eBook - Pathways to Meaningful Use

Pathways to
Meaningful Use
Meaningful Use (MU) Overview
MU Check List … 1, 2, 3
MU Stage 1 Grid
NextGen Healthcare MU Pathways
MU Stage 2 Grid
NextGen Healthcare MU Pathways
1
2
3
4
Pathways to Meaningful Use
with NextGen Healthcare Ambulatory Solutions

What is Meaningful Use (MU)?
The Health Information Technology for Economic and Clinical
Health (HITECH) Act under the American Recovery and
Reinvestment Act (ARRA) provides financial incentives to
encourage adoption and meaningful use of certified electronic
health record (EHR) technology (CEHRT).
The Centers for Medicare and Medicaid (CMS) EHR Incentives
Program (in reality two programs) offers up to $44,000 over five
years under the Medicare EHR Incentive Program and up to
$63,750 over six years under the Medicaid EHR Incentive Program.
HITECH envisioned a three-stage process for implementing
the EHR Incentive Program. Each stage has a goal and its own
“final rule”— a set of objectives and measures developed by the
Department of Health and Human Services (HHS) and published
in the Federal Register as regulations. If you meet the Medicare
or Medicaid EHR Incentive Program eligibility requirements and
successfully meet and report measures for each stage of the
program, you earn the incentives.
So far, the government has published final rules for Stage 1 and
Stage 2 Meaningful Use (MU1 and MU2). This document outlines
what is required of you under each stage.
The vision and purpose of HITECH is to drive the adoption
of CEHRT in order to:
• Improve quality, safety, and efficiency
• Engage patients and their families
• Improve care coordination
• Improve population and public health
• Ensure privacy and security protections
But Meaningful Use is more than an incentive program. It is a
means to a greater end and a likely driver for success in a
newly emerging healthcare delivery system. Under value-based
reimbursement models, provider payments are calculated
based upon improvements in quality care and coordination of
care across patient populations. Certified, interoperable EHR
technology is the cost of admission.
To learn more about Meaningful Use and the CMS EHR
Incentive Programs, read the NextGen Healthcare Meaningful
Use eBook.
This document was updated 06/1/2014 and reflects Stage 1 and
Stage 2 requirements starting in 2014.
Meaningful Use Overview

MU Checklist... 1,2,3
1. Register
Before you can attest and earn your incentives, go to
www.cms.gov, Regulations and Guidance, and click on EHR
Incentive Programs under the Legislation heading to register
for either the Medicare or Medicaid EHR Incentive Program.
You must pick one program in which to participate (although
you may switch one time before 2015). You only need to
register for the program once (no need to re-register each year).
• To register for the Medicare EHR Incentive Program, go to
the registration link on the CMS EHR Incentive Program
homepage and follow the instructions
• To register for the Medicaid EHR Incentive Program, go to
the registration link on the CMS EHR Incentive Program
homepage and follow the instructions; CMS will send your
information to your state for review and completion of your
registration process. Go here to find your state’s Medicaid
EHR Incentive Program URL
Have this information ready before registering:
• Name, NPI, address, and phone for each Eligible Provider
(EP) and Eligible Hospital (EH) being registered
• Taxpayer Identification Number
• CMS EHR Certification Number (optional at registration but
recommended, since you will eventually need it to attest)
- Visit the ONC/CHPL website to obtain the correct
certification number for your product version
- You must upgrade to the certified version prior to
the beginning of the reporting period
• PECOS number (if registering for Medicare EHR
Incentive Program)
Registering or attesting on behalf of one or more EPs? If so, visit the IA Security website to obtain a username
and password. (States may have different requirements for their Medicaid EHR Incentive Programs regarding the
representation of multiple EPs by a single individual.)
1For additional information and to get started, visit the CMS Registration Attestation site

