. Doing so will prevent waiting on long holds to reset passwords.

This process requires that you have the provider’s NPI number and either the providers NPPES web user account or, as an Office Manager, your own Identity and Web (I&A) user account access associated with the provider’s NPI number. You can create these or access them from the CMS attestation site here. Of course, you can always contact CMS for more assistance in this process by calling the EHR Information Center Help Desk for questions concerning registration at (888) 734-6433 / TTY: (888 ) 734-6563.

To learn more about these changes, register for our upcoming webinar,  2015 Meaningful Use Changes, Are You Ready? on December 17, 2015.

Meaningful Use Objectives

*Items in GREEN have been added / changed for 2015.

Objective 2: Clinical Decision Support

1. Measure 1:
   Implement five clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period and The EP has enabled and implemented the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period.
2. Measure 2:
   The EP has enabled drug-drug and drug-allergy interaction checks

–	Exclusion	Any EP who writes fewer than 100 medication orders during the EHR reporting period
NEW	Alternate	Implement one clinical decision support rule if scheduled for Stage 1

Objective 3: Computerized Provider Order Entry

1. Measure 1:
   > 60% of medication orders are entered by any licensed healthcare professional
2. Measure 2:
   > 30% of laboratory orders entered by any licensed healthcare professional
3. Measure 3:
   > 30% of radiology orders entered by any licensed healthcare professional

NEW	Exclusion	Medication – Write less than 100 prescriptions or use alternative measure if scheduled for Stage 1
NEW	Exclusion	Labs – Write fewer than 100 laboratory orders or excluded if scheduled for Stage 1
NEW	Exclusion	Radiology – Write fewer than 100 radiology orders or excluded if scheduled for Stage 1
NEW	Alternate	> 30% of unique patients with a medication list have at least one medication entered using CPOE if scheduled for Stage 1

Objective 4: Electronic Prescribing

1. Measure 1:
   More than 50% of permissible prescriptions generated are queried for drug formulary and transmitted electronically

–	Exclusion	Less than 100 prescriptions written
–	Exclusion	No pharmacy within organization or no pharmacy within 10 miles that accepts electronic prescriptions
NEW	Alternate	> 40% of all permissible prescriptions written by the EP are transmitted electronically if scheduled for Stage 1

Objective 5: Health Information Exchange

1. Measure 1:
   The EP that transitions a patient to another setting of care must create a summary of care record
2. Measure 2:
   Electronically transmit such summary to a receiving provider for more than 10 percent of transitions

–	Exclusion	An EP who transfers a patient to another setting less than 100 times during the EHR reporting period
NEW	Exclusion	if scheduled for Stage 1

Objective 6: Patient-Specific Education

1. Measure 1:
   > 10% of all unique patients are provided patient-specific education as identified by CEHRT

–	Exclusion	An EP who had no office visits during the reporting period
NEW	Exclusion	if scheduled for Stage 1

Objective 7: Medication Reconciliation

1. Measure 1:
   Performs medication reconciliation for more than 50% of patients that are transitioned into their care

–	Exclusion	Any EP who was not the recipient of any transitions of care during the EHR reporting period
NEW	Exclusion	if scheduled for Stage 1

Objective 8: Patient Electronic Access (VDT)

1. Measure 1:
   > 50% of patients seen by the EP are provided timely online access to health information within 4 business days
2. Measure 2:
   At least one patient views, downloads or transmits to a third-party his or her health information

–	Exclusion	Neither orders nor creates any of the information listed for inclusion of both measures
–	Exclusion	Conducts 50% or more of patient encounters in a county that does not have 50% or more housing with 4 Mbps broadband
NEW	Exclusion	EP may claim an exclusion to the second measure if scheduled for Stage 1

Objective 9: Secure Messaging

1. Measure 1:
   The capability for patients to send and receive a secure electronic message with the EP was enabled

–	Exclusion	An EP who has no office visits during the EHR reporting period
–	Exclusion	Conducts 50% or more of patient encounters in a county that does not have 50% or more housing with 4 Mbps broadband
NEW	Exclusion	if scheduled for Stage 1

Objective 10: Public Health Reporting

–	EP scheduled for Stage 2 must meet two of the following measures:
NEW	EP scheduled for Stage 1 must meet one of the following measures:

1. Measure 1:
   EP is in active engagement with a public health agency to submit immunization data

   Exclusion	EP does not administer any of the immunizations to any of the populations for which data is collected by their jurisdiction’s immunization registry or immunization information system during the EHR reporting period
   Exclusion	EP operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required for CEHRT at the start of their EHR reporting period
   Exclusion	EP Operates in a jurisdiction where no immunization registry or immunization information system has declared readiness to receive immunization data from the EP at the start of the EHR reporting period

2. Measure 2:
   EP is in active engagement with a public health agency to submit syndromic surveillance data

   Exclusion	EP is not in a category of providers from which ambulatory syndromic surveillance data is collected by their jurisdiction’s syndromic surveillance system
   Exclusion	Operates in a jurisdiction for which no public health agency is capable of receiving electronic syndromic surveillance data from EPs in the specific standards required to meet the CEHRT definition at the start of the EHR reporting period
   Exclusion	Operates in a jurisdiction where no public health agency has declared readiness to receive syndromic surveillance data from EPs at the start of the EHR reporting period

3. Measure 3:
   EP is in active engagement to submit data to a specialized registry

   Exclusion	Does not diagnose or treat any disease or condition associated with, or collect relevant data that is collected by, a specialized registry in their jurisdiction during the EHR reporting period
   Exclusion	Operates in a jurisdiction for which no specialized registry is capable of accepting electronic registry transactions in the specific standards required to meet the CEHRT definition at the start of the EHR reporting period
   Exclusion	Operates in a jurisdiction where no specialized registry for which the EP is eligible has declared readiness to receive electronic registry transactions at the beginning of the EHR reporting period

Removed Measures

If you attested for stage 2 in 2014, you might remember how some of these measures were a bit of a challenge to maintain. Again, all of those measures are no longer required for Meaningful Use 2015. Those removed measures are:

• Record Demographics
• Record Vitals
• Smoking Status
• Structured Lab Results
• Patient List
• Patient Reminders
• Imaging Results
• Electronic Notes
• Summary of Case Measure 1 any method and Measure 3
• Family History