5101:3-57-02 Medicaid provider incentive program (MPIP): certified electronic health record technology requirements, adopt, implement, or upgrade and meaningful use stage one.

(A) Certified electronic health record (EHR) technology.

(1) In order to qualify for incentive payments, eligible professionals and eligible hospitals are required to select and implement only certified EHR products consistent with the guidelines established by the office of the national coordinator of health information technology (ONC) found at 45 C.F.R. 170 (as in effect on July 28, 2010).

(2) Only MPIP applications that include certification numbers for products certified by the ONC authorized testing and certification bodies (ATCBs) and approved by the ONC will be accepted for processing by MPIP.

(B) Adopt, implement or upgrade (AIU).

(1) Eligible professionals and eligible hospitals applying for year one payment must meet AIU eligibility criteria as defined below:

(a) "Adopt" means acquiring, purchasing or securing access to certified EHR technology; or

(b) "Implement" means installing or commencing utilization of certified EHR technology capable of meeting meaningful use requirements. An eligible professional or eligible hospital must demonstrate actual installation of certified EHR technology prior to receiving an incentive payment, rather than effort to install certified EHR technology; or

(c) "Upgrade" means expanding the available functionality of certified EHR technology capable of meeting meaningful use requirements at the practice site, including staffing, maintenance, and training, or upgrade from existing EHR technology to certified EHR technology per the EHR certification criteria published by the ONC.

(2) Eligible professionals and eligible hospitals will be required to report which certified EHR technology they have adopted, implemented or upgraded to by providing supporting documentation through the MPIP system at the time of registration and attestation, in a manner specified by the Ohio department of job and family services (ODJFS).

(C) Meaningful use (MU) reporting periods.

(1) MU reporting periods for an eligible professional.

(a) For an eligible professionals second year of payment, the first year for which the eligible professional is demonstrating that he or she is a meaningful user of EHR, the EHR reporting period is a continuous ninety-day period within the calendar year (CY).

(b) For subsequent payment years, the EHR reporting period is the entire CY.

(2) MU reporting periods for an eligible hospital.

(a) For an eligible hospitals second year of payment, the first year for which the hospital is demonstrating that it is a meaningful user of EHR technology, the EHR reporting period is a continuous ninety-day period within the federal fiscal year (FFY).

(b) For subsequent payment years, the EHR reporting period is the entire (FFY).

(D) MU general requirements.

(1) "Meaningful use (MU)" means that certified EHR technology is connected in a manner that provides for the electronic exchange of health information to improve the quality of care and allows for the submission of clinical quality measures.

(2) Eligible professionals and eligible hospitals must attest to their meaningful use of certified EHR and will be required to provide MU standard specific information indicating that:

(a) The MU standard has been met; or

(b) The particular MU standard does not apply to the provider (and there will be no clinical quality measure); or

(c) The specific numerator and denominator, which represents the provider's experience with the MU standard.

(3) Dual eligible hospitals meeting MU criteria for the medicare EHR program will be deemed as meaningful users for MPIP, but will be required to meet additional MPIP program requirements.

(4) To be a meaningful EHR user, at least fifty per cent of an eligible professional's patient encounters during the EHR reporting period during the payment year must occur at a practice/location or practices/locations equipped with certified EHR technology. A practice/location is equipped with certified EHR technology if the certified EHR technology is available at the beginning of the EHR reporting period.

(5) An eligible professional who does not conduct fifty per cent of his or her patient encounters in any one practice/location must meet the fifty per cent threshold through a combination of practices/locations equipped with certified EHR technology.

(6) All MU objectives and measures are limited to actions taken by an eligible professional or eligible hospital at practices/locations equipped with certified EHR technology.

(7) Count of unique patients or actions by an eligible professional or eligible hospital for MU objectives and measures.