2. Achieve
You will need to use your EHR in a way that aligns with the MU
objectives outlined by CMS. This document includes an overview
of NextGen®
product requirements, as well as a listing of the Stage
1 and Stage 2 objectives with high-level details on how these
products are used. In addition to this MU Pathways document, you
can find detailed information about achieving MU, as well as white
papers, FAQs, webinars, educational information, and more on the
MU Resources page on the Knowlege Exchange. At a high level,
here are some things you need to know:
• Meaningful Use is a three-stage process. Final rules,
requirements, and timelines for Stage 1 and Stage 2 have
been published by the federal government
• Your first two years as a meaningful user will be at Stage 1
(unless you started in 2011, in which case 2013 would have
been your third year of Stage 1)
• Eligible Professionals (EPs) need to meet a set of Core (required)
objectives and also select from a set of Menu objectives.
• There are 13 Core objectives under Stage 1; and 17 Core
objectives under Stage 2
Note: CMS has formally retired earlier Stage 1 Core objectives for
submitting clinical quality measures and performing one test of health data
exchange. (CQMs must still be submitted, but no objective exists for it.)
• A new Stage 1 Core objective requires giving patients the
ability to view online, download and transmit personal
health information, replacing earlier Core and Menu objectives
• You must meet five out of nine Menu objectives under Stage 1;
and three out of six Menu objectives under Stage 2
• Under Stage 1, you must meet one of the two public health
reporting Menu objectives (immunization reporting or syndromic
disease reporting) unless you qualify for an exemption to both
• Under Stage 2, immunization reporting is now a Core objective,
while syndromic reporting remains a Menu objective. Both must
be successful and ongoing for meeting the corresponding Stage
2 objectives
• In addition to the Core and Menu objectives, you will need to
report a set of Meaningful Use Clinical Quality Measures (CQMs).
There is a new set of CQMs for Stage 1 and Stage 2 starting
in 2014
• You must meet the MU requirements using the appropriate
ONC Certified HIT 2014 Edition of your NextGen Healthcare
solutions. Product and version requirements are outlined later
in this document
2

3Once you have successfully met the objectives for your current
MU stage, you will need to attest with CMS (for the Medicare EHR
Incentive Program) or your state Medicaid Agency (for the Medicaid
EHR Incentive Program). Attestation is how you report the data you
captured during your reporting period. It’s the final step prior to
being issued an EHR incentive payment.
• First-time attesters, get your login/password for the CMS
attestation portal
• Create final MU reports using NextGen®
Health Quality Measures
(NextGen HQM) and save the reports you use for use during
attestations and for reference in the event of a future CMS audit
Visit Knowledge Exchange for detailed white papers on 2014
Stage 1 and Stage 2 objectives and CQMs.
• Stage 1 and Stage 2 (starting in 2014): NextGen HQM required
for all MU reporting
• For those beyond their first year of reporting MU, CQMs
can be electronically reported
• HQM must be re-installed after upgrading to NextGen®
Ambulatory
EHR version 5.8 (ONC Certified HIT 2014 Edition)
• Enter the required information for each MU Core/Menu
objective into the CMS Attestation portal following the
instructions provided on the CMS site. (Follow instructions
from your state Medicaid agency if you are participating in
the Medicaid EHR Incentive Program)
What to expect after attestation
Payments
• Under Medicare, you should expect to receive a single, annual
payment. You will receive this payment in the same manner as your
other Medicare reimbursements. This could take up to 60 days or
longer, according to experience, after attestation. If you’re in doubt
as to the status of the incentive payment, you should contact CMS
• Under Medicaid, check with your state Medicaid agency on
timelines and method of payment
Audits
• Both Medicare and Medicaid are conducting MU audits. To be
prepared for an audit, keep all reports and evidence that you
have met the Yes/No attestation objectives (e.g., Drug Formulary
feature enabled). Keep all reports and evidence for at least six
years. For more information on audit preparedness visit the
Meaningful Use Resources page on the NextGen Healthcare
Client Resource Center. If you have received an audit letter and
need assistance, please complete this documentation.
3. Attest

