Appendix Exhibit 7.

Final Stage 1 Meaningful Use Rule for Eligible Hospitals and Analogous AHA IT Survey Question

Objective and Measure	Analogous AHA IT Question
Core Set (Mandatory 14 Objectives)
Objective: Record patient demographics (gender, race, ethnicity, date of birth, preferred language, and date and preliminary cause of death in the event of mortality) Measure: More than 50% of patients’ demographic data recorded as structured data	Does your hospital have a computerized Electronic Clinical Documentation system for Patient demographics?
Objective Record and chart changes in vital signs (height, weight, blood pressure, calculate and display body-mass index, plot and display growth charts for children 2–20 years, including BMI) Measure: More than 50% of patients 2 years of age or older have height, weight, and blood pressure recorded as structured data	N/A
Objective: Maintain up-to-date problem list of current and active diagnoses Measure: More than 80% of patients have at least one entry recorded as structured data	Does your hospital have a computerized Electronic Clinical Documentation system for Problem Lists?
Objective: Maintain active medication list Measure: More than 80% of patients have at least one entry recorded as structured data	Does your hospital have a computerized Electronic Clinical Documentation system for Medication Lists?
Objective: Maintain active medication allergy list Measure: More than 80% of patients have at least one entry recorded as structured data	N/A
Objective: Record smoking status for patients 13 years old or older Measure: More than 50% of patients 13 years of age or older have smoking status recorded as structured data	N/A
Objective: Provide patients an electronic copy of hospital discharge instructions at time of discharge, upon request Measure: Clinical summaries provided to patients for more than 50% of all patients who are discharged from the inpatient department or emergency department of an eligible hospital or critical access hospital and who request an electronic copy of their discharge instructions are provided with it	N/A
Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies, discharge summary and procedures) upon request Measure: More than 50% of requesting patients receive electronic copy within 3 business days	Does your hospital have a computerized Electronic Clinical Documentation system for Discharge Summaries?
Objective: Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines Measure: More than 30% of patients with at least one medication in their medication list have at least one medication ordered through CPOE	Does your hospital have a Computerized Provider Order Entry system for Medications?
Objective: Implement drug–drug and drug allergy interaction checks Measure: Functionality is enabled for these checks for the entire reporting period	Does your hospital system for Computerized Provider Order Entry for Medications have drug-drug and drug- allergy checks?
Objective: Capability to electronically exchange key clinical information (for example, discharge summary, procedures, problem list, medication list, medication allergies, diagnostic test results), among providers of care and patient authorized entities electronically Measure: Perform at least one test of EHR’s capacity to electronically exchange information	Does your hospital electronically exchange any of the following patient data with hospitals or ambulatory provides outsides your system? (1) Patient demographics; (2) Clinical Care Record; (3) Lab results; (4) Medication history; or (5) Radiology reports?
Objective: Implement one clinical decision support rule relevant to high priority hospital condition along with ability to track compliance with that rule Measure: One clinical decision support rule implemented	Does your hospital have a computerized Decision Support System which allows for: (1) Clinical Guidelines; (2) Clinical Reminders; (3) Drug-Lab Interaction Alerts; (4) Drug Dosing Support?
Objective: 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, implement security updates as necessary, and correct identified security deficiencies	N/A
Objective: Report hospital clinical quality measures to CMS or states Measure: For 2011, provide aggregate numerator and denominator through attestation; for 2012, electronically submit measures	Does your electronic system allow you to automatically generate Hospital Quality Alliance measures by extracting data from an electronic record for a Medicare inpatient prospective payment system update?
Menu Set (Select any 5 of 10)
Objective: Implement drug formulary checks Measure: Drug formulary check system is implemented and has access to at least one internal or external drug formulary for the entire reporting period	N/A
Objective: Incorporate clinical lab-test results into certified EHR as structured data Measure: More than 40% of clinical laboratory test results whose results are in positive/negative or numerical format are incorporated into EHRs as structured data	Does your hospital have a computerized Results Viewing system which allows for the viewing of Lab results?
Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach Measure: Generate at least one listing of patients with a specific condition	N/A
Objective: Use EHR technology to identify patient-specific education resources and provide those to the patient if appropriate Measure: More than 10% of patients are provided patient-specific education resources	N/A
Objective: Perform medication reconciliation between care settings Measure: Medication reconciliation is performed for more than 50% of transitions of care	Does your electronic system allow you compare patient’s inpatient and preadmission medication lists?
Objective: Provide summary of care record for patients referred or transitioned to another provider or setting Measure: Summary of care record is provided for more than 50% of patient transitions or referrals	N/A
Objective: Capability to submit electronic data on immunizations registries or Immunization Information Systems and actual submission in accordance with applicable law and practice Measure: Perform at least one test of data submission and follow-up submission (where registries can accept electronic submissions)	N/A
Objective: Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice Measure: Perform at least one test of data submission and follow-up submission (where public health agencies can accept electronic data)	N/A
Objective: Record advance directives for patients 65 years of age or older Measure: More than 50% of patients 65 years of age or older have an indication of an advance directive status recorded	Does your hospital have a computerized Electronic Clinical Documentation system for Advanced directives?
Objective: Submit of electronic data on reportable laboratory results to public health agencies Measure: Perform at least one test of data submission and follow-up submission (where public health agencies can accept electronic data)	N/A

Source: HHS Centers for Medicare & Medicaid Services, “Medicare and Medicaid Programs; Electronic Health Record Incentive Program,” RIN 0938-AP78, 2010; Blumenthal D, Tavenner M. The “Meaningful Use” Regulation for Electronic Health Records. N Engl J Med. July 13; AHA Annual HIT Supplement of Acute Care Hospitals in the U.S.