Eligible Provider (EP) means a physician as defined in section 1861® of the Act which includes, with certain limitations, all of the flowing types of professionals (Section 495.10):

1. A doctor of medicine or osteopathy.
2. A doctor of dental surgery or medicine
3. A doctor of podiatric medicine
4. A doctor of optometry
5. A chiropractor

EP’s Eligible for Federal Incentive Payment

1. Must be an EP as defined in the regulation
2. Must use an EHR certified by a Office of the National Coordinator Authorized Testing and Certification Body (ONC-ATCB) for “Stage 1 “ usage
3. Must have either Medicare or Medicaid billing
4. Must use the EHR to meet “meaning use” stage 1 requirements

Stage 1 Meaningful Use:

EP MUST meeting these criteria

1. Use Computerized Provider Order Entry (CPOE) for mediation orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. Measure: 30% of all unique patients with at least one medication that has been seen by the EP.

2. Implement drug-drug and drug-allergy interaction checks. Measure: EP has enabled this function the EHR.

3. Maintain an up-to-date problem list of current and active diagnoses. Measure: More than 80 percent of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data.

4. Generate and transmit permissible prescriptions electronically. Measure: 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

5. Maintain active medication list. Measure: 80% or more of all unique patients seen by the EP have at least one entry recorded as structured data.

6. Maintain active medication allergy list. Measure: 80% or more of all unique patients seen by the EP have at least one entry recorded as structured data.

7. Record all of the following demographics as structured data; Preferred Language; Gender; Race; Ethnicity; Date of Birth. Measure: More than 50 percent of all unique patients seen by the EP have demographics recorded as structured data.

8. Record and chart changes in the following vital signs; Height; Weight; Blood Pressure; BMI (calculated). Measure: 50% or more of all unique patients age 2 and over seen by the EP have vital signs recorded as structured data.

9. Record smoking status for patients 13 years old or older. Measure: 50% or more of all unique visits for patients 13 years old or older seen by the EP have smoking status recoreded as structured data.

10. Report ambulatory clinical quality measures to CMS or, in the case of Medicaid EPs, the states. Measure: Successfully report to CMS ambulatory clinical quality measures selected by CMS in a manner specified by CMS (starting in 2012).

11. Implement one clinical decision support rules relevant to specialty or high clinical priority along with the ability to track compliance with that rule. Measure: Implement one clinical decision support rule.

12. Provide patients with an electronic (CD, DVD, Flash Drive or Web Portal) of their health information upon request. Measure: 50% or more of all patients who REQUEST an electronic copy of their health information are provided it within 3 business days.

13. Provide clinical summaries for patients for each office visit. Measure: 50% or more of all office visits within 3 business days.

14. Capability to exchange key clinical information amount providers of care and paitent authorized entities electronically. Measure: Performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information.

15. Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities. Measure: Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308 and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

EP’s must meet five of the next 10 criteria during Stage 1 Meaningful Use:

1. Implement drug-formulary checks. Measure: EP has enabled this functionality in the EHR.
2. Incorporate Clinical lab-test results into EHR as structured data. Measure: 40% or more of all lab data ordered by an EP during the EHR reporting period would be recorded as structured data
3. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach. Measure: Generate at least 1 report listing patients of the EP with a specific condition.
4. Send reminders to patients per patient preference for preventative/follow-up care. Measure: 20% or more of all patients 65 or older were sent an appropriate reminder during the EHR reporting period.
5. Provide patients with timely electronic access to their health information within 4 business days of the information being available to the EP. Measure: 10% or more of all unique patients seen by the EP are provided timely electronic access to their health information subject to the EP’s discretion to withhold certain information.
6. User certified EHR technology to identify patient-specific education resources. Measure: 10% or more of all unique patients seen by the EP are provided patient-specific education resources.
7. The EP who receives a patient from another setting of care or provider of care or believes and encounter is relevant should perform medication reconciliation. Measure: 50% or more of the transitions of care in which the patient is transitioned in the care of the EP.
8. The EP who transitions their patient to another setting of care or provider of care or referred their patient to another provider of care should provide summary care recorded for each transition of care o referral. Measure: 50% or more of the patients transitioned will have a summary.
9. Capability to submit electronic data to immunization registries or immunization information systems and actual submissions according to the applicable law and practice. Measure: Performed at least one test of the EHR technology’s capacity to submit electronic data to immunization registries.
10. Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice. Measure: Performed at least one test of the EHR technology’s capacity to submit syndromic surveillance data.

Stage 2 Meaningful Use regulations definition by 12/31/2011 for implementation 1/1/2013.

Stage 3 Meaningful Use regulation definition by 12/31/2013 for implementation 1/1/2015.

For more information please contact DeckerWright.