MU2 #13 – Menu Set Measures

 In Articles, Meaningful Use
Jeanne Chamberlin Director of EMR Consulting

Jeanne Chamberlin
Director of EMR Consulting

Whether you will be attesting to Stage 1 or Stage 2 measures in 2014, there is an important rule change that you need to be aware of. Previously, if you were excluded from a Menu Set (optional) measure, you could count it toward the number of measures you are required to meet. Starting in 2014, this is no longer true. Stage 2 has six Menu Set measures, and you are required to meet three of them. If you are excluded from two of the measures, then you must choose your three from the remaining four measures. For some providers, this change will significantly limit or even eliminate your options.

The three public health/registry reporting measures included in the Menu Set for Stage 2 were discussed in our last blog post. Many providers may find that they are excluded from all three of these, effectively resulting in a requirement that they report on the remaining three Menu Set Measures which are discussed below:

Electronic Notes: More than 30% of patients with at least one office visit during the reporting period have at least one electronic progress note entered into the EHR. The electronic progress note must have text-searchable data. Providers may use direct entry, dictation or converted handwritten notes into the EHR, as long as the end result is a document in the EHR that is text-searchable. The note may include drawings or other content that is not text-based. There are no exclusions for this measure.

Imaging Results: More than 10% of images associated with tests ordered by the provider must be accessible within the EHR. This will most often be accomplished by an interface with a radiology provider, or by printing images and scanning them into your EHR. Some EHRs will offer a link from within their program that brings up an external system to view the image; this is also acceptable. The denominator for this measure is the number of tests ordered by the provider during the reporting period where the test result is an image. At a minimum this includes radiology studies; however, a provider may include other types of tests that have an image, as long as they include them consistently across all patients and throughout the reporting period (for example, you could choose to include EKG images). A provider is excluded from the measure if she or he orders less than 100 radiology tests during the reporting period (for 2014, this is a calendar quarter). A second exclusion can be taken at the beginning of the reporting period if none of the imaging providers you work with are providing an electronic image that you can access through your EHR.

Family History: More than 20% of patients seen have structured data entered into the EHR that reflects the medical history of at least one first-degree relative (parents, offspring, siblings). For patients who are asked about their family history but do not know details, an entry of family history “unknown” is acceptable. Family history must be recorded using SNOWMEDCT or the HL7 Pedigree standard. All 2014 certified EHRs will be capable of recording family history using these nomenclatures; however, you should check with your EHR vendor to confirm that previously entered family history will be converted to this required data standard. A provider that has no office visits during the reporting period meets the exclusion for this measure.

We recommend that you work with your state and local public health agencies, your medical societies and your EHR Vendor in order to fully understand which measures you are excluded from and which are available choices for your practice and providers.

Visit the CMS Specification Sheet for each Stage 2 Measure.

Need help unraveling the complexities of Meaningful Use? MSOC Health can help! Contact Jeanne Chamberlin, Director of EMR Consulting at 919-442-2422 or


To learn more about Meaningful Use, read the entire blog series, Getting Ready for MU 2:

  1.   Intro to Stage 2 – Who needs to get ready
  2.   Stage 1 changes in 2013/2014
  3.   The Same … But More (measures w/higher thresholds & menu-to-core)
  4.   Ordering and Results (CPOE/Lab Results)
  5.   Access to Electronic Info – Patient Portal
  6.   Secure Messaging and Implementing Patient Portal
  7.   Clinical Summaries
  8.   Patient Reminders
  9.   Summary of Care – Part 1
  10.   Summary of Care – Part 2, Electronic Exchange
  11.   Clinical Quality Measures and Clinical Decision Support
  12.   Public Health & Registry Reporting



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