Name of person completing checklist: ______________________

Date: ______

Checklist for Meaningful Use Objectives

EVERY PATIENTAT LEAST ONE TIME EACH YEAR
Fill out the Patient History Form found in the Meaningful Use Training Summary for all Unique Patients who have an office visit during the reporting period. Then enter in the data from the forms into the EHR according to the instructions in training video so that you have entered in the following data: Remember, if there are no known meds or allergiesfor exampleenter in a selection of No Known Meds/Allergies, since you must have an entry of some type in each of the fields described below): Medications Allergies After entering in Meds and Allergies click on the drug-drug interaction inside RCopia meds/app every time you enter in or change a medication (same screen/see video). Problem List Demographics must include gender, race, ethnicity, preferred language, and DOB; also consider including email (optional). Smoking status, and if they answer Everyday or Someday smoker, create a follow-up appointment for the patient with a message/reminder to have the doctor discuss smoking cessation on next visit. Doctor must spend minimum of 3 minutes on discussion, and the CPT code for counseling would be entered in TX screen (see training video). Vital signs including blood pressure If they answer yes to Hypertension, enter in the Diagnosis of Hypertension on the problem list as a distinct problem at the bottom of the Problem List log. If they answered yes to Diabetes, enter a specific diagnosis of Diabetes on the problem list as a distinct problem at the bottom of the Problem List log (if applicable).

EVERY PATIENTEVERY OFFICE VISIT

1) Select either PRINT or EMAIL to send a clinical summary of the patients case and give it to the patient if printed. Ask them if the information is accurate and current. 2) If the patient asked to receive a copy of their health information, send to their email on the spot or within 3 days. 3) If a patient is referred to another doctor outside the clinic, get the email of that doctor and send the clinical summary form. (See training video).

IMPORTANT: COMPLETE BACK SIDE OF THIS FORM FOR COMPLIANCE

2011 Future Health

1109-19

COMPLETE THIS CHECKLIST MONTHLY

1) All patients with hypertension, positive smoking status or abnormal BMI, go to the EHR Scorecard for measure Clinical Quality Reporting and check on patients on the list who need to be reported upon. Submit quality reporting to CMS (see training video). 2) Go to the clinical decision support measure on the scorecard and validate that you have followed the smoking support rule related to counseling. 3) Print out or mail patient education information to minimally 10% of your patients that were seen in the clinic in the reporting period. The educational material must be related to their diagnosis. Mail it or hand it to them on their visit. 4) Send a reminder letter or a phone call to patients over the age of 65 and age 5 and under who should be seen for a preventative appointment. Document in the EHR log the reminder list was generated (see training video). 5) Any lab test ordered by the doctor (i.e. UA /blood) should be entered into the lab EHR section.

Initials/Date

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PERFORM ONCE IN THE REPORTING PERIOD (90 days reporting in 1st year; annually after that)
(see corresponding video for training) 1) Test sending a clinical care summary by sending to another provider of care electronically. Consider a doctor that you know well. Confirm that the test was sent successfully. Document the test and date. 2) Generate a list of patients that have a specific diagnosis code. You can select any code, but consider 784.0 or one that has several patients on it. Document the generation of the report in your Meaningful Use Compliance file. 3) Perform a test of sending a syndromic diagnosis to a public agency in your state if that agency accepts syndromic reporting. If they do accept, confirm that the test report was received. If they DO NOT accept syndromic reporting in your state, document your state does not accept such reporting.

Initials/Date

2011 Future Health

1109-19