(a) If a measure (or associated objective) in paragraphs (E) to (J) of this rule references paragraph (D)(7) of this rule, then the measure may be calculated by reviewing only the actions for patients whose records are maintained using certified EHR technology. A patient's record is maintained using certified EHR technology if sufficient data was entered in the certified EHR technology to allow the record to be saved, and not rejected due to incomplete data.

(b) If the objective and associated measure does not reference paragraph (D)(7) of this rule, then the measure must be calculated by reviewing all patient records, not just those maintained using certified EHR technology.

(c) For purposes of this rule, a "unique patient" means if a patient is seen by an eligible professional more than once during the EHR reporting period, then for purposes of measurement that patient is only counted once in the denominator for the measure.

(E) Eligible professional MU stage one objectives and measures.

(1) An eligible professional must meet the MU criteria established in 42 C.F.R. 495.6 (as in effect on July 28, 2010).

(2) To qualify for an incentive payment an eligible professional must meet a total of twenty MU objectives; fifteen are required core objectives and the remaining five objectives may be chosen from a list of ten menu set objectives.

(3) An eligible professional must report on six total clinical quality measures as defined at 75 Fed. Reg. 44,398 (2010): three required core measures (substituting alternate core measures where necessary) and three additional measures (selected from a set of thirty-eight clinical quality measures).

(4) Exclusion for non-applicable objectives.

(a) An eligible professional may exclude a particular objective, if all of the following requirements are met:

(i) The objective includes an option for the eligible professional to attest that the objective is not applicable.

(ii) The eligible professional meets the criteria in the applicable objective that would permit the attestation.

(iii) The eligible professional attests to meeting the requirements of the exclusion for the non-applicable objective.

(b) An exclusion will reduce (by the number of exclusions applicable) the number of objectives that would otherwise apply. For example, an eligible professional that has an exclusion from one of the menu set objectives in paragraph (G) of this rule shall meet four (and not five) menu set objectives of the eligible professional's choice to meet the definition of a meaningful EHR user.

(F) Stage one core criteria for Eligible professionals. An eligible professional must satisfy the following objectives and associated measures, except those objectives and associated measures for which an eligible professional qualifies for an exclusion under paragraph (E)(4) of this rule:

(1) Eligible professional core objective one:

(a) Objective. Use computerized provider order entry (CPOE) for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than thirty per cent of all unique patients with at least one medication in their medication list seen by the eligible professional have at least one medication order entered using CPOE.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. Any eligible professional who writes fewer than one hundred prescriptions during the EHR reporting period.

(2) Eligible professional core objective two:

(a) Objective. Implement drug-drug and drug-allergy interaction checks.

(b) Measure. The eligible professional has enabled this functionality for the entire EHR reporting period.

(3) Eligible professional core objective three:

(a) Objective. Maintain an up-to-date problem list of current and active diagnoses.

(b) Measure. More than eighty per cent of all unique patients seen by the eligible professional have at least one entry or an indication that no problems are known for the patient recorded as structured data.

(4) Eligible professional core objective four:

(a) Objective. Generate and transmit permissible prescriptions electronically (eRx).

(b) Measure. Subject to paragraph (D)(7) of this rule, more than forty per cent of all permissible prescriptions written by the eligible professional are transmitted electronically using certified EHR technology.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. Any eligible professional who writes fewer than one hundred prescriptions during the EHR reporting period.

(5) Eligible professional core objective five:

(a) Objective. Maintain active medication list.

(b) Measure. More than eighty per cent of all unique patients seen by the eligible professional have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data.

(6) Eligible professional core objective six:

(a) Objective. Maintain active medication allergy list.

(b) Measure. More than eighty per cent of all unique patients seen by the eligible professional have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data.

(7) Eligible professional core objective seven:

(a) Objective. Record all of the following demographics:

(i) Preferred language.

(ii) Gender.

(iii) Race.

(iv) Ethnicity.

(v) Date of birth.

(b) Measure. More than fifty per cent of all unique patients seen by the eligible professional have demographics recorded as structured data.

