ehr onc final certification - Department of Health Care Services
ehr onc final certification - Department of Health Care Services ehr onc final certification - Department of Health Care Services
Comments. A couple of commenters stated that the prescribing capabilities must allow for weight-based dosing calculation with intelligent rounding and that without this, e-prescribing will not be helpful to pediatricians. Response. We recognize that this is an important capability for pediatricians; however, we do not believe that it necessary to require it as a condition of certification at the present time. Again, this does not preclude Complete EHR and EHR Module developers from including this capability. Comments. A few commenters expressed concerns about some pharmacies not being capable of receiving electronic prescriptions which they stated could cause a negative impact on the workflow. One commenter suggested that we add a “where possible” to the certification criterion. Response. While we recognize that some pharmacies may be unable to receive electronic prescriptions at the present time, we do not believe this limitation should affect the capability that Certified EHR Technology must provide. Further, we do not believe that inserting “where applicable” would be beneficial because it would make the criterion unnecessarily ambiguous. This phrase would relate to when electronic prescribing should be conducted, not how it should be done, which is the focus of this certification criterion. Comment. A commenter stated that the electronic prescribing process should be linked to the contraindication and formulary conflict process and should provide automatic alerts. Another commenter recommended that information relating to the language the patient speaks should be required as part of the electronic prescribing process, so that pharmacy is notified of a patient’s need for language assistance. Page 134 of 228
Response. We do not believe that it would be appropriate to expand the certification criterion as suggested at this time. This does not preclude a Complete EHR or EHR Module developer from pursuing other ways to optimize how a Complete EHR or EHR Module may function. §170.304(c) - Record demographics Meaningful Use Stage 1 Objective Record demographics • preferred language • gender • race • ethnicity • date of birth Meaningful Use Stage 1 Measure More than 50% of all unique patients seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) have demographics recorded as structured data Page 135 of 228 Certification Criterion Interim Final Rule Text: Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, insurance type, gender, race, ethnicity, and date of birth. Final Rule Text: §170.304(c) Record demographics. Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, gender, race, ethnicity, and date of birth. Enable race and ethnicity to be recorded in accordance with the standard specified at 170.207(f). Comments. Several commenters recommended that we adopt the OMB race and ethnicity codes. Response. We agree with these commenters and have adopted the OMB race and ethnicity codes. In the Medicare and Medicaid EHR Incentive Programs proposed rule (75 FR 1855), CMS stated that race and ethnicity codes should follow current Federal standards. We note that the OMB race and ethnicity codes constitute a government- unique standard for the purposes of the National Technology Transfer and Advancement Act of 1995 (NTTAA). We have adopted this standard because it provides an easily understood structure and format for electronically transmitting the data elements identified in the meaningful use Stage 1 objective, the standard is readily available, in general it provides the best standard to use to support our policies goals. Moreover, we
- Page 83 and 84: the capability specified by the cer
- Page 85 and 86: vendors were unwilling or unable to
- Page 87 and 88: the concerns expressed by some comm
- Page 89 and 90: Page 89 of 228 electronically compa
- Page 91 and 92: (1) The standard (and applicable im
- Page 93 and 94: for the purposes of demonstrating c
- Page 95 and 96: Guide for Immunization Messaging Re
- Page 97 and 98: Response. We clarify for commenters
- Page 99 and 100: serve as a limiting factor, however
- Page 101 and 102: Page 101 of 228 Unchanged Comment.
- Page 103 and 104: Comment. One commenter suggested th
- Page 105 and 106: Response. We appreciate the thought
- Page 107 and 108: Complete EHRs or EHR Modules design
- Page 109 and 110: Response. We disagree. As stated ab
- Page 111 and 112: Response. As discussed above, we ha
- Page 113 and 114: SHA-1 and other secure hash algorit
- Page 115 and 116: misinterpreted our example and stat
- Page 117 and 118: Other commenters also expressed con
- Page 119 and 120: eferenced in FIPS 140-2 Annex A, wh
- Page 121 and 122: of the most secure encryption algor
- Page 123 and 124: the disclosure was made (recipient)
- Page 125 and 126: Use CPOE for medication orders dire
- Page 127 and 128: equire EHRs to build custom interfa
- Page 129 and 130: esult, we do not believe that this
- Page 131 and 132: was needed before RxNorm could be a
- Page 133: • MDDB - Medi-Span Master Drug Da
- Page 137 and 138: Send reminders to patients per pati
- Page 139 and 140: specified data elements and CMS’s
- Page 141 and 142: what would qualify as a "response."