NextGen Healthcare Product
Requirements Overview
* Menu objective – solution required or recommended only if clients choose to attest for the objective ** Stage 1 rule requires clients to select either the
immunization or syndromic reporting menu measure, unless you qualify for both exclusions. Starting in 2014, NextGen Ambulatory EHR version 5.8
is required for both Stage 1 and Stage 2. Also, starting in 2014, NextGen KBM Version 8.3 will be the only NextGen KBM version supported for both Stage 1
and Stage 2 Meaningful Use. Earlier NextGen KBM versions will not be supported for Meaningful Use reporting and attestation.
What you need to support your Ambulatory pathway to MU in 2014.
Stage 2
• NextGen Ambulatory EHR v. 5.8
• MU Compliant KBM (NextGen KBM
v.8.3 or higher)
• e-Prescribing
• NextGen HQM
• NextGen Patient Portal
• Advanced Audit Utility
• Medical Summary Utility
• ONC Direct Interface
• Lab Interface (recommended)
• Immunization Registry Interface
• Syndromic Reporting interface*
• Specialized Registry Interface*
• Cancer Registry Interface *
Stage 1
• NextGen Ambulatory EHR v. 5.8
• MU Compliant KBM (NextGen®
KBM
v.8.3 or higher)
• e-Prescribing
• NextGen HQM
• NextGen®
Patient Portal
• Advanced Audit Utility
• Lab Interface (recommended)*
• Immunization registry interface**
OR
• Syndromic Reporting interface**
NextGen Healthcare Pathways to Meaningful Use

Stage 1- Core Set
ID Objective Measure
Product Used to
Demonstrate
Meaningful Use*
Comments
1 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
More than 30% of medication
orders created by the EP during the EHR
reporting period are recorded using CPOE,
or, more than 30% of unique patients with
at least one medication in their medication
list seen by the EP have at least one
medication order entered using CPOE
NextGen Ambulatory EHR 5.8 1. Applies to orders entered by the physician OR entered for
the provider by someone who could exercise clinical judgment
(in the case that the entry generates any alerts about possible
interactions or other clinical decision support aides). This
necessitates that the CPOE occurs when the order first
becomes part of the patient’s medical record and before any
action can be taken on the order
2. Any EP who writes fewer than 100 prescriptions during an
EHR reporting period is excluded
3. 2013 - Externally Credentialed Individuals are allowed to
enter orders on behalf of EP
2 Implement drug-drug
and drug-allergy interaction
checks
The EP/eligible hospital/CAH has
enabled this functionality for the entire
EHR reporting period
NextGen Ambulatory EHR 5.8 1. Must set the minimum drug interaction level to at least one
(not zero)
2. EP has enabled this functionality during entire reporting period
3. Yes/No attestation only
3 Maintain an up-to-date
problem list of current and
active diagnoses
More than 80% 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 at least one entry or an indication
that no problems are known for the
patient recorded as structured data
NextGen Ambulatory EHR 5.8
4 Generate and transmit
permissible prescriptions
electronically (eRx)
More than 40% of all permissible
prescriptions written by the EP are
transmitted electronically using
certified EHR technology
1. NextGen Ambulatory
EHR 5.8
2. e-Prescribing
enabled
1. Excludes narcotics and DME
2. Any EP who writes fewer than 100 prescriptions
during an EHR reporting period is excluded
*Starting in 2014, NextGen Ambulatory EHR version 5.8 is required for both Stage 1 and Stage 2. Also, starting in 2014, NextGen Healthcare clients
will need to be on NextGen KBM Version 8.3 or higher. Older NextGen KBM versions will not be updated or supported for MU or ICD-10 purposes.

Stage 1- Core Set
Product Used to
Demonstrate
Meaningful Use
Comments
5 Maintain active medication
list
seen by the EP or admitted to the eligible
hospital’s or CAH’s 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
6 Maintain active medication
allergy list
More than 80% of all unique patients have
at least one entry recorded as structured
data or an indication that the patient has
no known allergies and is not currently
prescribed any medication
7 Record demographics:
• Preferred language
• Gender
• Race
• Ethnicity
• Date of birth
seen by the EP or admitted to the eligible
hospital’s or CAH’s inpatient or emergency
department (POS 21 or 23) have demo-
graphics recorded as structured data
EHR 5.8
Answers of “unknown”or “refused” or “declines to specify”
can be included in number. Multiple races can also be entered
8 Record and chart changes in
vital signs:
• Height
• Weight
• Blood pressure
• Calculate and display BMI
• Plot and display growth
charts for children 2-20
years including BMI
For more than 50% of all unique patients
seen by the EP, for all ages have height,
weight recorded, and for three years and
older have blood pressure recorded as
structured data
EHR 5.8
2. NextGen KBM v.8.3
or higher
1. Excludes an EP who either sees no patients three years or
older, or who believes that vital signs (height, weight, and
blood pressure) of their patients have no relevance to their
scope of practice
2. The exemption may be split to allow providers to exempt the
height/weight measure and still report the BP measure (or vice
versa) based on relevance to their scope of practice
9 Record smoking status for
patients 13 years old or older
For more than 50% of all unique patients
of all ages seen by the EP, have height,
weight recorded, and for three years and
older have blood pressure recorded as
structured data
EHR 5.8
or higher
Excludes an EP who sees no patients 13 years or older.

