Two changes – Summary of care record is for both Hospitals and EPs. Drug/Formulary checking was split to its own menu objective.

Many of the measures now include the Emergency Department. This was likely done since many organizations were concerned about meeting 10% CPOE without the ED. The unintended consequence of adding ED to the denominator of the other objectives is the ED systems need to be certified. Also, these ED systems now need to perform many of the same functions as the core clinical system to meet the measurement across the hospital population. i.e. Drug/Drug and Drug/Allergy Checking, Problem Lists, Vitals, Smoking etc.

RE: Eligibility and Electronic Claims – The comments in the standards final rule basically said that this is often performed outside of an EHR system (and sometimes by a third party); EHR vendors who might otherwise function as a Complete EHR would fail on this point. Also, as Pez points out, most already do this, so there was not need to provide incentives.

Inga, you might want to highlight which objectives are part of the core set of required definitions of MU and which are the optional ones. I would be interested in seeing a vote of folks on which ones they think their practices or hospitals will likely pursue from the optional list.

What is everyone’s thoughts on the required list and this new optional list? Some of the items on the optional list I know are not adopted by many states and if I read this 800+ page document correctly, could go against the 5 they get to “omit”. So instead of just choosing 5 to omit, they have to include the 2 or 3 that are not even required by their state into the 5 they omit instead of just ignoring them as impossible to meet & still getting to choose 5 to not meet at this time (if they so choose…).