1. HIT Policy Committee Meaningful Use Workgroup Update Paul Tang Palo Alto Medical Foundation George Hripcsak Columbia University January 13, 2010

2. Workgroup Members Co-Chairs: Paul Tang, Palo Alto Medical Foundation George Hripcsak, Columbia University Members: David Bates, Brigham & Women’s Hospital Christine Bechtel, National Partnership for Women & Families Neil Calman, The Institute for Family Health Art Davidson, Denver Public Health Department David Lansky, Pacific Business Group on Health Deven McGraw, Center for Democracy & Technology Latanya Sweeney, Carnegie Mellon University Charlene Underwood, Siemens ONC Lead: John Glaser

3. 3 WG Discussion on Meaningful Use Rule General Comments on Meaningful Use NPRM –CMS, ONC and HITPC have worked well together in defining Meaningful Use which is reflected well in the Rule –Majority of the WG recommendation have been incorporated in the Rule Specific Comments in Three Categories: 1.Philosophical policy comments 2.Areas needing further clarification 3.Granular comments on specific elements

4. Preliminary List of Specific Areas to be Discussed 1.Philosophical Policy Comments (examples) –Clinical quality reporting requirement Exemplar vs. “500 measures” approach Opportunity to promote accelerated development of outcomes- oriented quality measures (vs. process measures) –Maintenance of up-to-date information in record (vs. one-time) Problem list Medication list Allergy list –Stratification of quality reports by disparity variables –Creating a glidepath for future years to assist with planning and development (providers and vendors) –“Hospital-based physicians” –Stage 3 criteria for 2015 for penalties 4

5. Preliminary List of Specific Areas to be Discussed 1.Philosophical Policy Comments (examples) –Missed opportunities (criteria dropped from matrix) Progress notes Documentation of advance directives (Medicare population) Patient-specific information resources Generic substitution measure High cost imaging indications measure 5

6. Preliminary List of Specific Areas to be Discussed 2.Areas Needing Clarification –CPOE by authorizing provider or (any) licensed provider? –“Relevant encounter” for med reconciliation? –How to obtain denominator for measurement? With a supplemental manual process? –Testing of capabilities? 6

7. Preliminary List of Specific Areas to be Discussed 3.Granular Comments –Care summaries at all transitions of care (vs. site transfers) –Timeliness (48 hrs, 96 hrs)? –Patient reminders only for over 50 years old? 7

8. 8 QUESTIONS AND DISCUSSION