Stage 1- Core Set
Product Used to
Demonstrate
Meaningful Use
Comments
10 Implement one clinical
decision support rule relevant
to specialty or high clinical
priority along with the ability
to track compliance with
that rule
Implement one clinical decision
support rule
11 Provide patients with the
ability to view online,
download, and transmit
their health information
within four business days of
the information being
available to the EP
seen by the EP during the EHR
reporting period
EHR 5.8
2. NextGen Patient Portal
3. Medical Summary Utility
1. Use Medical Summary Utility to create document with
required information
2. PHR access should be enabled in file maintenance for
NextGen Patient Portal
12 Provide clinical summaries for
patients for each office visit
Clinical summaries provided to patients
for more than 50% of all office visits within
three business days
EHR 5.8
or higher
13 Protect electronic health
information created or
maintained by the certified
EHR technology through
the implementation of
appropriate technical
capabilities
Conduct or review a security risk analysis
per 45 CFR 164.308 (a)(1) and implement
security updates as necessary and correct
all identified security deficiencies as part of
its risk management process
EHR 5.8
2. Advanced Audit Utility
2. This objective is not specific to the use of certified EHR
technology, but applies to the implementation of a HIPAA
Privacy and Security program and related risk assessment
within the practice

Stage 1-Menu Set
Product Used to
Demonstrate
Meaningful Use
Comments
1 Implement drug formulary
checks
Functionality is enabled and provides
access to at least one internal or
external formulary for the entire EHR
reporting period
EHR 5.8
2. e-Prescribing
enabled
1. Ensure that you have access to a formulary (e.g., Surescripts
formulary) for the entire EHR reporting period
2. Yes/No attestation only measure
2 Incorporate clinical lab test
results into certified EHRs as
structured data
More than 40% of all clinical laboratory
tests ordered during EHR reporting period
whose results are in a positive / negative
or numerical format are incorporated in
certified EHR as structured data
EHR 5.8
2. Lab interface
(recommended)
1. Full bi-directional interface is optimal for ease of reporting.
2. Exclusion for EP who orders no lab tests whose results are
either in a positive / negative or numeric format during the
EHR reporting period; they would be excluded from this
requirement
3 Generate lists of patients by
specific conditions to use for
quality improvement, reduc-
tion of disparities, research,
or outreach
Generate at least one report listing
patients with a specific condition
NextGen Ambulatory EHR 5.8 1. Relevant to specialty
2. Use ad hoc report writer
3. Attestation only measure
4 Send reminders to patients
(per patient preference)
for preventive / follow-up care
More than 20% of all unique patients 65
years or older or five years old or younger
are sent appropriate reminders during
NextGen Ambulatory EHR 5.8 1. For electronic communications, secure email, or a patient
portal is required
2. Excludes an EP who has no patients 65 years old or
older or five years old or younger
3. Captured in Patient demographic template in EHR
Reminder Grid
5 Use certified EHR technology
to identify patient-specific
education resources and
provide those to the patient
if appropriate
More than 10% of all unique patients seen
are provided patient-specific education
resources
NextGen Ambulatory EHR 5.8 Patient education may be internal or external but needs to
be documented as ordered in the KBM

