Skip to Content
Meaningful Use Public Health Options in TN

Meaningful Use Summary

The Tennessee Office of E-Health Initiatives is coordinating the state's response to Meaningful Use, MU, and health information exchange. Please visit www.tn.gov/ehealth/ for more information on the federal programs driving these initiatives. For Medicaid specific MU information, please visit www.tn.gov/tenncare/mu.shtml.

The Centers for Medicare and Medicaid Services, or CMS, has specified three requirements for demonstrating Meaningful Use via the Electronic Health Record, EHR, Incentive Program. They are:

  1. Providers will use certified EHR technology in a meaningful manner (e.g., electronic prescribing);
  2. Providers will connect the certified EHR technology in a manner that provides for the electronic exchange of health information to improve the quality of care; and
  3. Providers using certified EHR technology will submit to the U.S. Health and Human Services Secretary, clinical quality measures and such other measures as selected by the Secretary. Submission by the provider of information, using certified EHR technology, regarding clinical quality measures and such other measures as selected by the Secretary.

Meaningful use involves three graduated stages for implementing meaningful use and electronic health record certification requirements. The meaningful use criteria for each stage will focus on the following:

Stage 1. Capture/Share data
Stage 2. Advanced care processes with decision support
Stage 3. Improved Outcomes

For Eligible Hospitals and Eligible Professionals in Stage 1

Eligible professionals, EPs, must attest to a total of 15 Core MU measures. Eligible hospitals, EHs, must attest to a total of 14 Core MU measures. In addition, EHs and EPs must choose five of the ten menu measures, including at least one Public Health measure.

The three Public Health objectives include:

  1. Sending immunization registry updates (menu option for both EHs and EPs, TDH encourages full exchange with the registry to include queries, responses, and updates) ;
  2. Sending electronic laboratory reports, or ELR (menu option for EHs only) ; and
  3. Sending syndromic surveillance information to PH agencies (menu option for both EHs and EPs, TDH is not currently participating in testing Syndromic Surveillance messages for Meaningful Use Stage 1).

Currently for MU purposes, TDH is exchanging immunization registry data for both children and adults and encourages full exchange with the immunization registry to include queries, responses, and updates. TDH is also currently accepting ELR using interoperability standards outlined in the MU objectives. At this time, however, TDH is not currently participating in testing Syndromic Surveillance messages for Meaningful Use.

For Eligible Hospitals and Eligible Professionals in Stage 2

Eligible professionals, EPs, must attest to a total of 17 Core MU measures. Eligible hospitals, EHs, must attest to a total of 16 Core MU measures. In addition, EHs and EPs must choose 3 of the 6 Menu measures.

The five Public Health objectives include 3 Core measures and 2 Menu measures.

Core measures:
  1. Sending immunization registry updates (core measure for both EHs and EPs, TDH encourages full exchange with the registry to include queries, responses, and updates)
  2. Sending electronic laboratory reports, or ELR (core measure for EHs only)
  3. Sending syndromic surveillance information to PH agencies (core measure for both EHs and EPs, TDH is not currently participating in testing Sydromic Surveillance messages for Meaningful Use Stage 2)
Menu measures:
  1. Sending cancer case reports to the cancer registry (menu option for EPs only); and
  2. Sending case reports to a specialized registry (menu option for EPs only, TDH is not currently participating in testing Other Registry reporting for Meaningful Use Stage 2)

The earliest Stage 2 could begin for EHs is October 2013, and the earliest Stage 2 could begin for EPs is January 2014. Currently for MU purposes, TDH is exchanging immunization registry data for both children and adults and encourages full exchange with the immunization registry to include queries, responses, and updates. TDH is also currently accepting ELR using interoperability standards outlined in the MU objectives. TDH anticipates accepting cancer case reports using interoperability standards outlined in the MU objectives starting in January 2014. At this time, however, TDH is not currently participating in testing Syndromic Surveillance messages or Other Registry reporting for Meaningful Use. For more information, see TDH’s Declaration of Readiness.

What do the regulations say?

According to the Stage 2 Final Rule and the Stage 2 MU Public Health Reporting Requirements Task Force, MU Stage 2 Public Health objectives require ongoing submission of actual patient data, and EPs and EHs will be contacting Public Health Agencies to register their intent to do so. If the Public Health Agency has the capacity to accept the data (see Tennessee Declaration of Readiness section below), an EP or EH can meet a Public Health objective through any of the following four (4) criteria:

  • Ongoing submission was already achieved for an EHR reporting period in a prior year and continues throughout the current EHR reporting period using either the current (2014 Edition) standards or the standards included in the 2011 Edition EHR certification criteria adopted by ONC during the prior EHR reporting period when ongoing submission was achieved.
  • Registration with the Public Health Agency or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline (within 60 days of the start of the EHR reporting period) and ongoing submission was achieved.
  • Registration of intent to initiate ongoing submission was made by the deadline and the EP or EH is still engaged in testing and validation of ongoing electronic submission (see On-Boarding section below).
  • Registration of intent to initiate ongoing submission was made by the deadline and the EP or EH is awaiting invitation to begin testing and validation (see On-Boarding section below).

The measure will not be met if the EP or EH:

  • Fails to register their intent by the deadline; or
  • Fails to participate in the on-boarding process as demonstrated by failure to respond to the Public Health Agency's written requests for action within 30 days on two separate occasions

*From the CMS Stage 2 Final Rule 77 FR 54021 - http://www.federalregister.gov/a/2012-21050/p-1009 and the Stage 2 MU Public Health Reporting Requirements Task Force http://www.phconnect.org/group/ph-reporting-task-force

Tennessee Declaration of Readiness

At this time, Tennessee is participating in the following Public Health objectives for Meaningful Use

Registration of Intent

To register your intent with TDH, please see the contact information below for each Public Health objective.

For questions about registration of intent, please contact CEDS.Informatics@tn.gov.

Please Note: TDH is currently working on a standardized, web-based registration portal with anticipated availability in 2014.

Meaningful Use On-Boarding and Documentation

On-Boarding

For specifics about on-boarding and testing processes, please see the contact information below for each Public Health objective.

Documentation

Please retain all email correspondence and official letters from TDH that document progress or steps achieved during on-boarding. These documents should be maintained and can be used for your MU attestation. Documentation for on-boarding status from TDH will be provided if the requirements of the particular on-boarding status are met and the trading partner is clearly identified in the artifact.

Preferred Secure Transport Methods

Below are the currently preferred transport methods for each Public Health objective. Additional mechanisms might be available for each objective and can be discussed upon establishment.

More Information About Public Health Objectives

For more information on the Public Health MU Items including the on-boarding and testing processes, trading partner agreements, and specifications please find the following.  All fact sheets will be updated annually.

ELR - For Eligible Hospitals:

Immunization Registry Submissions - For Eligible Professionals or Eligible Hospitals:

Syndromic Surveillance Submissions for MU testing - For Eligible Professionals or Eligible Hospitals:

  • Contact TDH Communicable Disease Surveillance Systems and Informatics Program at (615) 741-7247
  • Syndromic Surveillance Fact Sheet (PDF)
  • TDH is not currently participating in testing Syndromic Surveillance messages for Meaningful Use Stage 1 or Stage 2.

Cancer Case Reporting - For Eligible Professionals:

Other Registries - For Eligible Professionals:

  • TDH is not currently participating in testing Other Registry reporting for Meaningful Use Stage 2
  • If you have questions about any other TDH registry not listed above, please contact tn.health@tn.gov

For questions regarding Meaningful Use, please contact CEDS.Informatics@tn.gov