Meaningful Use: Eligible Hospitals

Meaningful use includes both a core set and a menu set of objectives that are specific for eligible hospitals. There are a total of 24 meaningful use objectives. Fourteen are core objectives that are required, and the remaining 5 objectives may be chosen from the list of 10 menu set objectives. Eligible hospitals must report on 19 of the 24 objectives during Stage 1. Objective completion does not apply to the Medicaid incentive program in year one.

14 Required Core Objectives

1. Computerized physician order entry (CPOE)
2. Drug-drug and drug-allergy interaction checks
3. Record demographics
4. Implement one clinical decision support rule
5. Maintain up-to-date problem list of current and active diagnoses
6. Maintain active medication list
7. Maintain active medication allergy list
8. Record and charge changes in vital signs
9. Record smoking status for patients 13 years or older
10. Report hospital clinical quality measures to CMS or States
11. Provide patients with an electronic copy of their health information, upon request
12. Provide patients with an electronic copy of their discharge instructions at time of discharge, upon request
13. Capability to exchange key clinical information among providers of care and patient-authorized entities electronically
14. Protect electronic health information

Select Five Menu Set Objectives

• Drug formulary checks
• Record advanced directives for patients 65 years or older
• Incorporate clinical lab test results as structured data
• Generate lists of patients by specific conditions
• Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate
• Medication reconciliation
• Summary of care record for each transition of care/referrals
• Capability to submit electronic data to immunization registries/systems*
• Capability to provide electronic submission of reportable lab results to public health agencies*
• Capability to provide electronic syndromic surveillance data to public health agencies*

*At least one public health objective must be selected

Meaningful Use and Critical Access Hospitals Primer

The Department of Health and Human Services, Health Resources and Services Administration (HRSA), Office of Rural Health Policy (ORHP) has a primer that introduces Critical Access Hospitals to a broad spectrum of health information technology (HIT) adoption issues and considerations. It identifies open-ended questions that help CAHs define their own roadmap for meaningful use of an electronic health record (EHR) system.

Useful Links

• Summary of Health Information Technology Incentives and Resources (National Rural Health Resource Center)
• HHS Electronic Health Records and Meaningful Use
• HHS Press Release Announcing Meaningful Use Rules
• NEJM Article:"The 'Meaningful Use' Regulation for Electronic Health Records", July 13, 2010.
• NEJM Article: "Finding My Way to Electronic Health Records," August 5, 2010
• CMS Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology
• Table Comparing Notice of Proposed Rulemaking (NPRM) vs. Final Rule on Meaningful Use
• Stage 1 Meaningful Use Objectives and Associated Measures Sorted by Core and Menu Set
• Stage 1 Meaningful Use Objectives and Associated Measures Sorted by Method of Measure Calculation