Product Used to
Demonstrate
Meaningful Use
Comments
6 Perform medication
reconciliation for a patient
from another care setting or
provider of care
Perform medication reconciliation for more
than 50% of transitions of care in which the
patient is transitioned in the care of the EP
EHR 5.8
2. e-Prescribing
enabled
or higher
Use KBM to document care transition and that medication
reconciliation was performed
7 Provide summary of care
record for patients referred
or transitioned to another
provider of care or setting
of care
Summary of care record is provided for
more than 50% of transitions of care or
referrals
EHR 5.8
or higher
4. Direct interface (optional)
1. Use Medical Summary Utility to create the summary of
care record
2. Objective/measure allows SOC to be printed, but if EP chooses
to send electronically, Direct interface is needed
3. Use KBM PHI Log template to document care transition and
that it was provided
8 Submit electronic data to im-
munization registries or
Immunization Information
Systems**
Perform 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
(unless none of the immunization registries
has the capacity to receive the information
electronically)
EHR 5.8
2. Immunization Registry
Interface
1. Exempt if you don’t give immunizations
2. Exempt if state doesn’t accept electronic data
3. If you are not exempt you may require an immunization
registry interface or HIE connection
9 Submit electronic syndromic
surveillance data to public
health agencies**
Perform 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 (unless none of the
public health agencies have the capacity
to receive the information electronically)
EHR 5.8
2. Public Health Reporting
Interface
1. Exemption is permitted if there is no state, city, or county
syndromic surveillance data source capable of receiving info
from the certified EHR. (Letter of exemption from state must
be on file)
2. If your agency can successfully accept, you must continue
to report
3. Requires HL7 interface or HIE connection
Stage 1-Menu Set

Product Used to
Demonstrate
Meaningful Use
Comments
1 Use computerized provider
order entry (CPOE) for
medication, laboratory, and
radiology orders directly en-
tered by any licensed health-
care professional who can
enter orders into the medical
record per state, local, and
professional guidelines
More than 60 percent of medication, 30
percent of laboratory, and 30 percent of
radiology orders created by the EP during
the EHR reporting period are recorded
using CPOE
NextGen Ambulatory EHR 5.8 1. Any externally licensed healthcare professionals and
credentialed medical assistants can enter orders into the
medical record for purposes of including the order in the
numerator for the objective of CPOE if they can originate
the order per state, local, and professional guidelines
2. Any EP who writes fewer than 100 medication, radiology, or
laboratory orders during the EHR reporting period is excluded
2 Generate and transmit
permissible prescriptions
electronically (eRx)
More than 50 percent of all permissible
prescriptions, or all prescriptions, written
by the EP are queried for a drug formulary
and transmitted electronically using CEHRT
EHR 5.8
2. e-Prescribing enabled
1. EPs may exclude or include narcotics. If they include, they
must do so for all patients in the reporting period. The rule
excludes DME and OTC
2. Any EP who writes fewer than 100 prescriptions during an
EHR reporting period or does not have a pharmacy within
their organization and there are no pharmacies that accept
electronic prescriptions within 10 miles is excluded
3 Record the following
demographics: preferred lan-
guage, gender, race, ethnicity,
date of birth
More than 80 percent of all unique patients
seen by the EP have demographics
recorded as structured data
NextGen Ambulatory
EHR 5.8
Answers of “unknown” or “refused,” or indication that it is against
state law to ask for this information are all acceptable in the
numerator as long as entered as structured data
4 Record and chart changes
in the following vital signs:
height/length and weight (no
age limit); blood pressure
(ages three and over);
calculate and display body
mass index (BMI); and plot
and display growth charts
for patients 0-20 years,
including BMI
seen by the EP have blood pressure (for
patients age three and over only) and/or
height and weight (for all ages) recorded as
structured data
EHR 5.8
2. NextGen KBM 8.3
or higher
1. Can be entered into the patient’s medical record in a number
of ways including: direct entry by the EP; entry by a designated
individual from the EP’s staff; data transfer from another provider
electronically, through an HIE or through other methods; or data
entered directly by the patient through a portal or other means
2. Any EP who:
A. Sees no patients three years or older is excluded from
recording blood pressure
B. Believes that all three vital signs of height/length, weight,
and blood pressure have no relevance to their scope of
practice is excluded from recording them
C. Believes that height/length and weight are relevant to their
scope of practice, but blood pressure is not, is excluded
from recording blood pressure
D. Believes that blood pressure is relevant to their scope of
practice, but height/length and weight are not, is excluded
from recording height/length and weight
Stage 2-Core Set

