Our skilled technicians foresaw many important clinical needs that were overlooked in the new Meaningful Use criteria. Stage 2 certification allows clients to meet their Meaningful Use needs, and assures them that our product is technologically sound, innovative, and competitive in today’s EHR software marketplace. However, we designed our system to go beyond the bare minimum. Backed by a support system that remains unparalleled by competitors, our full suite of products is crafted with the user in mind. We provide clinicians with a powerful, reliable, and intelligently integrated tool to improve patient care.

ARRA may have established the standards, but we are not satisfied with the status quo. We strive to go above and beyond what is required of us to ensure that our clients possess the most effective tools to complete their work as healthcare professionals. 16 core objectives and 6 menu objectives make up ARRA’s set requirements for Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs) as part of Stage 2.

As Stage 3 requirements have begun to roll out and take effect, Meta has also taken initiative to ensure our systems are ready for the next phase of Meaningful Use EHR adoption.

Read below to learn how Meta is meeting the mark — and surpassing the standard — in Stage 2 Meaningful Use certification.

Eligible Hospital and Critical Access Hospital Meaningful Use Core Objectives

1. Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders

We recognize the intrinsic need for a computerized system tasked with ordering and monitoring interactions between different hospital departments. The manual exchange of vital information is vulnerable to human error, but Metacare CPOE™ ensures the secure and efficient transfer of information between different clinical disciplines.

Our CPOE system is equipped with all the tools needed to assist health professionals in their daily activities. The intuitive user interface not only streamlines order entry, but also makes the application a tool that physicians will want to use. Metacare CPOE™ is completely integrated with all other Metacare Enterprise EHR™ solutions and utilizes a collective database for easy-access data storage. In addition, our browser-based design permits an easy and secure solution to accessing information from remote locations. Customizable order entry forms are integrated with MetaCare IntelliForms™ for comfortable use, and our patented Event Manager™ application even provides caretakers with patient follow-up alerts. These innovations in EHR technology are just a few of the many ways in which Meta’s system supplies healthcare providers with a secure and comprehensive solution to their healthcare IT needs.

The system as a whole is programmed in accordance with Six Rights Checking: the right patient, given the right drug, at the right dose, with the correct route of administration, at the right time, and documented in the correct manner. MetaCare CPOE™ also uses our IntelliMed™ interactive rules-based engine, which allows our users to determine their own preferences for real-time adverse reaction alerts and other clinical decision support (CDS) features – another way in which our EHR software improves patient safety and overall patient outcomes.

2. Record demographic information

This feature requires EHR systems to record and display five key factors to help identify and categorize patients:
(A) Preferred language
(B) Sex
(C) Race
(D) Ethnicity
(E) Date of birth
The recording of this information allows doctors and health professionals to obtain information that may be critical to patient care. Meta’s CPOE system prominently displays the patient’s preferred language, so as to avoid difficulties in communication when time is vital to his or her safety. Race and ethnicity remind doctors to check for certain genetic disorders, while sex and date of birth offer a solution to confusion and patient mix-ups. Each of the five key factors is readily accessible with Meta’s easy-to-use software, along with patient history, for more responsible patient care.

3. Record and chart changes in vital signs

Similar to the recording of demographic information, Meta’s healthcare software is required to identify and categorize four different vital signs:
(A) Height
(B) Weight
(C) Blood pressure
(D) Calculate and display body mass index (BMI)
Providers are responsible for entering patient height, weight, and blood pressure into the system, while Meta’s certified EHR technology takes care of calculating BMI and constructing graphic charts in applicable cases. Permission to view this information is controlled by the user, granting easy access to all pertinent healthcare providers while protecting patient privacy.

