Meaningful Use Stage 2 Notice of Proposed Rule-Making
This form is meant to provide patients an easy way to comment on the Meaningful Use Stage 2 Notice of Proposed Rule-Making. Please fill out the information below.

For a bookmarked copy of the proposed rules, follow this link. http://goo.gl/A710H

The deadline for public comments is May 7 2012, and we are looking to receive patient feedback by April 24 2012.
Secure Messaging with Patients
Objective: Use secure messaging to communicate with patients on relevant health information.

Measure: A secure message was sent using the electronic messaging function of Certified EHR Technology by more than 10 percent of unique patients seen during the EHR reporting period.
Secure Messaging with Patients
MU Objective: Use secure electronic messaging to communicate with patients on relevant health information. Ambulatory setting only – secure messaging. Enable a user to electronically send messages to, and receive messages from, a patient in a manner that ensures: (i) Both the patient and EHR technology are authenticated; and (ii) The message content is encrypted and integrity-protected in accordance with the standard for encryption and hashing algorithms specified at § 170.210(f). Standard § 170.210(f) Any encryption and hashing algorithm identified by the National Institute of Standards and Technology (NIST) as an approved security function in Annex A of the Federal Information Processing Standards (FIPS) Publication 140-2.
Your answer
Patient Education Resources
Objective: Use Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient.

Measure: Patient-specific education resources identified by Certified EHR Technology are provided to patients for more than 10 percent of all office visits by the Eligible Provider.
More than 10 percent of all unique patients admitted to the eligible hospital's or CAH's inpatient or emergency departments (POS21 or 23) are provided patient-specific education resources identified by Certified EHR Technology.
Patient Education Resources
§ 170.314(a)(16) - Patient-specific education resources MU Objective Use clinically relevant information from Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient. 2014 Edition EHR Certification Criterion Patient-specific education resources. Enable a user to electronically identify and provide patient-specific education resources according to: (i) At a minimum, each one of the data elements included in the patient's: problem list; medication list; and laboratory tests and values/results; and (ii) The standard specified at § 170.204(b)(1). Standard § 170.204(b)(1) (HL7 Context-Aware Knowledge Retrieval (Infobutton) Standard, International Normative Edition 2010).
Your answer
E-Prescribing
Objective: Generate and transmit permissible prescriptions electronically (eRx)

Measure: More than 65 percent of all permissible prescriptions written by the EP are compared to at least one drug formulary and transmitted electronically using Certified EHR Technology.
E-Prescribing
§ 170.314(b)(3) - Electronic prescribing [Note: this is a revised certification criterion for the ambulatory setting and why this table appears twice, see page 7] MU Objective Generate and transmit permissible prescriptions electronically (eRx) 2014 Edition EHR Certification Criterion Electronic prescribing. Enable a user to electronically create prescriptions and prescription-related information for electronic transmission in accordance with: (i) The standard specified in § 170.205(b)(2); and (ii) At a minimum, the version of the standard specified in § 170.207(h)..
Your answer
Patient Visit Summaries (Ambulatory/Outpatient)
Objective: Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the Eligible Provider.