Product Used to
Demonstrate
Meaningful Use
Comments
5 Record smoking status for
patients 13 years old or older
13 years old or older seen by the EP have
smoking status recorded as structured data
EHR 5.8
2. NextGen KBM 8.3
or higher
Any EP that neither sees nor admits any patients 13 years old or
older is excluded
6 Use clinical decision support
to improve performance on
high-priority health conditions
Measure 1:
Implement five clinical decision support
interventions related to four or more
clinical quality measures at a relevant
point in patient care for the entire EHR
reporting period. Absent four clinical
quality measures related to an EP’s scope
of practice or patient population, the
clinical decision support interventions
must be related to high-priority health
conditions
Measure 2:
The EP has enabled and implemented
the functionality for drug-drug and drug-
allergy interaction checks for the entire
NextGen Ambulatory
EHR 5.8
1. For the second measure, any EP who writes fewer than
100 medication orders during the EHR reporting period
is excluded
2. Second Measure: Yes/No attestation only
7 Provide patients the ability to
view online, download, and
transmit their health information
within four business days of
the information being
available to the EP
Measure 1:
seen by the EP during the EHR reporting
period are provided timely (available to the
patient within four business days after the
information is available to the EP) online
access to their health information
Measure 2:
More than five 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
EHR 5.8
Any EP who:
1. Neither orders nor creates any of the information listed for
inclusion as part of both measures, except for “Patient name”
and “Provider’s name and office contact information,”may
exclude both measures
2. Conducts 50 percent or more of his or her patient encounters
in a county that does not have 50 percent or more of its housing
units with 3Mbps broadband availability according to the latest
information available from the FCC: on the first day of the EHR
reporting period may exclude only the second measure
Stage 2-Core Set

Product Used to
Demonstrate
Meaningful Use
Comments
8 Provide clinical summaries for
patients for each office visit
Clinical summaries provided to patients or
patient-authorized representatives within
one business day for more than 50 percent
of office visits
1. NextGen Ambulatory EHR 5.8
2. NextGen KBM 8.3 or higher
Excludes an EP who has no office visits during the EHR
reporting period
9 Protect electronic health
information created or
maintained by the certified
EHR technology (CEHRT)
through the implementation
of appropriate technical
capabilities
Conduct or review a security risk analysis
in accordance with the requirements under
45 CFR 164.308(a) (1), including addressing
the encryption/security of data stored in
CEHRT in accordance with requirements
under 45 CFR 164.312 (a)(2)(iv) and 45
CFR 164.306(d)(3), and implement security
updates as necessary and correct identified
security deficiencies as part of the provider’s
risk management process for EPs
EHR 5.8
2. Advanced Audit Utility*
3. NextGuard (recommended)
*The Advanced Audit Utility is required for 2014, both Stage 1
and Stage 2
10 Incorporate clinical lab test
results into Certified EHR
Technology (CEHRT) as
structured data
More than 55 percent of all clinical lab tests
results ordered by the EP 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
NextGen Ambulatory EHR 5.8 Any EP who orders no lab tests where results are either in a positive/
negative affirmation or numeric format during the EHR reporting
period is excluded
11 Generate lists of patients by
specific conditions to use for
quality improvement, reduc-
tion of disparities, research,
or outreach
Generate at least one report listing patients
of the EP with a specific condition
NextGen Ambulatory EHR 5.8 1. NextGen Ambulatory EHR ad hoc report writer can be
utilized to create patient lists
Stage 2-Core Set

Product Used to
Demonstrate
Meaningful Use
Comments
12 Use clinically relevant
information to identify
patients who should receive
reminders for preventive/
follow-up care and send
these patients the reminders,
per patient preference
More than 10 percent of all unique
patients who have had two or more office
visits with the EP within the 24 months
before the beginning of the EHR reporting
period were sent a reminder, per patient
preference when available
EHR 5.8
2. NextGen KBM 8.3
or higher
1. Any EP who has had no office visits in the 24 months
before the EHR reporting period is excluded
2. Captured in Patient demographic template in EHR
Reminder Grid
13 Use clinically relevant
information from Certified
EHR Technology to identify
patient-specific education
resources and provide those
resources to the patient
Patient-specific education resources
identified by Certified EHR Technology
are provided to patients for more than 10
percent of all unique patients with office
visits seen by the EP during the EHR
reporting period
EHR 5.8
2. HealthWise Patient
Education (Recommended)
Any EP who has no office visits during the EHR reporting
period is excluded
14 The EP who receives a patient
from another setting of care
or provider of care or believes
an encounter is relevant
should perform medication
reconciliation
The EP who performs medication
reconciliation for more than 50 percent
of transitions of care in which the patient
is transitioned into the care of the EP
EHR 5.8
2. NextGen KBM 8.3
or higher
Any EP who was not the recipient of any transitions of
care during the EHR reporting period is excluded
Stage 2-Core Set