(8) Eligible professional core objective eight:

(a) Objective. Record and chart changes in the following vital signs:

(i) Height.

(ii) Weight.

(iii) Blood pressure.

(iv) Calculate and display body mass index (BMI).

(v) Plot and display growth charts for children ages two through twenty years, including BMI.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than fifty per cent of all unique patients age two and over, seen by the eligible professional, height, weight and blood pressure are recorded as structured data.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. Any eligible professional who either see no patients two years or older, or who believes that all three vital signs of height, weight, and blood pressure of their patients have no relevance to their scope of practice.

(9) Eligible professional core objective nine:

(a) Objective. Record smoking status for patients thirteen years old or older.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than fifty per cent of all unique patients thirteen years old or older seen by the eligible professional have smoking status recorded as structured data.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. Any eligible professional who sees no patients thirteen years or older.

(10) Eligible professional core objective ten:

(a) Objective. Report ambulatory clinical quality measures to ODJFS.

(b) Measure. Subject to paragraph (D)(7) of this rule, successfully report to ODJFS ambulatory clinical quality measures selected by the federal centers for medicare and medicaid services (CMS) in the manner specified by ODJFS.

(11) Eligible professional core objective eleven:

(a) Objective. Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule.

(b) Measure. Implement one clinical decision support rule.

(12) Eligible professional core objective twelve:

(a) Objective. Provide patients with an electronic copy of their health information (including diagnostics test results, problem list, medication lists, medication allergies) upon request.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than fifty per cent of all patients who request an electronic copy of their health information are provided it within three business days of the request.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. Any eligible professional that has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period.

(13) Eligible professional core objective thirteen:

(a) Objective. Provide clinical summaries for patients for each office visit.

(b) Measure. Subject to paragraph (D)(7) of this rule, clinical summaries provided to patients for more than fifty per cent of all office visits within three business days of the office visit.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. Any eligible professional who has no office visits during the EHR reporting period.

(14) Eligible professional core objective fourteen:

(a) Objective. Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, and diagnostic test results) among providers of care and patient authorized entities electronically.

(b) Measure. Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information.

(15) Eligible professional core objective fifteen:

(a) Objective. Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.

(b) Measure. Conduct or review a security risk analysis in accordance with the requirements under 45 C.F.R. 164.308(a)(1) (as in effect on October 1, 2007) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

(G) Stage one menu set criteria for eligible professionals. An eligible professional must meet five of the following objectives and associated measures, one of which must be either paragraph (G)(9) or (G)(10) of this rule. If an eligible professional qualifies for an exclusion under paragraph (E)(4) of this rule, the required number of objectives and associated measures in this paragraph is reduced by the eligible professional's number of exclusions.

(1) Eligible professional menu set objective one:

(a) Objective. Implement drug-formulary checks.

(b) Measure. The eligible professional has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period.

(c) Exclusion. In accordance with (E)(4) of this rule. An eligible professional who writes fewer than on hundred prescriptions in the EHR reporting period.

(2) Eligible professional menu set objective two:

(a) Objective. Incorporate clinical lab-test results into EHR as structured data.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than forty per cent of all clinical lab tests results ordered by the eligible professional during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. An eligible professional who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period.

(3) Eligible professional menu set objective three:

(a) Objective. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.

(b) Measure. Subject to paragraph (D)(7) of this rule, generate at least one report listing patients of the eligible professional with a specific condition.

(4) Eligible professional menu set objective four:

(a) Objective. Send reminders to patients per patient preference for preventive/follow-up care.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than twenty per cent of all patients sixty-five years or older or five years old or younger were sent an appropriate reminder during the EHR reporting period.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. An eligible professional who has no patients sixty-five years old or older or five years old or younger with records maintained using certified EHR technology.

(5) Eligible professional menu set objective five:

(a) Objective. Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, and allergies) within four business days of the information being available to the eligible professional.

