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You will select (2) Core objectives to enable EHRs to support healthcare from Stage 1. You will select (2) Menu objectives that provide flexibility for providers to choose from Stage 1 or Stage 2. Table 17-1 (Sewell text, chapter 17-1, p. 274). TABLE 17-1: Stages 1 and 2 Meaningful Use Core and Menu Objectives for Eligible Providers Core objectives to enable EHRs to support healthcare Stage 1 1. Use computerized provider order entry (CPOE). 2. Use drug–drug and drug–allergy interaction checks. 3. Maintain an up-to-date list of diagnoses. 4. Create and transmit prescriptions electronically. 5. Maintain an active medication list. 6. Maintain an allergy list. 7. Record demographics. 8. Record vital signs. 9. Record smoking status for patients 13 years and older. 10. Use one clinical decision support rule. 11. Provide patients the ability to view online, and transmit information within 4 days after information is available to the provider. 12. Provide clinical summaries for each office visit. 13. Protect electronic health information. Stage 2—Meet all 13 objectives above plus 4 additional ones. 1. Include clinical lab test results in the EHR. 2. Perform medication reconciliation. 3. Submit electronic data to immunization registries. 4. Use secure electronic messaging to communicate with patients on relevant health information. Menu objectives that provide flexibility for providers to choose Stage 1—Select 5 of the following menu objectives; at least 1 is a public health measure. 1. Implement drug formulary checks. 2. Use clinical lab test results in the EHR as structured data. 3. Create patient lists by condition for quality improvement, reduction of disparities, research, or outreach. 4. Send patient reminders for preventive and follow-up care. 5. Use certified EHR technology to provide patient education resources. 6. Perform medication reconciliation for patients received from another setting/provider. 7. Provide a summary of care for patients referred to another setting/provider. 8. Able to submit electronic immunization information. 9. Able to submit electronic syndromic surveillance data to public health agencies. Stage 2—Select 3 of the following menu objectives. 1. Submit electronic syndromic surveillance data to public health agencies. 2. Record patient notes electronically. 3. Have imaging results accessible in the EHR. 4. Record family history data. 5. Report cancer cases to public health cancer registry. 6. Report specific cases to a specialized registry. Source: The Eligible Professional Meaningful Use Table of Contents Core and Menu Set Objectives at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_MeaningfulUseSpecSheet_TableContents_EPs.pdf; the Eligible Professional’s Guide to Stage of the EHR Incentive Program at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_Guide_EPs_9_23_13.pdf To earn full credit, your paper must include the following components: A. Introduction and overview of the Meaningful Use Program – provide an overview of the Meaningful Use Program. Describe its significance to advanced practice registered nursing and the impact it has on the nursing profession. What is it? When did it originate? Why is it needed? What are the relationships between EMR, EHR, and ePHR to clinical information systems? What is the significance to the nursing profession, especially to the PCP? B. Discussion and analysis of the Meaningful Use Program (MUP) – describe and analyze the goals and objectives of meaningful use as well as its implications for nurses, nursing, national health policy, patient outcomes, and population health associated with the collection and use of meaningful use core criteria. Review the goals and objectives and discuss them. Is this something you see or deal with in your workplace? Discuss the implications – is the program effective? Is it affordable? Does it work? Does it really improve quality and efficiency of care? What are the strengths and weaknesses of MUP? Support your ideas with evidence-based practice. C. Core Requirements of the Meaningful Use Program – analyze how the core requirements are beneficial for advanced nurses, nursing, monitoring population health, setting national health policies, and/or improvements in patient outcomes or population health. Patients – discuss impact of MUP on the use of patient reminders, ePrescribing, electronic access, etc. Providers – does MUP assist providers in making more informed decisions, deliver better care, and create greater efficiencies? Nursing – does MUP help to prevent duplicative testing, eliminate adverse drug reactions, and enhance provider collaboration? Population health – does MUP encourage providers to send data to immunization registries and public health agencies? D. Challenges and recommendations – discuss current challenges with meaningful use seen in practice today and provide recommendations using evidence-based rationale. Challenges – lack of clear plan, cost, lack of oversight, privacy risks, concerns about sustainability Recommendations – realistic, scalable, and flexible starting point for adopting EHR, allow reasonable time for robust EHR use, ensure adequate training, better communication with physicians and providers E. Conclusion – summarize your findings and conclude by providing insights gained from your analysis. Do not introduce new concepts Summarize the highlights of your findings Offer your insights A minimum of 2 scholarly resources are required not including your texts. Your paper should be 2-3 pages, not including title and reference pages. Use current APA format to style your paper and to cite your sources. Your source(s) should be integrated into the paragraphs. Use internal citations pointing to evidence in the literature and supporting your ideas. Include a title page and a reference page listing the sources you used. Be sure to allow time for editing and proofreading. Review the rubric for more information on how your assignment will be graded. Due: Sunday, 11:59 p.m. (Pacific time) Points: 100 Rubric Meanigful Use Paper Rubric Meanigful Use Paper Rubric Criteria Ratings Pts This criterion is linked to a Learning Outcome Content 55 to >45.1 pts Responds clearly, thoroughly, and effectively to all aspects of the assignment. All content is accurate and/or supported. 45.1 to >41.25 pts Responds adequately to the assignment but may not be thorough. 41.25 to >0 pts Does not respond to the assignment. 55 pts This criterion is linked to a Learning Outcome Focus and Detail 25 to >20.5 pts There is a clear, well-focused topic. Main ideas are clear and are well supported by detailed and accurate information gathered from scholarly sources. 20.5 to >18.75 pts There is a clear, well-focused topic. Main ideas are clear but are not well supported by scholarly sources and detailed information. 18.75 to >0 pts The topic and main ideas are not clear. 25 pts This criterion is linked to a Learning Outcome Organization 10 to >8.2 pts The introduction is inviting, states the main topic, and provides an overview of the paper. Information is relevant and presented in a logical order. The conclusion is strong. 8.2 to >7.5 pts The introduction states the main topic and provides an overview of the paper. A conclusion is included. 7.5 to >0 pts There is no clear introduction, structure, or conclusion. 10 pts This criterion is linked to a Learning Outcome Mechanics and APA 10 to >8.2 pts The assignment consistently follows current APA format and is free of errors in formatting, citation, and references. There are no grammatical, spelling, or punctuation errors. All sources are correctly cited and referenced. 8.2 to >7.5 pts The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are correctly cited and referenced. 7.5 to >0 pts The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Many sources are incorrectly cited and referenced or citations and references are missing. 10 pts Total Points: 100