Having this information on a single platform makes viewing easy and efficient, allowing doctors, pharmacists, and nurses to coordinate effectively on vital sign-specific patient needs. Information is managed simultaneously between MetaCare CPOE™, MetaCare eMAR™, and MetaCare IntelliForms™ to be viewed and recorded in various manners. Our eMAR software verifies the medication type, dosage and restrictions based on these readings with its barcode technology, while IntelliForms’ user-friendly interface allows for the information to be recorded with customizable text and data layouts. Care providers are able to view both the patient’s history and current state across multiple locations, reducing time, cost, and most importantly, mistakes.

4. Record smoking status for patients 13 years old or older

Tobacco use poses one of the greatest health risks to patients in the United States. The evidence is clear and straightforward: the simple act of inquiring about and recording a patient’s tobacco use can have a profound effect on patient outcome. Doctors will be able to easily reference this information with MetaCare CPOE™ and make decisions based on different smoker codes. These include current every day smoker, current some day smoker, former smoker, never smoker, smoker (current status unknown), unknown if ever smoked, heavy tobacco smoker and light tobacco smoker. This is just another simple, but effective way that Meta’s software assists physicians, and protects patients.

5. Use clinical decision support to improve performance on high-priority health conditions

Meta provides its users with an intelligent clinical decision support system (CDSS) to assist clinicians at the point of care. According to Dr. Jeremy Wyatt and Dr. David Spiegelhalter, experts in the field who have been discussing the topic for more than twenty years, Clinical Decision Support Systems (CDSS) are defined as “active knowledge systems, which use two or more items of patient data to generate case-specific advice” (Wyatt J, Spiegelhalter D, 1991). With Meta’s CDSS solution, source information is recorded and processed by our patented MetaCare CPOE™ technology. After input by the user, the system provides physicians with what it determines to be the “correct” patient assessment. The interaction between doctor and CDSS allows for a more accurate analysis than either could achieve alone.

Our CDSS is driven by our IntelliMed™ Guidelines feature. This feature is part of the comprehensive MetaCare Enterprise EHR suite of products, and is integrated into our MetaCare CPOE™ system. IntelliMed™ concurrently evaluates and initiates clinical decision support as the user interacts with the patient’s records. As orders and patient files are updated, our software offers alerts to any adverse reactions that may arise as a result of that decision. The system resolves the patient’s medical history, vital signs, current medications, lab results, allergies, etc., to help determine the most appropriate course of action for that patient. All guidelines can be set by the user in accordance with facility mandates and protocol to ensure that the system maximizes efficiency and safety in the care setting. With Meta’s IntelliMed™ feature, health professionals can be reassured that only the most accurate and thorough healthcare technology is being employed to link observation and medical knowledge, improving clinical decisions and patient outcome.

6. Patient electronic access

Meta Healthcare, in compliance with new Stage 2 standards, now provides patients with the ability to view, download and transmit information about a hospital admission from a secure webpage. Upon request, patients may access the following information from any remote location with the Meta Healthcare Patient Portal:

  • Patient name
  • Admit and discharge date and location
  • Reason for hospitalization
  • Care team including the attending of record as well as other providers of care
  • Procedures performed during admission
  • Current and past problem list
  • Current medication list and medication history
  • Current medication allergy list and medication allergy history
  • Vital signs at discharge
  • Laboratory test results (available at time of discharge)
  • Summary of care record for transitions of care or referrals to another provider
  • Care plan field(s), including goals and instructions
  • Discharge instructions for patient
  • Demographics maintained by hospital (sex, race, ethnicity, date of birth, preferred language)
  • Smoking status

The secure exchange of health information is important to Meta, not only for patient privacy matters, but also to ensure patient safety after discharge. By reviewing and discussing this information with the patient before they leave the physician’s care, doctors are able to give their patients clear instructions that can be easily accessed and reviewed. Allowing patient electronic access is hugely helpful in reducing patient error after discharge, and preventing patient relapse.