(b) Measure. At least ten per cent of all unique patients seen by the eligible professional are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the eligible professional's discretion to withhold certain information.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. Any eligible professional that neither orders nor creates any of the information listed at 45 C.F.R. 170.304(g) (as in effect on October 1, 2010) during the EHR reporting period.

(6) Eligible professional menu set objective six:

(a) Objective. Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate.

(b) Measure. More than ten per cent of all unique patients seen by the eligible professional are provided patient-specific education resources.

(7) Eligible professional menu set objective seven:

(a) Objective. The eligible professional who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.

(b) Measure. Subject to paragraph (D)(7) of this rule, the eligible professional performs medication reconciliation for more than fifty per cent of transitions of care in which the patient is transitioned into the care of the eligible professional.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. An eligible professional who was not the recipient of any transitions of care during the EHR reporting period.

(8) Eligible professional menu set objective eight:

(a) Objective. The eligible professional who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral.

(b) Measure. Subject to paragraph (D)(7) of this rule, the eligible professional who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than fifty per cent of transitions of care and referrals.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. An eligible professional who neither transfers a patient to another setting nor refers a patient to another provider during the EHR reporting period.

(9) Eligible professional menu set objective nine:

(a) Objective. Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice.

(b) Measure. Performed at least one test of certified EHR technology's capacity to submit electronic data to immunization registries and follow up submission if the test is successful.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. An eligible professional who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically.

(10) Eligible professional menu set objective ten:

(a) Objective. Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice.

(b) Measure. Performed at least one test of certified EHR technology's capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful.

(c) Exclusion in accordance with paragraph (E)(4) of this rule. An eligible professional who does not collect any reportable syndromic information on their patients during the EHR reporting period or does not submit such information to any public health agency that has the capacity to receive the information electronically.

(H) MU stage one objectives and measures for an eligible hospital.

(1) An eligible hospital must meet the MU criteria established in 42 C.F.R. 495.6 (as in effect on July 28, 2010).

(2) To qualify for an incentive payment an eligible hospital must meet a total of nineteen MU objectives; fourteen are required core objectives and the remaining five objectives may be chosen from the list of ten menu set objectives.

(3) An eligible hospital must report on all fifteen clinical quality measures as defined at 75 Fed. Reg. 44,418 (2010).

(4) Exclusions for non-applicable objectives.

(a) An eligible hospital may exclude a particular objective that includes an option for exclusion, if the hospital meets all of the following requirements:

(i) The eligible hospital meets the criteria in the applicable objective that would permit an exclusion.

(ii) The eligible hospital so attests.

(b) An exclusion will reduce (by the number of exclusions received) the number of objectives that would otherwise apply. For example, an eligible hospital that is excluded from one of the menu set objectives in paragraph (J) of this rule must meet four (and not five) objectives of the hospital's choice to meet the definition of a meaningful EHR user.

(I) Stage one core criteria for eligible hospitals. An eligible hospital must meet the following objectives and associated measures except those objectives and associated measures for which an eligible hospital qualifies for an exclusion under paragraph (H)(4) of this rule:

(1) Eligible hospital core objective one:

(a) Objective. Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per State, local, and professional guidelines.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than thirty per cent of all unique patients with at least one medication in their medication list admitted to the eligible hospitals inpatient or emergency department (place of service (place of service (POS) 21 or 23) have at least one medication order entered using CPOE.

(2) Eligible hospital core objective two:

(a) Objective. Implement drug-drug and drug-allergy interaction checks.

(b) Measure. The eligible hospital has enabled this functionality for the entire EHR reporting period.

(3) Eligible hospital core objective three:

(a) Objective. Maintain an up-to-date problem list of current and active diagnoses.

(b) Measure. More than eighty per cent of all unique patients admitted to the eligible hospitals inpatient or emergency department (POS 21 or 23) have at least one entry or an indication that no problems are known for the patient recorded as structured data.

(4) Eligible hospital core objective four:

(a) Objective. Maintain active medication list.