Measures:
1) More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timeline (within 4 business days after the information is available to the EP) online access to their helath information subject to the EP's discretion to withhold certain information
2) More than 10 percent of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download, or transmit to a third party their health information.
Patient Visit Summaries
§ 170.314(e)(2) - Clinical summaries MU Objective Provide clinical summaries for patients for each office visit. 2014 Edition EHR Certification Criterion Ambulatory setting only – clinical summaries. Enable a user to provide clinical summaries to patients for each office visit that include, at a minimum, the following data elements: provider’s name and office contact information; date and location of visit; reason for visit; patient’s name; gender; race; ethnicity; date of birth; preferred language; smoking status; vital signs and any updates; problem list and any updates; medication list and any updates; medication allergy list and any updates; immunizations and/or medications administered during the visit; procedures performed during the visit; laboratory tests and values/results, including any tests and values/results pending; clinical instructions; care plan, including goals and instructions; recommended patient decision aids (if applicable to the visit); future scheduled tests; future appointments; and referrals to other providers. If the clinical summary is provided electronically, it must be: (i) Provided in human readable format; and (ii) Provided in a summary care record formatted according to the standard adopted at § 170.205(a)(3) with the following data elements expressed, where applicable, according to the specified standard(s): (A) Race and ethnicity. The standard specified in § 170.207(f); (B) Preferred language. The standard specified in § 170.207(j); (C) Smoking status. The standard specified in § 170.207(l); (D) Problems. At a minimum, the version of the standard specified in § 170.207(a)(3); (E) Encounter diagnoses. The standard specified in § 170.207(m); (F) Procedures. The standard specified in § 170.207(b)(2) or § 170.207(b)(3); (G) Laboratory test(s). At a minimum, the version of the standard specified in § 170.207(g); (H) Laboratory value(s)/result(s). The value(s)/results of the laboratory test(s) performed; and (I) Medications. At a minimum, the version of the standard specified in § 170.207(h). Standards § 170.205(a)(3) (Consolidated CDA); § 170.207(f) (OMB standards for the classification of federal data on race and ethnicity); § 170.207(j) (ISO 639-1:2002 (preferred language)); § 170.207(l) (smoking status types); § 170.207(a)(3) (SNOMED-CT® International Release January 2012); § 170.207(m) (ICD-10-CM); § 170.207(b)(2) (HCPCS and CPT-4) or § 170.207(b)(3) (ICD-10-PCS); § 170.207(g) (LOINC version 2.38); § 170.207(h) (RxNorm February 6, 2012 Release).
Your answer
Patient Visit Summaries (Eligible Hospital or CAH)
Objective: Provide patients the ability to view online, download, and transmit information about a hospital admission

Measures:
1) More than 50 percent of all patients who are discharged from the inpatient or emergency department (POS 21 or 23) of an eligible hospital or CAH have their information online within 36 hours of discharge.
2) More than 10 percent of all patients who are discharged from the inpatient or emergency department (POS 21 or 23) of an eligible hospital or CAH view, download or transmit to a third party their information during the reporting period.
Patient Visit Summaries
§ 170.314(e)(2) - Clinical summaries MU Objective Provide clinical summaries for patients for each office visit. 2014 Edition EHR Certification Criterion Ambulatory setting only – clinical summaries. Enable a user to provide clinical summaries to patients for each office visit that include, at a minimum, the following data elements: provider’s name and office contact information; date and location of visit; reason for visit; patient’s name; gender; race; ethnicity; date of birth; preferred language; smoking status; vital signs and any updates; problem list and any updates; medication list and any updates; medication allergy list and any updates; immunizations and/or medications administered during the visit; procedures performed during the visit; laboratory tests and values/results, including any tests and values/results pending; clinical instructions; care plan, including goals and instructions; recommended patient decision aids (if applicable to the visit); future scheduled tests; future appointments; and referrals to other providers. If the clinical summary is provided electronically, it must be: (i) Provided in human readable format; and (ii) Provided in a summary care record formatted according to the standard adopted at § 170.205(a)(3) with the following data elements expressed, where applicable, according to the specified standard(s): (A) Race and ethnicity. The standard specified in § 170.207(f); (B) Preferred language. The standard specified in § 170.207(j); (C) Smoking status. The standard specified in § 170.207(l); (D) Problems. At a minimum, the version of the standard specified in § 170.207(a)(3); (E) Encounter diagnoses. The standard specified in § 170.207(m); (F) Procedures. The standard specified in § 170.207(b)(2) or § 170.207(b)(3); (G) Laboratory test(s). At a minimum, the version of the standard specified in § 170.207(g); (H) Laboratory value(s)/result(s). The value(s)/results of the laboratory test(s) performed; and (I) Medications. At a minimum, the version of the standard specified in § 170.207(h). Standards § 170.205(a)(3) (Consolidated CDA); § 170.207(f) (OMB standards for the classification of federal data on race and ethnicity); § 170.207(j) (ISO 639-1:2002 (preferred language)); § 170.207(l) (smoking status types); § 170.207(a)(3) (SNOMED-CT® International Release January 2012); § 170.207(m) (ICD-10-CM); § 170.207(b)(2) (HCPCS and CPT-4) or § 170.207(b)(3) (ICD-10-PCS); § 170.207(g) (LOINC version 2.38); § 170.207(h) (RxNorm February 6, 2012 Release).
Your answer
Patient Reminders (Ambulatory/Outpatient)
Objective: Use clinically relevant information to identify patients who should receive reminders for preventative/follow-up care