7. Protect electronic health information created or maintained by Certified EHR Technology

Protecting personal information is an ancient tradition and sacred responsibility of healthcare providers (if you have not already heard of him, check out a physician by the name of Hippocrates!). By safeguarding patient information in accordance with the HIPAA Privacy Rule, the MetaCare Enterprise EHR™ suite quells the fears some practices have against implementing EHR technology.

Meta’s security system focuses on non-local data storage, and does not allow users to disable Audit Logs (complete records of all clinical activity) and other security features. All patient information is stored on the server and is unable to be accessed by users directly. The application instead creates an ASP.NET session ID, which is then temporarily stored as a cookie so as to identify the current user during the retrieval of patient information; none of this data is stored locally on the workstation or in the web-browser cache or local repositories. Once the user logs out of the application, the ASP.NET session ID is removed from the web-browser. Audit logs cannot be disabled and are used to track all activity, holding clinicians accountable for their actions. Clinicians may override the system’s commands, granted the action is justified and reported in an Override Report. Though these features remain strictly in this way to protect information, many of Meta’s other security features can be configured during system installation to allow preferences to be set in accordance with the user’s needs.

Stage 2 Meaningful Use measures also required us to conduct a risk analysis to prevent, detect, contain and correct any possible security violations. We are proud to declare that our system’s defenses against cyber-attacks and other common security gaps have been approved and fortified to protect patients, information, and our clients’ practices.

8. Incorporate clinical lab test results into Certified EHR Technology as structured data

The importance of test results cannot be understated, which is why at Meta we have dedicated our efforts to ensure that results can be accessed quickly, easily, and effortlessly. Having clinical test results available within the complete EHR helps physicians make real time decisions based on critical results and contributes to efficiency in the workplace. It also reduces the error involved in the transferring paper results between offices and departments. One of Meta’s most innovative features in this regard, however, is the ability to view the complete patient diagnostic result history represented both numerically and visually in reverse chronological order with our flow chart feature. All results can be filtered based on clinician input, allowing for accurate visual aids that assist clinicians in patient assessment.

With Meta Healthcare IT Solutions’ full suite of EHR technology, results are transmitted and fully integrated with MetaCare CPOE™. All test results can be viewed by clinicians across all platforms, improving productivity and allowing for a more assured patient care.

9. Generate patient lists

This objective requires EHs and CAHs to generate reports that list patients of a specific condition. These reports are then used for quality improvement, reduction of disparities, research, or outreach. The patient lists are also versatile, allowing healthcare providers to modify reports and determine what criteria would most serve their needs. Generating these lists is especially useful for Population Health Management (PHM), allowing for patient information to be easily grouped for syndromic surveillance, and for the monitoring of patient progress. This objective also helps practices target areas of focus for the education of their staff and patients, as well as assist in identifying areas of outreach. The full MetaCare Enterprise EHR™ suite coordinates information between each individual application to summarize all pertinent information into a useful, input-specific patient list.

10. Use EHR system to identify and supply patient-specific education resources

Electronic Health Record systems are intelligent—they are built to evaluate a patient’s data (i.e. a problem list, a medication list, or laboratory test results) and suggest beneficial educational resources for the individual. This extends the reach of care by empowering the patient with knowledge that can influence their lifestyle outside of the health care facility. Acting on both internal and external sources of information, MetaCare CPOE™ aligns a patient’s condition with research available in several medication, allergy and diagnosis databases.

MetaCare CPOE™ supports the HL7 Infobutton Standard which allows end users to access external information, thus expanding the amount of available resources of patient-specific education. By meeting this standard, our software has the ability to send out a customized URL coded with clinical information about a patient; this URL then populates any third-party sources that support and interact with the HL7 Infobutton standard, matching the patient’s information with appropriate educational resources. Third-party sources that support this standard include Medline Plus, run by the National Institutes of Health.

Our application also comes embedded with innovative and up-to-date databases, allowing internal medical reference searches through our partner First Databank. In combining both internal and external sources of potential patient education resources, MetaCare CPOE™ helps health care providers encourage patients to make informed decisions on their health.

