Table 1.
Stage 1 and stage 2 meaningful use (MU) objectives categorized by primary care attribute
| MU objectives | Stage 1 objectives | Stage 2 objectives |
|---|---|---|
| IOM primary care attribute: accessibility | ||
| Secure messaging | No measure | Use secure messaging for 10% of patient communications (C) |
| IOM primary care attribute: coordination | ||
| CPOE | Use CPOE for medication orders for 30% of patients (C) | Use CPOE for medication, laboratory results, and radiology orders for 60% of patients, includes drug-formulary check (C) |
| Drug-formulary checks | Implement drug-formulary checks (C) | |
| ePrescribing | Generate and transmit 40% of prescriptions electronically (C) | Generate and transmit 65% of prescriptions electronically (C) |
| Summary of care | Provide patient care summaries for 50% of care transitions (C)* | Provide patient care summaries for 65% of care transitions, includes up-to-date problem, medication, and allergy lists (C) |
| Problem list | Maintain an up-to-date problem list for 80% of patients (C)† | |
| Medication list | Maintain an active medication list for 80% of patients (C)† | |
| Medication allergy list | Maintain an active medication allergy list for 80% of patients (C)† | |
| Timely electronic access to health information | Provide 10% of patients timely electronic access to health information (E) | View, download, and transmit to 3rd party—revised objectives to provide 50% of patients the ability to view, download, and transmit health information electronically (C) |
| Electronic copy of health information | Provide patients with an electronic copy of their health information (C) | |
| Electronic copy of discharge instructions | No measure | |
| IOM primary care attribute: sustained care | ||
| Patient reminders | Send reminders to 20% of patients for follow-up care (E) | Send reminders to 20% of patients for follow-up care (C) |
| Patient list | Generate one list of patients by condition for outreach (E) | Generate one list of patients by condition for outreach (C) |
| IOM primary care attribute: comprehensiveness | ||
| Vital signs | Record vital signs (height, weight, blood pressure, BMI) on 50% patients (C) | Record vital signs (height, weight, blood pressure, BMI) on 50% patients (C) |
| Smoking status | Record 50% of patients’ smoking status (C) | Record 80% of patients’ smoking status (C) |
| Medication reconciliation | Perform medication reconciliation on 50% of patients (E) | Perform medication reconciliation on 65% of patients (C) |
| Laboratory results into EHR | Incorporate 40% of laboratory results as structured data (E) | Incorporate 55% of laboratory results as structured data (C) |
| Imaging results | No measure | 40% of imaging results and information accessible through the EHR (E) |
| IOM primary care attribute: partnership with patients | ||
| Clinical summaries for office visits | Provide patients a clinical summary after 50% of office visits (C) | Provide patients a clinical summary after 50% of office visits (C) |
| Patient-specific education | Identify patient-specific education resources for 10% of patients (E) | Identify patient-specific education resources for 10% of patients (C) |
| Advance directives | Record advanced directives for 50% of patients over 65 years (E) | Record advanced directives for 50% of patients over 65 years(E) |
| IOM primary care attribute: person-centered | ||
| Demographics | Record demographics (language, gender, race, ethnicity, date of birth) on 50% patients (C) | Record demographics (language, gender, race, ethnicity, date of birth) on 80% patients (C) |
| Family history | No measure | Family history (E) |
| IOM primary care attribute: integrated | ||
| CDS | Implement 1 clinical decision support rule (C) | Implement 5 clinical decision support rules counting drug–drug and drug–allergy interactions (C) |
| Drug–drug and drug–allergy interactions | Implement drug–drug and drug–allergy interaction checks (C) | |
| Immunization registry | Be capable of submitting electronic data to immunization registries (E) | Be capable of submitting electronic data to immunization registries (C) |
| Laboratory results to public health agency | Be capable of submitting electronic laboratory results to public health agencies (E) | Be capable of submitting electronic laboratory results to public health agencies (E) |
| Specialized registry | No measure | Be capable of identifying and reporting specific cases to a specialized registry (E) |
| Cancer registry | No measure | Be capable of identifying and reporting cancer cases to a State registry (E) |
| Privacy and security | Protect electronic health information (C) | Protect electronic health information (C) |
*The stage 1 objective is better categorized as ‘partnership with patients’, but the stage 2 modification is categorized as ‘coordinated’.
†The stage 1 objective is better categorized as ‘comprehensive’, but the stage 2 modification is categorized as ‘coordinated’.
BMI, body mass index; C, core (required) MU objective; CDS, clinical decision support; CPOE, computerized physician order entry; E, elective MU objective; EHR, electronic health record; IOM, Institute of Medicine.