Measure: More than 10 percent of all unique patients who have had an office visit with the Eligible Providers within the 24 months prior to the beginning of the EHR reporting period were sent a reminder, per patient preference.
Patient Reminders
§ 170.314(a)(15) - Patient reminders MU Objective Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care. 2014 Edition EHR Certification Criterion Ambulatory setting only – patient reminders. Enable a user to electronically create a patient reminder list for preventive or follow-up care according to patient preferences based on, at a minimum, the data elements included in: (i) Problem list; (ii) Medication list; (iii) Medication allergy list; (iv) Demographics; and (v) Laboratory tests and values/results.
Your answer
Provide Clinical Summaries (Ambulatory/Outpatient)
Objective: Provide clinical summaries for patients for each office visit.

Measure: Clinical summaries provided to patients within 24 hours for more than 50 percent of office visits.
Clinical Summaries (Outpatient/Ambulatory)
MU Objective Provide clinical summaries for patients for each office visit. 2014 Edition EHR Certification Criterion Ambulatory setting only – clinical summaries. Enable a user to provide clinical summaries to patients for each office visit that include, at a minimum, the following data elements: provider’s name and office contact information; date and location of visit; reason for visit; patient’s name; gender; race; ethnicity; date of birth; preferred language; smoking status; vital signs and any updates; problem list and any updates; medication list and any updates; medication allergy list and any updates; immunizations and/or medications administered during the visit; procedures performed during the visit; laboratory tests and values/results, including any tests and values/results pending; clinical instructions; care plan, including goals and instructions; recommended patient decision aids (if applicable to the visit); future scheduled tests; future appointments; and referrals to other providers. If the clinical summary is provided electronically, it must be: (i) Provided in human readable format; and (ii) Provided in a summary care record formatted according to the standard adopted at § 170.205(a)(3) with the following data elements expressed, where applicable, according to the specified standard(s): (A) Race and ethnicity. The standard specified in § 170.207(f); (B) Preferred language. The standard specified in § 170.207(j); (C) Smoking status. The standard specified in § 170.207(l); (D) Problems. At a minimum, the version of the standard specified in § 170.207(a)(3); (E) Encounter diagnoses. The standard specified in § 170.207(m); (F) Procedures. The standard specified in § 170.207(b)(2) or § 170.207(b)(3); (G) Laboratory test(s). At a minimum, the version of the standard specified in § 170.207(g); (H) Laboratory value(s)/result(s). The value(s)/results of the laboratory test(s) performed; and (I) Medications. At a minimum, the version of the standard specified in § 170.207(h). Standards § 170.205(a)(3) (Consolidated CDA); § 170.207(f) (OMB standards for the classification of federal data on race and ethnicity); § 170.207(j) (ISO 639-1:2002 (preferred language)); § 170.207(l) (smoking status types); § 170.207(a)(3) (SNOMED-CT® International Release January 2012); § 170.207(m) (ICD-10-CM); § 170.207(b)(2) (HCPCS and CPT-4) or § 170.207(b)(3) (ICD-10-PCS); § 170.207(g) (LOINC version 2.38); § 170.207(h) (RxNorm February 6, 2012 Release).
Your answer
Accounting of Disclosures
§ 170.314(d)(9) - Accounting of disclosures MU Objective Protect electronic health information created or maintained by the Certified EHR Technology through the implementation of appropriate technical capabilities. 2014 Edition EHR Certification Criterion Optional – accounting of disclosures. Record disclosures made for treatment, payment, and health care operations in accordance with the standard specified in §170.210(d).
Your answer
Advance Directives
Objective: Record whether a patient 65 years old or older has an advance directive.

Measure: More than 50 percent of all unique patients 65 years old or older admitted to the eligible hospital's or CAH's inpatient department (POS 21) during the EHR reporting period have an indication of an advance directive status recorded as structured data.
Advance Directives
§ 170.314(a)(18) - Advance directives MU Objective Record whether a patient 65 years old or older has an advance directive. 2014 Edition EHR Certification Criterion Inpatient setting only – advance directives. Enable a user to electronically record whether a patient has an advance directive.
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Additional Comments
If you have any additional commments on the proposed rulemaking, please put them here.
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