11. Perform medication reconciliation either when the health care facility finds an encounter relevant, or when a patient is either received from another health care setting or provider

There are several instances during which a health care facility may find it “relevant” to perform an updated medication reconciliation for a patient: when a patient returns to the facility after an extended period of time since his or her last visit; when a patient receives a new medication prescription; when a patient transfers into a health care facility for the first time; or when another legitimate reason exists. Medication reconciliation lists a patient’s current medications, problems, and medication allergies based on a comparison of his or her medical record with an external list of medications given by that patient, a hospital, or another provider. The following details must be included:

  • Name of medication
  • Dosage
  • Frequency
  • Route

Performing a medication reconciliation not only keeps staff members informed of a patient’s most recent pharmaceutical concerns, but also gives them the power to update records with swift and efficient technology. There is no need to be hassled with multiple documents and folders. With MetaCare CPOE™, end users can electronically access a list of home medications as well as data from CDA standardized documents. All clinicians can contribute to the population of medication lists, just one example of the advanced interconnectivity of our complete EHR system.

This information is processed and displayed on one screen, giving end users the flexibility of merging and removing data to create a reconciled list of patient medications, problems, and medication allergies. By decreasing the amount of paperwork and time spent on manually updating old records, MetaCare products free end users’ time so they can focus on their main concern: the patient in need.

12. During a patient transition or referral to another health care facility, provide a summary care record for each transition of care or referral

At Meta Healthcare IT Solutions, our main concern is creating a product that will ensure patient safety while reducing risk of error. Part of this task is guaranteeing the safe and seamless flow of information from one clinical sector to the next.

In the event a patient needs to be referred to or transitioned from one health facility to another, the former must supply a Summary of Care Record in order to meet Stage 2 Meaningful Use certification standards. This report includes unique, detailed patient information such as encounter diagnosis, past immunizations, vital signs, smoking status, demographic information, and current problem, medication, and allergy lists.

Each time a patient comes into a health facility using MetaCare CPOE™, his or her information is stored on our common database. MetaCare CPOE™ was skillfully designed to integrate itself with all MetaCare products, allowing all users to view, change, and add to a patient’s information. This easy electronic access simplifies the process of creating a Summary Care Record during the transition period; the current health provider needs only navigate Patient Reports in the CPOE menu tree and automatically generate the Summary Report with the click of the button. Rest assured that information travels safely with MetaCare CPOE™ — by using our certified Direct Project method, the report travels securely to the destination address as entered by the end user.

13. Ability to submit electronic data to immunization registries or immunization information systems

Various concerns have been raised in regards to modern vaccination practices. What vaccinations are necessary to protect our health? What is the threshold for over-vaccination? Health care facilities play a critical role in analyzing and understanding the contemporary use of vaccines by submitting data to immunization registries and information systems. Throughout an entire EHR reporting period, a health facility meeting Stage 2 Meaningful Use requirements can be confident that its MetaCare eMAR™ application will successfully submit such data without concern.

With the advent of EHR, health facilities can rely on eMAR software applications to increase patient safety during vaccine administration. MetaCare eMAR™ assists clinicians by transmitting electronic data to the appropriate external institutions, alleviating the stress on facility staff to send data in a timely fashion.

During vaccination administration, our eMAR system is designed to automatically create an immunization message that will be received by an external immunization registry or information system. The vaccination administration data is stored in our unified database, which automatically triggers the generation of a conformant HL7 v2.5.1 message containing the immunization record information, and sends it to the institution that requires this data. Alternatively, MetaCare eMAR™ has the option to create an immunization record directly within the immunization module.

In the past few decades, Healthcare IT has successfully reduced the lag time between data collection, transmission and analysis. By creating efficient automated systems that decrease the burden, stress, and tediousness of paperwork distribution, Meta Healthcare IT Solutions makes interfacing with external institutions one less area of concern for our clients.

