PUBLIC HEALTH MU OBJECTIVES…

STAGE 2

3/14/2013

Specific to Stage 2 MU Public Health Objectives, the capability to submit electronic data for Immunizations, Reportable Laboratory Results and
Syndromic Surveillance are all in the core set for EH’s. Two new public health objectives for EP’s have been added to the menu set , and include the
capability to identify and report 1) Cancer cases to cancer registry and 2) specific case to a specialized registry (other than a cancer registry)
STAGE 2 PUBLIC HEALTH MU OBJECTIVES…

MEANINGFUL
2014 Edition EHR
USE MEANINGFUL
42 CFR 495.6(j)-
CERTIFICATION STANDARDS
USE
(m) Stage 2 42 CFR 495.6(j)-(m)
CRITERIA
45 CFR 170.314
EP EH Objective

Performed at least § 170.205(g) – HL7 2.5.1.

one test of CEHRT’s Implementation specifications: HL7
Inpatient setting only—transmission of reportable Version 2.5.1 Implementation Guide:
Capability to capacity to provide
laboratory tests and values/results. Electronic Laboratory Reporting to
submit electronic electronic submission
data on reportable or reportable lab Public Health, Release 1 (US Realm)
EHR technology must be able to electronically with Errata and Clarifications, and ELR
(as required by results to public
create reportable laboratory tests and values/results 2.5.1 Clarification Document for EHR
State or local law) health agencies and
for electronic transmission in accordance with: Technology Certification.
lab results to public follow up submission
CORE

EH health agencies if the test is successful

 (i) The standard (and applicable § 170.207(a)(3) – IHTSDO SNOMED
and actual (unless none of the
implementation specifications) specified in § CT® International Release, July 2012
submission except public health agencies
170.205(g); and and US Extension to SNOMED CT,®
where prohibited to which the EH or
 (ii) At a minimum, the versions of the March 2012 Release.
and according to CAH submits such
standards specified in § 170.207(a)(3) and
applicable law and information have the
(c)(2). § 170.207(c)(2) – LOINC® version 2.40,
practice. capacity to receive
the information June 2012, a universal code system for
electronically). indentifying laboratory and clinical
observations produced by the
Regenstrief Institute, Inc

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STAGE 2 PUBLIC HEALTH MU OBJECTIVES…

MEANINGFUL
2014 Edition EHR
USE MEANINGFUL
42 CFR 495.6(j)-
CERTIFICATION STANDARDS
USE
(m) Stage 2 42 CFR 495.6(j)-(m)
CRITERIA
45 CFR 170.314
EP EH Objective

 § 170.205(e)(3) – HL7 2.5.1.

Immunization information. Enable a user to
Implementation specifications:
Capability to Successful ongoing electronically record, change, and access
Hl7 2.5.1 Implementation
submit electronic submission of immunization information.
Guide for Immunization
data to electronic Transmission to immunization registries. EHR
Messaging, Release 1.4
immunization immunization data technology must be able to electronically create
registries or from CEHRT to an immunization information for electronic
immunization immunization registry transmission in accordance with:

CORE

§ 170.207(e)(2) – HL7 Standard

EP EH information or immunization
Code Set CVX -- Vaccines
systems, except information system  The standard and applicable implementation
Administered, updates through
where prohibited, for the entire specifications specified in § 170.205(e)(3);
July 11, 2012.
and in accordance reporting period. and
with applicable law
and practice.  At a minimum, the version of the standard
specified in § 170.207(e)(2).

*Exclusions apply: see

CMS rule for details

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STAGE 2 PUBLIC HEALTH MU OBJECTIVES…

MEANINGFUL
2014 Edition EHR
USE MEANINGFUL
42 CFR 495.6(j)-
CERTIFICATION STANDARDS
USE
(m) Stage 2 42 CFR 495.6(j)-(m)
CRITERIA
45 CFR 170.314
EP EH Objective

Transmission to public health agencies – syndromic

 § 170.205(d)(2) – HL7 2.5.1.
surveillance. EHR technology must be able to
Successful ongoing
electronically create syndrome-based public health
Capability to submission of  § 170.205(d)(3) – HL7 2.5.1.
surveillance information for electronic transmission
submit electronic electronic Implementation specifications:
in accordance with:
syndromic immunization data PHIN Messaging Guide for
surveillance data to from CEHRT to an Syndromic Surveillance and
Ambulatory setting only.
public health immunization registry Conformance Clarification for
CORE

(A)The standard specified in § 170.205(d)(2).

EH agencies, except or immunization EHR Certification of Electronic
(B) Optional. The standard (and applicable
where prohibited, information system Syndromic Surveillance,
implementation specifications) specified in §
and in accordance for the entire Addendum to PHIN Messaging
170.205(d)(3).
with applicable law reporting period. Guide for Syndromic
and practice. Surveillance.
Inpatient setting only. The standard (and applicable
implantation specifications) specified in §
170.205(d)(3).

*Exclusions apply: see

CMS rule for details

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STAGE 2 PUBLIC HEALTH MU OBJECTIVES…

MEANINGFUL
2014 Edition EHR
USE MEANINGFUL
42 CFR 495.6(j)-
CERTIFICATION STANDARDS
USE
(m) Stage 2 42 CFR 495.6(j)-(m)
CRITERIA
45 CFR 170.314
EP EH Objective

Transmission to public health agencies – syndromic

surveillance.  § 170.205(d)(2) – HL7 2.5.1.
Successful ongoing EHR technology must be able to electronically create
Capability to submission of syndrome-based public health surveillance  § 170.205(d)(3) – HL7 2.5.1.
submit electronic electronic information for electronic transmission in Implementation specifications:
syndromic immunization data accordance with: PHIN Messaging Guide for
surveillance data to from CEHRT to an Syndromic Surveillance and
public health immunization registry (i) Ambulatory setting only. (A) The standard Conformance Clarification for
MENU

EP agencies, except or immunization specified in § 170.205(d)(2). EHR Certification of Electronic

where prohibited, information system (B) Optional. The standard (and applicable Syndromic Surveillance,
in accordance with for the entire implementation specifications) specified in § Addendum to PHIN Messaging
applicable law and reporting period. 170.205(d)(3). Guide for Syndromic
practice. Surveillance.
(ii) Inpatient setting only. The standard (and
applicable implantation specifications) specified in §
170.205(d)(3).

