1. Meeting Stage 1 Meaningful Use Criterion Carlos A. Leyva, Esq. Digital Business Law Group, P.A. www.digitalbusinesslawgroup.com

2. Stage 1 Meaningful Use Core Set Health Outcomes Policy PriorityObjectivesMeasures Eligible ProfessionalsEligible Hospitals and CAHs Improving quality safety, efficiency, and reducing health disparities CPOE for medication orders> 30% of patients with at least one medication ordered with CPOE Implement drug-drug and drug-allergy interaction checks.Enabled for entire EHR reporting period Generate and transmit permissible prescriptions electronically> 40% of all permissible prescriptions transmitted electronically Record demographics: language, gender, race, ethnicity, DOB Record demographics: language, gender, race, ethnicity, DOB, date and preliminary cause of death in the event of mortality in eligible hospital or CAH > 50% Maintain up-to-date problem list of current and active diagnoses> 80% have at least one entry or indication of no known problems Maintain active medication list> 80% Maintain active medication allergy list> 80% Record and chart changes in vital signs: height, weight, blood pressure, calculate and display BMI, Plot and display growth charts for children 2-20 years, including BMI > 50% unique patients ages 2 and over Record smoking status for patients 13 years and older> 50% Implement one clinical decision support rule relevant to specialty or high clinical priority along with ability to track compliance Implement one clinical decision support rule

3. Health Outcomes Policy Priority ObjectivesMeasures Eligible ProfessionalsEligible Hospitals and CAHs Report ambulatory clinical quality measures to CMS or StatesFor 2011, provide aggregate number, denominator and exclusions through attestation. For 2012, electronically submit clinical quality measures. Engage patients and families in their health are Provide patients with an electronic copy of health information (including diagnostic test results, problem list, medication lists, medication allergies) upon request > 50% inpatient or ED departments or hospital or clinic/provider's office within 3 business days Provide patients with an electronic copy of discharge instructions at time of discharge, upon request > 50% at time of discharge Provide clinical summaries for patients for each office visit > 50% within 3 business days Improve care coordinationCapability to exchange key clinical information among providers of care and patient authorized entities electronically. Performed at least one test of EHR technology's capability to electronically exchange key clinical information Ensure adequate privacy and security protections for personal health information Protect electronic health information crated by or maintained by certified EHR technology through implementation of appropriate technical capabilities Conduct or review a security risk analysis per 45 CF4 164.308(a)(1) and implement security updates as necessary as part of risk management process Stage 1 Meaningful Use Core Set (Cont.)

4. Stage 1 Meaningful Use Menu Set Health Outcomes Policy PriorityObjectivesMeasures Eligible ProfessionalsEligible Hospitals and CAHs Report ambulatory clinical quality measures to CMS or StatesFor 2011, provide aggregate number, denominator and exclusions through attestation. For 2012, electronically submit clinical quality measures. Improving quality safety, efficiency, and reducing health disparities Implement drug-formulary checks Enabled access to at least one internal or external drug formulary Record advance directives for patients 65 or older > 50% Incorporate clinical lab-test results into certified EHR technology as structured data > 40% of all clinical lab tests during EHR reporting period with results in a positive/negative or numerical format Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach Generate at least one report listing patients with a specific condition Send reminders to patients per patient preference for preventative/follow up care > 20% patients 65 or older or 5 yrs or younger were sent reminder during reporting period

5. Stage 1 Meaningful Use Menu Set Health Outcomes Policy PriorityObjectivesMeasures Eligible ProfessionalsEligible Hospitals and CAHs Engage patients and families in their health are Provide patients with timely electronic access to their health information within 4 business days of information being available to provider > 10% subject to EP's discretion to withhold certain information Use certified EHR technology to identify patient-specific education resources and provide those resources to patient if appropriate > 10% Improve population and public health Capability to submit electronic data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable law and practice Performed at least one test of certified EHR technology's capacity to submit electronic data and follow up submission if successful test Capability to submit electronic data on reportable lab results to public health agencies and actual submission in accordance with applicable law and practice Performed at least one test and follow-up submission if test is successful Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice Performed at least one test and follow-up submission if test is successful

6. Stage 1 Meaningful Use Measures with a Denominator of Unique Patients Regardless of Whether the Patient's Records Are Maintained Using Certified EHR Technology ObjectivesMeasures Eligible ProfessionalsEligible Hospitals and CAHs Maintain an up-to-date problem list of current and active diagnoses> 80% Maintain active medication list> 80% Maintain active medication allergy list> 80% Record demographics: language, gender, race, ethnicity, DOB Record demographics: language, gender, race, ethnicity, DOB, date and preliminary cause of death in the event of mortality in eligible hospital or CAH > 50% Provide patients with timely electronic access within 4 business days of information available to EP > 10% Use certified EHRE technology to identify patient-specific education resources and provide if appropriate > 10%

7. Stage 1 Meaningful Use Measures with a Denominator Based on Counting Actions for Patients whose Records are Maintained Using Certified EHR Technology ObjectivesMeasures Eligible ProfessionalsEligible Hospitals and CAHs Use CPOE for med orders> 30% Generate and transmit permissible prescriptions electronically > 40% Record and chart changes in vital signs: height, weight, blood pressure, calculate and display BMI, Plot and display growth charts for children 2-20 years, including BMI > 50% recorded as structured data Record smoking status for patients 13 years and older> 50% Record advance directives for patients 65 and older > 50% Incorporate clinical lab-test results into certified EHR technology as structured data> 40% during reporting period for results either positive/negative or numerical format as structured data Provide patients with electronic copy of health information upon request> 50% within 3 business days Provide electronic copy of D/C instructions at time of discharge upon request > 50% Provide clinical summaries for patients for each office visit > 50% within 3 business days Send reminders to patients per preference for preventative follow up care > 20% For EP, eligible hospital or CAH who receives patient from another setting should perform medication reconciliation > 50% of transitions of care For EP eligible hospital or CAH who transitions their patient to another setting of care should provide summary of care record for each transition of care or referral > 50% of transitions of care or referral

8. Stage 1 Objectives and Measures Requiring Only a Yes/No Attestation ObjectivesMeasures Eligible ProfessionalsEligible Hospitals and CAHs Implement drug-rug and drug-allergy interactions checksHas enabled this functionality for entire reporting period Implement drug-formulary checksEnabled for entire reporting period and has access to at least one internal or external drug formulary Implement one clinical decision support rule relevant to specialty or high clinical priority with ability to track compliance Implement one clinical decision support rule relevant to high priority hospital condition with ability to track compliance Implement one clinical decision support rule Capability to exchange key clinical information among providers of care and patient authorized entities electronically At least one test of capacity to exchange key clinical information Capability to submit electronic data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable law and practice Performed at least one test Capability to submit electronic data on reportable lab results to public health agencies and actual submission Performed at least one test to provide submission to public health agency Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice Performed at least one test Protect electronic health information created or maintained by the certified EHRE technology through implementation of appropriate technical capabilities Conduct or review a security risk analysis per 45 CFR 164.308(a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process