14. Ability to submit electronic reportable laboratory results to public health agencies

Stage 2 Meaningful Use calls for the transfer of electronic reportable laboratory results between health facilities and public health agencies (PHAs). These PHAs may include state, regional and/or local public health authorities, as well as designated third parties. A prime example of this objective’s utility, health facilities are able to make immunization records easily available to public institutions in need of them, such as schools. By focusing on patient health on a grand scale, PHAs and care providers can successfully collaborate towards the improvement of syndromic surveillance – a term that entails analyzing comprehensive medical data to detect and prevent outbreaks of disease and epidemics.

MetaCare Enterprise EHR™ is capable of integrating successfully with external software systems to provide hospitals with this functionality. However, the team at Meta is currently developing a homegrown version of this feature, and plans to incorporate it into our complete EHR to allow providers to contribute to the improvement of public health, both in their communities and on a national scale.

15. Ability to submit electronic syndromic surveillance data to public health agencies

As part of the late 19th-century movement to prevent emerging infectious outbreaks, the CDC has asked hospitals to enhance the role it plays in surveying public health by sending syndromic surveillance data to public health agencies. By their definition, syndromic surveillance data includes “health-related data that precede diagnosis and signal a sufficient probability of a case or an outbreak to warrant further public health response.”

Meta Healthcare IT Solutions is taking its part in detecting disease outbreak and preventing the potential for biological warfare by incorporating syndromic surveillance (SS) into its Stage 2 Meaningful Use certified EHR system. Each time a patient visits a health care facility using MetaCare CPOE™, their information is logged into a unified database that is enabled to send syndromic surveillance data to PHAs. Such PHAs may include state, regional and/or local public health authorities, as well as a designated third party.

Our certified HL7 2.5.1 interface architecture, the “standard” architecture for PHAs receiving syndromic surveillance data, gives end users leeway and control in this automated process. MetaCare CPOE™ is built to detect SS data and electronically send it to external institutions without an end user’s command. However, at Meta Healthcare IT Solutions we want the power to be in the hands of our clients. We will work with you to set up an automated data transmission plan so that information is sent on a pre-determined, periodic schedule. Allowing for configurable functionality and accommodating future developments in HIT are just a few of the ways in which we attempt to include our clients in the continual improvement of our technology.

16. Automatically track medications from order to administration

Our enterprise-wide EHR is capable of tracking medication orders at every step of the fulfillment process. Beginning at order inception, physicians can place and modify orders using MetaCare CPOE™, our computer prescriber order entry system. This application not only streamlines order entry through automation, but also provides clinicians with alerts, integrated medical references, and condition-specific order sets to provide physicians with a comprehensive CDSS.

MetaCare Rx™, our closed-loop pharmacy management system, allows pharmacists to play a greater role in patient care. Pharmacists can directly access and monitor patient charts during medication verification, and any order changes made by the pharmacist will be automatically updated so that the patient’s clinician is aware. Physicians also benefit from the simple, utile design of our Digital Order Entry Panel, where they are able to create and modify all existing orders, and provide other clinicians with drug notes, accurate medication labels, and other information useful during assessment and administration.

Backed with BCMA technology, MetaCare eMAR™ has been internationally recognized for its virtually perfect bar code compliance. Each time a patient’s bar code is scanned, end users gain access to a wealth of information about a patient and his/her drug dose therapy. MetaCare eMAR™ implements Six Rights Checking, as dictated by Stage 2 Meaningful Use certification criteria, to verify the following information:

  • The right patient
  • The right medication
  • The right dose
  • The right route of medication
  • The right time
  • The right method of documentation

The flow of each patient’s unique information is tracked from order entry, to pharmacy fulfillment, administration at the point of care, and back. Drug and order-specific MAR notes made by a prescriber are included in the computerized system to assist interdepartmental communication and ensure clinicians are provided with all pertinent information related to the patient and his/her specific drug therapy. Any clinical alerts overridden by the pharmacy are recorded into the audit log, safeguarding patient health and safety. Additionally, end users can access important information such as a patient’s therapeutic drug utilization report, statistical dose administration report, or record of past drug administrations with just the click of a button. Each time a drug is administered to a patient, MetaCare eMAR™ records the name of the caretaker administering the drug, as well as the time and date using a Network Time Protocol-synced clock.