(b) Measure. More than eighty per cent of all unique patients admitted to the eligible hospitals inpatient or emergency department (POS 21 or 23) have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data.

(5) Eligible hospital core objective five:

(a) Objective. Maintain active medication allergy list.

(b) Measure. More than eighty per cent of all unique patients admitted to the eligible hospitals inpatient or emergency department (POS 21 or 23) have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data.

(6) Eligible hospital core objective six:

(a) Objective. Record all of the following demographics;

(i) Preferred language.

(ii) Gender.

(iii) Race.

(iv) Ethnicity.

(v) Date of birth.

(vi) Date and preliminary cause of death in the event of mortality in the eligible hospital.

(b) Measure. More than fifty per cent of all unique patients admitted to the eligible hospitals inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data.

(7) Eligible hospital core objective seven:

(a) Objective. Record and chart changes in the following vital signs:

(i) Height.

(ii) Weight.

(iii) Blood pressure.

(iv) Calculate and display body mass index (BMI).

(v) Plot and display growth charts for children ages two through twenty years, including BMI.

(b) Measure. Subject to paragraph (D)(7) of this rule, for more than fifty per cent of all unique patients age two and over admitted to the eligible hospitals inpatient or emergency department (POS 21 or 23), height, weight, and blood pressure are recorded as structured data.

(8) Eligible hospital core objective eight:

(a) Objective. Record smoking for patients thirteen years old or older.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than fifty per cent of all unique patients thirteen years old or older or admitted to the eligible hospitals inpatient or emergency department (POS 21 or 23) have smoking status recorded as structured data.

(c) Exclusion in accordance with paragraph (H)(4) of this rule. Any eligible hospital that admits no patients thirteen years or older to their inpatient or emergency department (POS 21 or 23).

(9) Eligible hospital core objective nine:

(a) Objective. Report hospital clinical quality measures to ODJFS.

(b) Measure. Subject to paragraph (D)(7) of this rule, successfully report to ODJFS hospital clinical quality measures selected by CMS in the manner specified by ODJFS.

(10) Eligible hospital core objective ten:

(a) Objective. Implement one clinical decision support rule related to a high priority hospital condition along with the ability to track compliance with that rule.

(b) Measure. Implement one clinical decision support rule.

(11) Eligible hospital core objective eleven:

(a) Objective. Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies, discharge summary, procedures) upon request.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than fifty per cent of all patients of the inpatient or emergency departments of the eligible hospital (POS 21 or 23) who request an electronic copy of their health information are provided it within three business days of the request.

(c) Exclusion in accordance with paragraph (H)(4) of this rule. Any eligible hospital that has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period.

(12) Eligible hospital core objective twelve:

(a) Objective. Provide patients with an electronic copy of their discharge instructions at time of discharge, upon request.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than fifty per cent of all patients who are discharged from a eligible hospitals inpatient or emergency department (POS 21 or 23) and who request an electronic copy of their discharge instructions are provided it.

(c) Exclusion in accordance with paragraph (H)(4) of this rule. Any eligible hospital that has no requests from patients or their agents for an electronic copy of the discharge instructions during the EHR reporting period.

(13) Eligible hospital core objective thirteen:

(a) Objective. Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, and diagnostic test results) among providers of care and patient authorized entities electronically.

(b) Measure. Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information.

(14) Eligible hospital core objective fourteen:

(a) Objective. Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.

(b) Measure. Conduct or review a security risk analysis in accordance with the requirements under 45 C.F.R. 164.308(a)(1) (as in effect on October 7, 2007) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

(J) Stage one menu set criteria for eligible hospitals. Eligible hospitals must meet five of the following objectives and associated measures, one of which must be either paragraph (J)(8), (J)(9), or (J)(10) of this rule. If an eligible hospital qualifies for an exclusion under paragraph (H)(4) of this rule, the required number objectives and associated measures in this paragraph is reduced by the eligible hospitals number of exclusions.

(1) Eligible hospital menu set objective one:

(a) Objective. Implement drug-formulary checks.

