Health Outcomes Care Goals Objectives for Objectives for Stage 1 Measures

Policy Priority Eligible Professionals Hospitals

Improving quality, Provide access to Use computerized Use of CPOE for For EPs, CPOE is used for at least 80%
safety, efficiency, comprehensive physician order entry orders of all orders.
and reducing patient health data (CPOE). (any type) directly For eligible hospitals, CPOE is used for
health disparities. for patient’s health entered by 10% of all orders.
care team. authorizing
Provider.
Use evidence- Implement drug-drug, Implement drug-drug, The EP/eligible hospital has enabled
based order sets drug-allergy, drug- drug-allergy, drug- this functionality.
and CPOE. formulary checks. formulary checks.
Apply clinical Maintain an up-to- Maintain an up-to- At least 80% of all unique patients
decision support at date date seen by the EP or admitted to the
the point of care. problem list of current problem list of current eligible hospital have at least one
Generate lists of and active diagnoses and active diagnoses entry or an indication of none
patients who need based on ICD–9–CM based on ICD–9–CM recorded as structured data.
care and use them or SNOMED CTR. or SNOMED CTR.
to reach out to
patients.
Report information Generate and At least 75% of all permissible
for quality transmit permissible prescriptions written by the EP are
improvement and prescriptions transmitted electronically using
public reporting. electronically (eRx). certified EHR technology.
Maintain active Maintain active At least 80% of all unique patients
medication list. medication list. seen by the EP or admitted to the
eligible hospital have at least one
entry (or an indication of ‘‘none’’ if
the patient is not currently prescribed
any medication) recorded as
structured data.
Maintain active Maintain active At least 80% of all unique patients
medication allergy list. medication allergy list. seen, by the EP or admitted to the
eligible hospital have at least one
entry or (an indication of ‘‘none’’ if
the patient has no medication
allergies) recorded as structured data.
Record demographics: Record demographics: At least 80% of all unique patients
- Preferred - Preferred seen by the EP or admitted to the
language language eligible hospital have demographics
- Insurance type - Insurance type recorded as structured data.
- Gender - Gender
- Race - Race
- Ethnicity - Ethnicity
- Date of birth - Date of birth
- Date & cause of
death in the event
of mortality
Record and chart Record and chart For at least 80% of all unique patients
changes in vital signs: changes in vital signs: age 2 and over seen by the EP or
- Height - Height admitted to eligible hospital, record
- Weight - Weight blood pressure and BMI; additionally
- blood pressure - blood pressure plot growth chart for children age 2–
- Calculate and - Calculate and 20.
display BMI. display BMI.
- Plot and display - Plot and display
growth charts for growth charts for
children children
2–20 years, including 2–20 years, including
BMI. BMI.
Record smoking status Record smoking status At least 80% of all unique patients 13
for patients 13 years for patients 13 years years old or older seen by the EP or
old or older. old or older. admitted to the eligible hospital have
‘‘smoking status’’ recorded.