- Page 143 and 144: Comment. A commenter recommended th
- Page 145 and 146: in accordance with one of the adopt
- Page 147 and 148: Comments. Many commenters suggested
- Page 149 and 150: flexibility in this certification c
- Page 151 and 152: productive, confusing, time-consumi
- Page 153 and 154: include in this initial set. Accord
- Page 155 and 156: to the HITSP C32 implementation spe
- Page 157 and 158: Response. Again, we do not believe
- Page 159 and 160: e achieved without these and recomm
- Page 161 and 162: electronically record, store, retri
- Page 163 and 164: EHRs and EHR Modules designed for a
- Page 165 and 166: §170.205(a)(2)(iii); and (v) The s
- Page 167 and 168: Response. We disagree, as doing so
- Page 169 and 170: Dental Terminology as a condition o
- Page 171 and 172: However, we do not preclude Complet
- Page 173 and 174: ability of CCD and CCR to support t
- Page 175 and 176: ability to receive these reports. M
- Page 177 and 178: commenters acknowledged and express
- Page 179 and 180: a meaningful use objective they wou
- Page 181 and 182: CMS and ONC had worked together to
- Page 183 and 184: The eligible professional or eligib
Response. We do not believe that it would be appropriate to expand the<br />
<strong>certification</strong> criterion as suggested at this time. This does not preclude a Complete EHR<br />
or EHR Module developer from pursuing other ways to optimize how a Complete EHR<br />
or EHR Module may function.<br />
§170.304(c) - Record demographics<br />
Meaningful Use<br />
Stage 1<br />
Objective<br />
Record<br />
demographics<br />
• preferred<br />
language<br />
• gender<br />
• race<br />
• ethnicity<br />
• date <strong>of</strong> birth<br />
Meaningful Use Stage<br />
1 Measure<br />
More than 50% <strong>of</strong> all<br />
unique patients seen by<br />
the EP or admitted to<br />
the eligible hospital’s or<br />
CAH’s inpatient or<br />
emergency department<br />
(POS 21 or 23) have<br />
demographics recorded<br />
as structured data<br />
Page 135 <strong>of</strong> 228<br />
Certification Criterion<br />
Interim Final Rule Text:<br />
Enable a user to electronically record, modify, and<br />
retrieve patient demographic data including preferred<br />
language, insurance type, gender, race, ethnicity, and date<br />
<strong>of</strong> birth.<br />
Final Rule Text:<br />
§170.304(c)<br />
Record demographics. Enable a user to electronically<br />
record, modify, and retrieve patient demographic data<br />
including preferred language, gender, race, ethnicity, and<br />
date <strong>of</strong> birth. Enable race and ethnicity to be recorded in<br />
accordance with the standard specified at 170.207(f).<br />
Comments. Several commenters recommended that we adopt the OMB race and<br />
ethnicity codes.<br />
Response. We agree with these commenters and have adopted the OMB race and<br />
ethnicity codes. In the Medicare and Medicaid EHR Incentive Programs proposed rule<br />
(75 FR 1855), CMS stated that race and ethnicity codes should follow current Federal<br />
standards. We note that the OMB race and ethnicity codes constitute a government-<br />
unique standard for the purposes <strong>of</strong> the National Technology Transfer and Advancement<br />
Act <strong>of</strong> 1995 (NTTAA). We have adopted this standard because it provides an easily<br />
understood structure and format for electronically transmitting the data elements<br />
identified in the meaningful use Stage 1 objective, the standard is readily available, in<br />
general it provides the best standard to use to support our policies goals. Moreover, we