Meaningful Use Menu Measures without a Threshold: That was Easy
Last week we looked at the core measures without a threshold in the CMS EHR incentive program. Today we’ll examine measures on the menu without a threshold. As you may recall, in addition to the 15 core objectives, each provider must select 5 of the 10 menu objectives to report in order to demonstrate meaningful use. There is one minor nuance when selecting the 5 menu objectives to report; at least one of those selected must be a public health related objective (number 3 or 4 below).
As with the core objectives, the menu objectives can be divided into two broad categories: those with a threshold that must be met and those without a threshold. Again, measures in this later group are asking the provider to attest to the fact the objective was met, typically a minimum of once during the reporting period. There are 4 objectives without a threshold on the menu:
1. Drug-formulary checks
2. Generate a patient list
3. Immunization registry
4. Syndromic surveillance
Verify drug-formulary checks were turned on
Very similar to the drug-drug and drug-allergy core objective, this measure asks the provider to attest to the fact the drug-formulary checking feature within the e-prescribing tool is “turned on” for the entire reporting period. All certified EHRs (and stand alone eRx tools for those of you taking the modular route to meaningful use) posses a drug-formulary checking feature. This measure is another low hurdle to clear in the EHR incentive program.
Generate a patient list
This objective requires the provider to attest to the fact that during the reporting period the EHR was utilized to generate at least one patient list. A patient list in this context is a list of patients generated using various attributes such as a medication, diagnosis on the problem list, demographic or lab result (e.g., create a list of all CKD stage 4 patients with an iPTH > 110). All certified EHRs have the ability to generate patient lists—yet another low bar to clear.
Submit data electronically to an immunization registry
This measure is asking the provider to attest to the fact that they tested the EHRs ability to submit immunization information electronically to a local immunization registry or to an immunization information system at least one time before the end of the EHR reporting period. As with the core measure related to the exchange of key clinical data (reviewed last week), meeting this measure can be accomplished with actual patient data or using “dummy data.” Another similarity between these two measures applies to group practices using the same EHR: a successful transmission by one provider during the reporting period will satisfy this measure for every provider in the group using the EHR. Every certified-complete EHR is capable of creating the export for this measure utilizing the appropriate standard. Providers that do not administer immunizations are excluded from reporting this measure.
Report syndromic surveillance electronically to a public health agency
The last measure on our list today is asking the provider to attest to the fact that at least one time prior to the end of the reporting period they tested the EHRs ability to send syndromic surveillance data electronically to a public health entity. What is syndromic surveillance? An example would be identifying all of the provider’s patients with the diagnosis of H1N1 during a certain time interval. Who are the eligible public health agencies? This list is long, quoting from the final rule: “A public health agency is an entity under the jurisdiction of the U.S. Department of Health and Human Services, tribal organization, State level and/or city/county level administration that serves a public health function.” As with the immunization measure, the test can be accomplished with actual data or test data, and group practices using the same EHR are only required to complete the measure for a single provider after which all providers in the group can attest to the measure. As with the immunization measure above, providers who do not collect reportable syndromic information on their patients during the reporting period are excluded from reporting this measure.
In summary, the meaningful use objectives are divided into a core set and a menu set. These two sets of objectives can be further divided into those with a target threshold and those without a threshold. Over the past few weeks we have explored the 9 objectives without a threshold (5 core objectives and the 4 on the menu today). In the coming weeks we will take a look at some of the remaining objectives within the CMS EHR incentive program.
Wishing each of you a Happy and Prosperous New Year.