Through the pairing of MetaCare eMAR™ and CPOE, users gain access to MetaCare Event Manager™, an intuitive clinical event scheduler. This feature reduces the tedious nature of ordering and arranging events such as post-op procedures and follow-up medications. Updated in real-time based on the updates of a patient’s condition, the end user may schedule appropriate events so as not to overlook a patient’s comfort—or pain.

Eligible Hospital and Critical Access Hospital Meaningful Use Menu Objectives

1. Record whether a patient 65 years old or older has an advance directive

In order to guarantee that patient wishes are always being observed, the MetaCare CPOE™ system lists, when legally permitted within state legislation, what actions should be taken by clinicians in the event that sick patients are too ill to make decisions for themselves. The information can subsequently be recorded on MetaCare IntelliDocs™ for the modifiable visualization of patient data. By using Meta’s systems, doctors and healthcare providers can be assured that the will of a patient is securely stored on our CPOE database and easily accessible at all times.

2. Record electronic notes in patient records

Users will be able to electronically record, change, access, and search computerized patient notes, which can be used to track patient progress, and remind doctors of previous thoughts and observations. Digital note entry allows for neat, legible information documentation that is accessible on all MetaCare applications in order to avoid confusion between caretakers. The use of electronic notes, such as MetaCare Progress Notes, assists doctors and improves overall patient care and outcomes.

3. Imaging Results

Meta provides its users with imaging results, such as x-rays and CT scans, to make important clinical results readily accessible at the point of care. MetaCare CPOE™ receives imaging results from an external radiology source or diagnostic information system, and integrates the images into MetaCare CPOE™. By having the images stored on one common database, results are always at the clinician’s fingertips to help make responsible assessments, and never at risk of being misplaced, lost, or stolen.

4. Record patient family health history as structured data

Understanding a patient’s family health history is significant for protecting his or her safety and understanding current health status. Being aware of familial drug allergies, genetic disorders and diseases are a few of the many ways to increase background knowledge on a patient before providing care. Without this information, health care providers put themselves at risk for error; they could administer potentially life-threatening medications or fail to recognize symptoms of a recurring disease. With the Stage 2 Meaningful Use certified MetaCare CPOE™ system, end users can quickly access and update critical information.

Easily found under the CPOE menu tree, end users can view, add, and change information about a patient’s Family Health History. To update a patient’s unique history, clinicians can access Family Health History to alter details such as age groups, relationship types, and disease codes. Family is always a major concern in health care. Whether they present themselves at the bedside or as a genetic flag for critical attention, they should never be ignored.

5. Generate and transmit permissible prescriptions electronically (eRx)

MetaCare Enterprise EHR™ boasts one of the most comprehensive and secure pharmacy management systems available in today’s EHR market. To be certain that a drug has been administered correctly, our software surveys the entire medicine delivery process. Additionally, to avoid problems of illegibility and miscommunication, our software has also been equipped to handle electronic prescriptions.

The MetaCare Rx™ interface benefits clinicians by including pre-set fields that allow all patient information, integrated from MetaCare CPOE™, to be submitted and saved. This makes MetaCare Rx™ a fast and efficient way to write, re-order and transmit prescriptions. Information is easily accessible during follow-up visits and readily available during transitions between physicians/pharmacies. Patients benefit from the ease of being able to forward prescriptions to the pharmacy of their choice, and pharmacies benefit from the simple and practical transfer of information. All of these factors combine to increase the safety and happiness of both patient and clinician.