Meaningful Use Stage 3 (MU3) Objective 3

1. Introduction 

• Purpose: This comprehensive guide outlines the steps required to obtain credit for Objective 3: Clinical Decision Support (CDS) under the Meaningful Use Stage 3 (MU3) framework. 

• Key Features: Implementation of clinical decision support rules, integration with office visits, and enabling drug-drug and drug-allergy interaction checks. 

2. MU3 Objective 3: Clinical Decision Support (CDS) 

Overview 

Objective 3 focuses on enhancing patient care through the implementation of clinical decision support tools. There are two measures required to meet this objective: 

1. Implement 5 Clinical Decision Support Rules related to Clinical Quality Measures (CQMs). 

2. Enable Drug-Drug and Drug-Allergy Interaction Checks for the entire reporting period. 

3. Measure 1: Implementing Clinical Decision Support Rules 

Step 1: Activating Decision Support in iClinic 

1. Click on the Settings Icon. 

2. Navigate to EMR > General. 

3. Locate the Decision Support setting. 

4. Change the option from No to Yes. 

5. Click Save to activate decision support. 

Step 2: Creating Decision Support Rules 

1. Access Health Registry: 

• Click on the Health Registry Icon located on the left side of your screen. 

2. Create New Rule: 

• Click New. 

• In the pop-up box, enter a name under Guideline Name. 

• Select Decision Support from the Guideline Type dropdown. 

• Ensure Enable is checked. 

• Click Save to proceed. 

3. Configuring the Decision Support Rule: 

• The Action Editor will open automatically. 

• Click Add Operator.  

• Leave the first dropdown as “AND”. 

• In the second dropdown, select Diagnosis Code. 

4. Adding ICD Codes: 

• A box labeled Action Guideline Editor will appear. 

• Click Add. 

• Search for the required ICD Code (e.g., type “Hypertension” and click Go). 

• From the results, select the correct code (e.g., I-10) by double-clicking it. 

• Click Save after selecting the ICD code. 

Step 3: Customizing the Order Set 

1. Click Customize (located to the right of the Order Set). 

2. On the Order Set Customization Page: 

• Enter a name for the order set. 

• Complete the desired sections (these will appear in the office visit when the rule is triggered). 

• Click Save after completing the customization. 

3. Linking the Order Set to the Decision Support Rule: 

• Return to the Action Editor Page. 

• Click Refresh. 

• Click Add next to Order Set. 

• In the pop-up box labeled Add Order Set:  

• Select the appropriate order set from the dropdown. 

• Click Select. 

• Click Save Action to finalize. 

Step 4: Applying the Decision Support Rule in an Office Visit 

1. Open the patient's visit. 

2. Navigate to the ICD/CPT Section. 

3. Add the diagnosis code linked to your decision support rule:  

• Search the Superbill or the Database. 

• Double-click the code to add it. 

4. Click Save. 

5. On the right panel under Reference, look for Decision Support (should appear in blue). 

6. Click Decision Support:  

• The applicable decision support rule will appear. 

• Click Apply to integrate it into the office visit. 

7. Review the visit sections to ensure the order set is applied correctly. 

4. Measure 2: Enabling Drug-Drug and Drug-Allergy Interaction Checks 

Step 1: Enabling Interaction Checks in iClinic 

1. Click the Settings Icon. 

2. Navigate to E-Prescription > Options. 

3. Scroll to the bottom to locate Interaction Checks:  

• Check Drug Interaction Automatically: Set to Yes. 

• Check Drug Allergy Interaction Automatically: Set to Yes. 

• Check Drug Disease Interaction Automatically: Optional (not mandatory). 

4. Click Save to confirm the settings. 

Compliance Requirements 

• Ensure that interaction checks remain enabled for the entire reporting period. 

• Periodically verify that these settings are active to maintain compliance. 

5. Troubleshooting Tips 

• Decision Support Not Triggering: 

• Verify that the rule is enabled. 

• Check if the correct ICD code is associated with the rule. 

• Ensure the order set is properly linked to the decision support rule. 

• Missing Decision Support Options: 

• Confirm that decision support is activated in EMR Settings. 

• Refresh the patient visit screen after applying changes. 

• Interaction Check Errors: 

• Recheck the E-Prescription Settings to ensure interaction checks are enabled. 

• Clear cache or log out and back in if settings are not applying. 

6. Support Guidelines 

• In-App Support: Utilize the help feature within iClinic for immediate assistance. 

• Compliance Officer: Contact your organization’s compliance officer for regulatory inquiries. 

• Technical Support: Reach out to IT support for technical issues related to decision support or interaction checks. 

Thank you for following the MU3 compliance process. This guide ensures you meet regulatory standards while promoting enhanced clinical decision-making and patient safety.