Stage 1

1

Computerized physician order entry (CPOE) of medications

More than 30% of unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE

2

Generate and transmit permissible prescriptions electronically (eRx)

More than 40% of all permissible prescriptions written by the EP are transmitted electronically

3

Report a total of 6 ambulatory clinical quality measures to CMS (Medicare EHR Incentive Program) or States (Medicaid EHR Incentive Program)

For 2011, provide aggregate numerator, denominator, and exclusions through attestation as discussed in section II(A)(3) of this final rule

For 2012, electronically submit the clinical quality measures as discussed in section II(A)(3) of this final rule

4

Implement one clinical decision support rule

Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance for that rule

5

Provide patients with an electronic copy of their health information, upon request

More than 50% of all patients of the EP who request an electronic copy of their health information are provided it within three business days

6

Provide clinical summaries for patient for each office visit

Clinical summaries provided to patients for more than 50% of all office visits within three business days

7

Drug-drug and drug-allergy interaction checks

The EP has enabled this functionality for the entire EHR reporting period

8

Enable a user to electronically record, modify, and retrieve patient demographic data including perferred language, gender, race, ethnicity, and date of birth

More than 50% of all unique patients seen by the EP have demographics recorded as structured data

9

Maintain an up-to-date problelm list of current and active diagnoses based on ICD-9-CM or SNOMED CT©

More than 80% 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

10

Maintain the patient's active medication list

More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data

11

Maintain the patient's active medication allergy list

More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data

12

Record and chart changes in vital signs: height, weight, blood pressure; Calculate and display BMI; Plot and display growth charts for children 2-20 years, including BMI

For more than 50% of all unique patients age 2 and over seen by the EP, the height, weight, and blood pressure are recorded as structured data

13

Record smoking status for patients 13 years old or older

More than 50% of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data

14

Capability to exchange key clinical information among providers of care and patient-authorized entities electronically

Performed at least one test 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

Conduct or review a security risk analysis per 45 CFR 164.308 (a)(1), implement security updates as necessary and correct identified security deficiencies as part of its risk management process

1

Drug-formulary checks

The EP has enabled this functionality and has access to at least one internal or external drug formulary for the entire EHR reporting period

2

Document clinical lab test results as structured data

More than 40% of all clinical lab test results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data

3

Generate lists of patients by specific conditions

Generate at least one report listing patients of the EP with a specific condition

4

Send reminders to patients per patient preference for preventive/follow-up care

More than 20% of all unique patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period

5

Provide patients with timely electronic access to their health information

More than 10% of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP's discretion to withhold certain information

6

Use certified EHR technology to identify patient-specific education resources and provide to patient

More than 10% of all unique patients seen by the EP are provided patient-specific education resources

7

Medication reconciliation

The EP performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP

8

Summary of care record for each transition of care/referral

The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50% of transitions of care and referrals

9

Capability to submit electronic data to immunization registries/systems (public health objective)

Performed at least one test to submit electronic data to immunization registries and follow up submission if the test is successful where accepted and required

10

Capability to provide electronic syndromic surveillance data to public health agencies (public health objective)

Performed at least one test to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful where accepted and required