Product Used to
Demonstrate
Meaningful Use
Comments
15 The EP 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
Measure 1:
The EP who transitions or refers their
patient to another setting of care or
provider of care provides a summary of
care record for more than 50 percent of
transitions of care and referrals
Measure 2:
The EP who transitions or refers their
patient to another setting of care or
provider of care provides a summary of
care record for more than 10 percent of
such transitions and referrals either (a)
electronically transmitted using CEHRT
to a recipient or (b) where the recipient
receives the summary of care record via
exchange facilitated by an organization
that is a NwHIN Exchange participant or
in a manner that is consistent with the
governance mechanism ONC establishes
for the NwHIN
Measure 3:
An EP must satisfy one of the
following criteria:
Conducts one or more successful
electronic exchanges of a summary of
care document, part of which is counted
in “measure 2” (for EPs the measure
at §495.6(j)(14)(ii)(B) with a recipient
who has EHR technology that was
developed/designed by a different EHR
Conducts one or more successful tests with
the CMS-designated test EHR during the
EHR 5.8 UD1
2. NextGen KBM 8.3 or higher.
Multi-RHIO connectivity
requires v.8.3.3 or higher
3. ONC-Direct interface
1. Provider must connect using ONC Direct protocol through a
registered HISP. A state, regional, or local HIE may or may not
include a registered HISP. Engage your NextGen Healthcare
representative to assist in discovery to ensure that your method
of connectivity meets the MU2 requirement
2. Any EP who transfers a patient to another setting or refers a
patient to another provider fewer than 100 times during the
EHR reporting period is excluded from all three measures
3. If the provider to whom the referral is made or to whom the
patient is transitioned has access to the medical record
maintained by the referring provider, then a summary
of care record would not need to be provided. In this case,
the patient must not be included in the denominator for
transitions of care
Stage 2-Core Set

Product Used to
Demonstrate
Meaningful Use
Comments
16 Capability to submit
electronic data to immunization
registries or immunization
information systems except
where prohibited, and in
accordance with applicable
law and practice
Successful ongoing submission of elec-
tronic immunization data from CEHRT to
an immunization registry or immunization
information system for the entire EHR
reporting period
EHR 5.8
2. Immunization registry
interface
Any EP that meets one or more of the following criteria may be
excluded from this objective:
1. The EP does not administer any of the immunizations to any of
the populations for which data is collected by their jurisdiction’s
immunization registry or immunization information system
during the EHR reporting period;
2. The EP operates in a jurisdiction for which no immunization
registry or immunization information system is capable of
accepting the specific standards required for CEHRT at the
start of their EHR reporting period;
3. The EP operates in a jurisdiction where no immunization
registry or immunization information system provides timely
information on capability to receive immunization data; or
4. The EP operates in a jurisdiction for which no immunization
registry or immunization information system that is capable
of accepting the specific standards required by CEHRT at the
start of their EHR reporting period can enroll additional EPs
17 Use secure electronic
messaging to communicate
with patients on relevant
health information
A secure message was sent using the
electronic messaging function of CEHRT by
more than five percent of unique patients
(or their authorized representatives) seen by
the EP during the EHR reporting period
EHR 5.8
Excluded is any EP who has no office visits during the EHR
reporting period, or any EP who conducts 50 percent or more
of his or her patient encounters in a county that does not have
50 percent or more of its housing units with 3Mbps broadband
availability according to the latest information available from
the FCC on the first day of the EHR reporting period
Stage 2-Core Set

