but physicians need to choose at least one even if only to claim the exclusion.
• Immunization registry: Perform one test of EHR’s capability to submit electronic data to immunization reg- istries and perform follow-up submis- sion if test is successful. Exclusion: Does not perform immunizations.
• Syndromic surveillance data: Per- form one test to provide electronic syndromic surveillance data to public health agencies, and perform follow- up submission if successful. Exclu- sion: Public health department does not accept syndromic surveillance data from ambulatory practices.
E-prescribing Five of the meaningful use measures are related to e-prescribing and medications. The CMS e-prescribing program is wind- ing down, as the EHR program includes e-prescribing measures.
Privacy and security Practices must ensure that protected health information is HIPAA-compliant at all times. Practices must conduct a se- curity risk analysis, taking appropriate action to correct any privacy or security shortfalls they identify and adopting on-
going privacy and security procedures. Having a designated compliance officer will help the practice regulate and moni- tor these actions. The Office of the Na- tional Coordinator for HIT has created a risk analysis tool accessible through the TMA HIPAA Resource Center at www
.texmed.org/HIPAA.
Stage 2 of meaningful use In Stage 1, physicians must meet 14 core objectives plus five of 10 menu ob- jectives, for a total of 19 objectives. Stage 2 will require meeting 17 core objectives (see Table 2 on page 53) plus three of six menu objectives (see Table 3 below), totaling 20. In regards to clinical quality measures, physicians must complete nine out of 64 measures.
Getting help Physicians needing help should consider the federally funded regional extension centers (RECs). RECs help with selection, implementation, meaningful use require- ments, and meaningful use attestation of EHRs. More information is available in the
Texas Medical Association’s Texas Re- gional Extension Center Resource Center at
www.texmed.org/hitrec.
CME instructions Remember to visit
www.texmed.org/ meaningfuluse to complete an online post-test and evaluation to receive CME credit.
Table 3. Stage 2 menu objectives (physicians must choose three). Menu Objective
Measure Imaging results Family history
Syndromic surveillance Cancer
Specialized registry Progress notes
54 TEXAS MEDICINE February 2014
More than 20 percent of imaging results accessible through certified electronic health record technology
Record family history for more than 20 percent
Successful ongoing transmission of syndromic surveillance data Successful ongoing transmission of cancer case information Successful ongoing transmission of data to a specialized registry
Enter an electronic progress note for more than 30 percent of unique patients
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