The Centers for Medicare and Medicaid Services (CMS) specifies the criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to continue to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The EHR Incentive Program provides financial incentives for the “meaningful use” (MU) of certified EHR technology to improve patient care. To receive an EHR incentive payment, providers have to show that they are “meaningfully using” their EHRs by meeting thresholds for a number of objectives. Providers must meet the Stage 1 requirements for a 90-day period in their first year of meaningful use and a full year in their second year of meaningful use. After meeting Stage 1 criteria, providers then have to meet Stage 2 requirements for two full years. 

There are Public Health MU objectives that must be met in Oregon. For Stage 1, electronic immunization data must be submitted, and CAHs have the option of also meeting the electronic laboratory (ELR) or syndromic surveillance reporting objectives. During Stage 2 (which begins in October 2013 for Medicare eligible providers and in January 2014 for Medicaid eligible providers), in addition to ongoing submission of immunization data, EPs may also choose to submit electronic data to the cancer registry. CAHs will be required to send ongoing data to the immunization registry, ELR, and syndromic surveillance data. For more information on MU attestation, please visit the Oregon Medicaid EHR Incentive Program website.

Below is a description of the methods to submit electronic health information to meet Public Health Meaningful Use.

• To meet this objective, an eligible provider or eligible hospital must perform at least one test of the certified EHR capacity to submit electronic data to an immunization registry (ALERT IIS).
• Ongoing submissions of data are encouraged if the test is successful.
• Successful submissions to ALERT IIS are
  • generated by certified EHR technology,
  • follow HL7 version v2.4 specifications, and
  • include CVX codes as the vocabulary standard. 

 Electronic Laboratory Reporting  

• To meet this objective, an eligible hospital must perform at least one test of the certified EHR capacity to submit reportable laboratory results to the Public Health Division.
• In addition to meaningful use, ELR is now legally mandated by the state for laboratories sending an average of more than 30 records per month to Oregon Public Health.
• Ongoing submissions of data are encouraged if the test is successful.
• Successful submissions to Oregon ELR are
  • generated by certified EHR technology,
  • follow HL7 version 2.5.1 specifications, and
  • include LOINC and SNOMET CT codes as data content standard. 
    

To meet this objective, an eligible hospital must perform at least one test of the certified EHR capacity to submit electronic data to the Public Health Division (ESSENCE).

• Ongoing submissions of data are encouraged if the test is successful.
• Successful submissions to ESSENCE are
  • generated by certified EHR technology and
  • follow HL7 version 2.5.1 specifications

Steps for Meaningful Use Testing

1. Visit www.cms.gov/EHRIncentivePrograms for Medicare EHR incentives, and www.medicaidehrincentives.oregon.gov/ for Oregon's Medicaid EHR incentives
2. Review the appropriate Public Health message specification guide.
   1. ALERT IIS: www.immalert.org/NEW_ALERT_IIS/alert_iis_gen_xfer_spec.pdf
   2. ELR: www.healthoregon.org/elrresources
   3. Syndromic Surveillance: www.cdc.gov/phin/library/guides/Syndromic_Surveillance_Implementation_Guide_Release_1_4.pdf
3. Prepare and send a sample message to the appropriate Public Health program.
4. Receive a report from the Public Health program on whether the results of the test submission meet Meaningful Use requirements for attestation purposes.
5. Work with program technical staff to set up ongoing data reporting or exchange.