*Exclusions apply: see

CMS rule for details

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STAGE 2 PUBLIC HEALTH MU OBJECTIVES…

MEANINGFUL
2014 Edition EHR
USE MEANINGFUL
42 CFR 495.6(j)-
CERTIFICATION STANDARDS
USE
(m) Stage 2 42 CFR 495.6(j)-(m)
CRITERIA
45 CFR 170.314
EP EH Objective

 § 170.205(i) – HL7 Clinical

Document Architecture (CDA),
Release 2.0, Normative Edition
Optional—ambulatory setting only—cancer case Implementation specifications:
information. Implementation Guide for
Enable a user to electronically record, change, and Ambulatory Healthcare
Successful ongoing
access cancer case information. Provider Reporting to Central
Capability to submission of
Cancer Registries, HL7 Clinical
identify and report electronic
Optional—ambulatory setting only—transmission to Document Architecture (CDA).
cancer cases to a immunization data
cancer registries.
public health from CEHRT to an
EHR technology must be able to electronically create  § 170.207(a)(3) – IHTSDO
central cancer immunization registry
Menu

cancer case information for electronic transmission SNOMED CT® International

EP registry, except or immunization
in accordance with: Release, July 2012 and US
where prohibited, information system
Extension to SNOMED CT,®
and in accordance for the entire
(i) The standard (and applicable March 2012 Release.
with applicable law reporting period.
implementation specifications) specified
and practice.
in § 170.205(i); and  170.207(c)(2) – LOINC® version
(ii) (ii) At a minimum, the versions of the 2.40, June 2012, a universal
standards specified in § 170.207(a)(3) code system for indentifying
and (c)(2). laboratory and clinical
observations produced by the
*Exclusions apply: see
Regenstrief Institute, Inc.
CMS rule for details

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STAGE 2 PUBLIC HEALTH MU OBJECTIVES…

MEANINGFUL
2014 Edition EHR
USE MEANINGFUL
42 CFR 495.6(j)-
CERTIFICATION STANDARDS
USE
(m) Stage 2 42 CFR 495.6(j)-(m)
CRITERIA
45 CFR 170.314
EP EH Objective

Successful ongoing
Capability to submission of
identify and report electronic
cancer cases to a immunization data
public health from CEHRT to an
central cancer immunization registry
Menu

No specific certification criteria or standards

EP registry, except or immunization
adopted. Use of data from CEHRT required.
where prohibited, information system
and in accordance for the entire
with applicable law reporting period.
and practice.

*Exclusions apply: see

CMS rule for details

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STAGE 2 PUBLIC HEALTH MU OBJECTIVES…
DATA
Common MU Data Set means the following data expressed,
where indicated, according to the specified standard(s):
(1) Patient name.
(2) Sex.
(3) Date of birth.
(4) Race – the standard specified in § 170.207(f).
(5) Ethnicity – the standard specified in § 170.207(f).
(6) Preferred language – the standard specified in §
170.207(g).
(7) Smoking status – the standard specified in § 170.207(h).
COMMON MU DATA SET
(8) Problems – at a minimum, the version of the standard
specified in § 170.207(a)(3)
(9) Medications– at a minimum, the version of the standard
specified in § 170.207(d)(2).
(10) Medication allergies – at a minimum, the version of the
standard specified in § 170.207(d)(2).
(11) Laboratory test(s) – at a minimum, the version of the
standard specified in § 170.207(c)(2).
(12) Laboratory value(s)/result(s).
(13) Vital signs – height, weight, blood pressure, BMI.
(14) Care plan field(s), including goals and instructions.
(15) Procedures –
(i) At a minimum, the version of the standard specified in §
170.207(a)(3) or § 170.207(b)(2).
(ii) Optional. The standard specified at § 170.207(b)(3).
(iii) Optional. The standard specified at § 170.207(b)(4).
(16) Care team member(s).
STANDARDS
 § 170.207(f) – OMB standards for Maintaining, Collecting, and
Presenting Federal Data on Race and Ethnicity, Statistical Policy
Directive No. 15, Oct 30, 1997.
 § 170.207(g) – ISO 639-2 alpha-3 codes limited to those that also
have a corresponding alpha-2 code in ISO 639-1.
 § 170.207(h) – Coded to one of the following SNOMED CT® codes:
(1) Current every day smoker. 449868002
(2) Current some day smoker. 428041000124106
(3) Former smoker. 8517006
(4) Never smoker. 266919005
(5) Smoker, current status unknown. 77176002
(6) Unknown if ever smoked. 266927001
(7) Heavy tobacco smoker. 428071000124103
(8) Light tobacco smoker. 428061000124105
 § 170.207(a)(3) – IHTSDO SNOMED CT® International Release, July
2012; and US Extension to SNOMED CT,® March 2012.
 § 170.207(d)(2) – RxNorm, August 6, 2012 Release.
 § 170.207(c)(2) – LOINC® version 2.40, June 2012, a universal code
system for indentifying laboratory and clinical observations
produced by the Regenstrief Institute, Inc.
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