Meaningful Use - how close are we?

Discussion in 'Synapse' started by Graham, Sep 10, 2010.

  1. Graham

    Graham Developer Staff Member

    Time to revisit meaningful use and to see what we have to do get there.

    We have this nice quote from http://motorcycleguy.blogspot.com/2010/07/meaningful-use-standards-summary.html

    Yeah, right!
  2. Graham

    Graham Developer Staff Member

    This is a summary of the requirements for MU http://mycourses.med.harvard.edu/ec_res/nt/26F568D6-E6F3-418A-96B9-497666DEF5C0/MUQuick.pdf

    Let's look thru them to see what we need to allow you to achieve MU with Synapse without spending $4,800,000!

    1. CPOE
    No excuses here. Synapse has CPOE of medications since year 0. And the recent addition of RxTerms should make it even easier.

    2. Implement drug-drug and drug allergy interaction checks
    We used to have this but dropped it a long time ago. This is really part of eRx

    3. ePrescribing
    The core code has been written. Just waiting for Surescripts to play ball here so we can do testing

    4. Demographics
    ONC want preferred language, and race which we do not have. Actually our ethnicity appears to be race, so in reality we don't have what they call ethnicity. And ethnicity is not even that, but whether the patient is Latino or not! But this can be inferred from the race, so I don't think we need add anything here except language preference.

    5. Problem List - covered
    6. Medication List - covered
    7. Vital Signs/Growth Charts - covered
    8. Smoking Status - covered

    9. Clinical Decision Support -
    You only have to implement one rule. Can use one of the DM rules

    10. Calculate and Transmit CMS Quality Measures
    This is through attestation in 2011, and electronically in 2012. Not sure what is required here. Percentage of DMs on an ACE inhibitor? DM with HbA1c below 7% ??

    11. Electronic Copy of Health Information
    Provide patients with an electronic copy of their health information (including diagnostic test results, problem ....
    They can do this via the patient portal.

    12. Clinical Summaries
    Just print off using [Docs] button

    13.Exchange Key Clinical Information
    Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, .... )
    this is a single test.
    I presume it means effectively being able to generate a CCR and consume a CCR. We can currently consume a CCR, and generating a CCR is fairly trivial.

    14. Privacy / Security
    Protect electronic health information created or maintained by the certified EHR technology through the ....
    Currently all communication to the server is encrypted in transit.
    Have to investigate what else is required

    And you have to select 5 measures including one from population health.
    We can do of these right now

    1. Lab Results into EHR
    2. Patient List
    3. Patient Reminders
    4. Timely Electronic Access to Health Records - via Portal
    5. Patient Specific Education
  3. Graham

    Graham Developer Staff Member

  4. Graham

    Graham Developer Staff Member

    If anyone has the time and will to read through these and see what we can't do .. you're welcome.
  5. Graham

    Graham Developer Staff Member

  6. Graham

    Graham Developer Staff Member

  7. Graham

    Graham Developer Staff Member

    Added an Inactive Allergy class to the medication management.
  8. Graham

    Graham Developer Staff Member

  9. Graham

    Graham Developer Staff Member

  10. Graham

    Graham Developer Staff Member

  11. Graham

    Graham Developer Staff Member

  12. Graham

    Graham Developer Staff Member

  13. Graham

    Graham Developer Staff Member

  14. Graham

    Graham Developer Staff Member

  15. Graham

    Graham Developer Staff Member

    http://xw2k.nist.gov/healthcare/docs/170.302.j_ MedicationReconciliation_v1.0.pdf

    This seems to require that the user can display the patient's medication list electronically, and a separate list electronically to compare them, and then reconcile in a manner the user chooses.
    Synapse 37 now imports a medication list from a supplied CCR and will display the two lists simultaneously, and will allow the import of medications from the CCR list.
  16. Graham

    Graham Developer Staff Member

  17. Graham

    Graham Developer Staff Member

    I just noticed that the test requires one to record date of death, and preliminary cause of death. We can do this already so no change here.
  18. Graham

    Graham Developer Staff Member

    And just noticed that the immunization test suite requires recording of the country as part of the demographics, so I have now added in Country. I will make it a non required field so you can leave it blank. It is just there to pass the tests.

    PS: This apparently was an error in the part of NIST and the revised scripts 1.1 have the country removed from the addresses now. However, I can still leave the country in as it is too much effort to remove it now.
  19. Graham

    Graham Developer Staff Member

  20. Graham

    Graham Developer Staff Member

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