Incorporate clinical Incorporate clinical At least 50% of all clinical lab tests
lab test results into lab test results into ordered whose results are in a
HER as structured HER as structured positive/ negative or numerical
data. data. format are incorporated in certified
HER technology as structured data.
Generate lists of Generate lists of Generate at least one report listing
patients by specific patients by specific patients of the EP or eligible hospital
conditions to use for conditions to use for with a specific condition.
quality improvement, quality improvement,
reduction of reduction of
disparities, and disparities, and
outreach. outreach.
Report ambulatory Report hospital For 2011, provide aggregate
quality measures to quality measures to numerator
CMS or the States. CMS or the States. and denominator through attestation
as discussed in section
II(A)(3) of this proposed rule.
For 2012, electronically submit the
measures as discussed in section
II(A)(3) of this proposed rule.
Send reminders to Reminder sent to at least 50% of all
patients per patient unique patients seen by the EP that
preference for are age 50 or over.
preventive/ follow up
care.
Implement 5 clinical Implement 5 clinical Implement 5 clinical decision support
decision support rules decision support rules rules relevant to the clinical quality
relevant to specialty related to a high metrics the EP/Eligible Hospital is
 or high clinical priority hospital responsible for as described further
priority, including condition, including in section II(A)(3).
diagnostic test diagnostic test
ordering, along with ordering, along with
the ability to track the ability to track
compliance with those compliance with those
rules. rules.
Check insurance Check insurance Insurance eligibility checked
eligibility eligibility electronically for at least 80% of all
electronically from electronically from unique patients seen by the EP or
public and private public and private admitted to the eligible hospital.
payers. payers.
Submit claims Submit claims At least 80% of all claims filed
electronically to public electronically to public electronically by the EP or the eligible
and private payers. and private payers. hospital.
Engage patients Provide patients Provide patients with Provide patients with At least 80% of all patients who
and families in and families with an electronic copy of an electronic copy of request an electronic copy of their
their health care. timely access to their health their health health information are provided it
data, knowledge, information (including information (including within 48 hours.
and tools to make diagnostic test results, diagnostic test results,
informed decisions problem list, problem list,
and to manage medication lists, medication lists,
their health. allergies), upon allergies, discharge
request. summary,
procedures), upon
request.
Provide patients with At least 80% of all patients who are
an electronic copy of discharged from an eligible hospital
their discharge and who request an electronic copy of
instructions and their discharge instructions and
procedures at time of procedures are provided it.
 discharge, upon
request.
Provide patients with At least 10% of all unique patients
timely electronic seen by the EP are provided timely
access to their health electronic access to their health
information (including information.
lab results, problem
list, medication lists,
and allergies) within
96 hours of the
information being
available.
Provide clinical Clinical summaries are provided for at
summaries for least 80% of all office visits.
patients for each
office visit.
Improve care Exchange Capability to exchange Capability to exchange Performed at least one test of
coordination. meaningful clinical key clinical key clinical certified EHR technology’s capacity to
information among information (for information (for electronically exchange key clinical
professional health example, problem list, example, discharge information.
care team. medication list, summary, procedures,
allergies, diagnostic problem list,
test results), among medication list,
providers of care and allergies, diagnostic
patient authorized test results), among
entities electronically. providers of care and
patient authorized
entities electronically.
Perform medication Perform medication Perform medication reconciliation for
reconciliation at reconciliation at at least 80% of relevant encounters
relevant encounters relevant encounters and transitions of care.
 and each transition of and each transition of
care. care.
Provide summary care Provide summary care Provide summary of care record for at
record for each record for each least 80% of transitions of care and
transition of care and transition of care and referrals.
referral. referral.
Improve Communicate with Capability to submit Capability to submit Performed at least one test of
population and public health electronic data to electronic data to certified HER technology’s capacity to
public health. agencies. immunization immunization submit electronic data to
registries and actual registries and actual immunization registries.
submission where submission where
required and required and
accepted. accepted.
Capability to provide Performed at least one test of the
electronic submission EHR system’s capacity to provide
of reportable lab electronic submission of reportable
results (as required by lab results to public health agencies
state or local law) to (unless none of the public health
public health agencies agencies to which eligible hospital
and actual submission submits such information have the
where it can be capacity to receive the information
received. electronically).
Capability to provide Capability to provide Performed at least one test of
electronic syndromic electronic syndromic certified EHR technology’s capacity to
surveillance data to surveillance data to provide electronic syndromic
public health agencies public health agencies surveillance data to public health
and actual and actual agencies (unless none of the public
transmission transmission health agencies to which an EP or
according to according to eligible hospital submits such
applicable law and applicable law and information have the capacity to
practice. practice. receive the information
 electronically).

Ensure adequate Ensure privacy and Protect electronic Protect electronic Conduct or review a security risk
privacy and security protections health information health information analysis per 45 CFR 164.308(a)(1) and
security for confidential created or maintained created or maintained implement security updates as
protections for information by the certified HER by the certified HER necessary.
personal health through operating technology through technology through
information. policies, the implementation of the implementation of
procedures, and appropriate technical appropriate technical
technologies and capabilities. capabilities.
compliance with
applicable law.