Product Used to
Demonstrate
Meaningful Use
Comments
1 Capability to submit electronic
syndromic surveillance data to
public health agencies except
law and practice
Successful ongoing submission of electron-
ic syndromic surveillance data from CEHRT
to a public health agency for the entire EHR
reporting period
EHR 5.8
2. Syndromic Reporting
interface
Any EP who meets one or more of the following criteria may
be excluded from this objective:
1. The EP is not in a category of providers that collects ambulatory
syndromic surveillance information on their patients during the
EHR reporting period;
2. The EP operates in a jurisdiction for which no public health
agency is capable of receiving electronic syndromic surveillance
data in the specific standards required by CEHRT at the start of
their EHR reporting period;
3. The EP operates in a jurisdiction where no public health
agency provides information timely on capability to receive
syndromic surveillance data; or
agency that is capable of accepting the specific standards
required by CEHRT at the start of their EHR reporting period
can enroll additional EPs
2 Record electronic notes in
patient records
Enter at least one electronic progress note
created, edited, and signed by an EP for
more than 30 percent of unique patients
with at least one office visit during the EHR
reporting period. The text of the electronic
note must be text searchable and may
contain drawings and other content
NextGen Ambulatory
EHR 5.8
3 Imaging results consisting
of the image itself and any
explanation or other ac-
companying information are
accessible through CEHRT
More than 10 percent of all tests whose
result is one or more images ordered by
the EP during the EHR reporting period
are accessible through CEHRT
NextGen Ambulatory
EHR 5.8
Excluded is any EP who orders fewer than 100 tests resulting in
an image during the EHR reporting period; or any EP who has
no access to electronic imaging results at the start of the EHR
reporting period
4 Record patient family health
history as structured data
seen by the EP during the EHR reporting
period have a structured data entry for one
or more first-degree relatives
NextGen Ambulatory
EHR 5.8
Any EP who has no office visits during the EHR reporting period
Stage 2-Menu Set

Product Used to
Demonstrate
Meaningful Use
Comments
5 Capability to submit cancer
case measure data to a public
health central cancer registry
except where prohibited, and
in accordance with applicable
law and practice
Successful ongoing submission of cancer
case information from CEHRT to a public
health central cancer registry for the entire
EHR 5.8
2. NextGen KBM v.8.3 or higher
3. Cancer Case Measure
Any EP who meets one or more of the following criteria may be
excluded from this objective:
1. The EP is not in a category of providers that collect ambulatory
cancer case measure information on their patients during the
agency is capable of receiving electronic cancer case data in
the specific standards required by CEHRT at the start of their
3. The EP operates in a jurisdiction where no public health
agency provides information timely on capability to receive
cancer case data; or
agency that is capable of accepting the specific standards
required by CEHRT at the start of their EHR reporting period
can enroll additional EPs
6 Capability to identify and
report specific cases to a
specialized registry (other
than a cancer registry), except
law and practice
Successful ongoing submission of
specific case information from CEHRT to
a specialized registry for the entire EHR
reporting period
EHR 5.8
2. Specialized registry
interface
Any EP who meets at least one of the following criteria may
be excluded from this objective:
1. The EP does not diagnose or directly treat any disease
associated with a specialized registry sponsored by a relevant
national specialty society, or a public health agency (PHA) in
his/her jurisdiction;
2. The EP operates in a jurisdiction for which no specialized
registry sponsored by a relevant national specialty society
is capable of receiving electronic information in the specific
standards required by CEHRT at the beginning of their EHR
reporting period; or
3. PHA does not provide timely information on such capability.
4. PHA is unable to enroll additional EPs on time for the EHR
reporting period
Stage 2-Menu Set

NextGen Healthcare Information Systems, LLC / 795 Horsham Road, Horsham, PA 19044 /
p: 215.657.7010 / f: 215.657.7011 / nextgen.com
Copyright © 2014 NextGen Healthcare Information Systems, LLC. All rights reserved.
NextGen is a registered trademark of QSI Management, LLC, an affiliate of NextGen
Healthcare Information Systems, LLC. All other names and marks are the property of their
respective owners. Patent pending.
To learn how we can help,
contact us:
sales@nextgen.com
855 - 510 - 6398
Take the Next Step
NextGen Healthcare Meaningful Use Resources
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tools, experts, experience, and critical information
• Our extensive MU Resource Center is filled with the latest MU
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• Go here to continue your MU journey with NextGen Healthcare
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