(b) Measure. The eligible hospital has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period.

(2) Eligible hospital menu set objective two:

(a) Objective. Record advance directives for patient sixty-five years old or older.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than fifty per cent of all unique patients sixty-five years old or older admitted to the eligible hospitals inpatient (POS 21) have an indication of an advance directive status recorded as structured data.

(c) Exclusion in accordance with paragraph (H)(4) of this rule. An eligible hospital that admits no patients age sixty-five years old or older during the EHR reporting period.

(3) Eligible hospital menu set objective three:

(a) Objective. Incorporate clinical lab-test results into EHR as structured data.

(b) Measure. Subject to paragraph (D)(7) of this rule, more than forty per cent of all clinical lab test results ordered by an authorized provider of the eligible hospital for patients admitted to its inpatient or emergency department (POS 21 and 23) during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data.

(4) Eligible hospital menu set objective four:

(a) Objective. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.

(b) Measure. Subject to paragraph (D)(7) of this rule, generate at least one report listing patients of the eligible hospital with a specific condition.

(5) Eligible hospital menu set objective five:

(a) Objective. Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate.

(b) Measure. More than ten per cent of all unique patients admitted to the eligible hospitals inpatient or emergency department (POS 21 or 23) are provided patient-specific education resources.

(6) Eligible hospital menu set objective six:

(a) Objective. The eligible hospital who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.

(b) Measure. Subject to paragraph (D)(7) of this rule, the eligible hospital performs medication reconciliation for more than fifty per cent of transitions of care in which the patient is admitted to the eligible hospitals inpatient or emergency department (POS 21 or 23).

(7) Eligible hospital menu set objective seven:

(a) Objective. The eligible hospital that transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral.

(b) Measure. Subject to paragraph (D)(7) of this rule, the eligible hospital that transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than fifty per cent of transitions of care and referrals.

(8) Eligible hospital menu set objective eight:

(a) Objective. Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice.

(b) Measure. Performed at least one test of certified EHR technology's capacity to submit electronic data to immunization registries and follow up submission if the test is successful.

(c) Exclusion in accordance with paragraph (H)(4) of this rule. An eligible hospital that administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically.

(9) Eligible hospital menu set objective nine:

(a) Objective. Capability to submit electronic data on reportable (as required by state or local law) lab results to public health agencies and actual submission according to applicable law and practice.

(b) Measure. Performed at least one test of certified EHR technology's capacity to provide electronic submission of reportable lab results to public health agencies and follow-up submission if the test is successful.

(c) Exclusion in accordance with paragraph (H)(4) of this rule. No public health agency to which the eligible hospital submits such information has the capacity to receive the information electronically.

(10) Eligible hospital menu set objective ten:

(a) Objective. Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice.

(b) Measure. Performed at least one test of certified EHR technology's capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful.

(c) Exclusion in accordance with paragraph (H)(4) of this rule. No public health agency to which the eligible hospital submits information has the capacity to receive the information electronically.

(K) Demonstration of MU objectives and measures.

(1) An eligible professional and eligible hospital must demonstrate that MU objectives and measures are met, in accordance with 42 C.F.R. 495.8 (as in effect on July 28, 2010).

(a) Eligible professionals and eligible hospitals must attest, through a secure mechanism, in a manner specified by ODJFS, that during the EHR reporting period, the eligible professional and eligible hospital:

(i) Used certified EHR technology, and specify the technology used;

(ii) Satisfied the required objectives and associated measures under paragraphs (E) to (J) of this rule; and

(iii) Specified the EHR reporting period and provided the result of each applicable measure for all patients seen during the EHR reporting period for which a selected measure is applicable.

(L) Demonstration of MU is subject to review by both ODJFS and CMS.

Effective: 01/01/2012
R.C. 119.032 review dates: 01/01/2017
Promulgated Under: 119.03
Statutory Authority: 5111.0215
Rule Amplifies: 5111.0215