Meaningful Use Workgroup June 24, 2013

1. Meaningful Use WorkgroupJune 24, 2013 Paul Tang, chair George Hripcsak, co-chair

2. Agenda • Subgroup 1 - Universal device identifier (UDI) • David Bates • Subgroup 3 review of recommendations • Charlene Underwood

3. UDI - 123 Stage

4. Meaningful Use WorkgroupSubgroup 3 – Improving Care Coordination Charlene Underwood, Subgroup Chair Paul Tang, MU WG Chair

5. Improving Care Coordination Objectives • Reconciliation – 302 • Care summary – 303 • Referral loop – 305 (consolidated) • Care plan - 304 (future stage) • Interdisciplinary problem list -127 (consolidated) • Follow-up on notifications – 308 (certification only) • Med adherence/PDMP – 125 (future stage)

6. Reconciliation - 302 • Certification stage 2 includes clinical information reconciliation (active medications, problems, and medication allergies) • Intent change to ensuring data integrity - include CDS for problems, medications, and med allergies in subgroup 1 objectives. § 170.314 (b)(4) Clinical Information Reconciliation: Enable a user to electronically reconcile the data that represent a patient’s active medication, problem, and medication allergy list as follows. For each list type: (i) Electronically and simultaneously display (i.e., in a single view) the data from at least two list sources in a manner that allows a user to view the data and their attributes, which must include, at a minimum, the source and last modification date. (ii) Enable a user to create a single reconciled list of medications, medication allergies, or problems. (iii) Enable a user to review and validate the accuracy of a final set of data and, upon a user’s confirmation, automatically update the list.

7. SGRP113: Clinical Decision Support • Additional certification criteria? • 6. Ability to use structured information within systems to support clinicians’ maintenance of up-to-date accurate problem lists, med lists, and med allergy lists.  Systems provide decision support about additions, edits, and deletions for review and action, but would not automatically add anything to these lists without professional action. • EHR systems should provide functionality to code medication allergies including its related drug family to code related reactions.

8. IE WG: informing provider directories • Added order tracking for results into test tracking (122) • FU w/ Standards in 5-6 weeks: Need to find balance between high priority transition of care use cases and additional data capture required with actual needs of receiving provider. Should there be query capability? Care Summary - 303 CC#3: MU WG to decided whether to include?

9. Care Summary – 303 (II)

10. Referral loop – 305Consolidated in Care Summary 303 • Eliminated to fulfill use case of sending back a referral specific CDA • Include in care plan

11. Future Stage Care Plan - 304

12. Interdisciplinary Prob list – 127Consolidated Moved to care plan (304) objective and included in CDS objective (113)

13. Notifications – 308 Certification ONLY

14. Med Adherence, PDMP - 125 Future Stage