Meaningful use can be challenging to achieve in different practice settings and with different scopes of practice. Much of meaningful use was designed around the paradigm of a primary care practitioner, but the overall approach to meaningful use has aspects of flexibility. For scopes of practice that include various types of encounters, return to the preparation page to learn more about one fundamental concept, counting patients "seen by the EP." For non-hospital based eligible professionals (EPs) transitioning between inpatient and outpatient settings, return to the preparation page to learn about working at multiple sites.
Ultimately, though, everyone pursuing meaningful use has the same set of meaningful use criteria as their primary care counterparts. For example, dentists are one of the five provider types eligible for the TennCare Medicaid EHR Incentive Program but may face particular challenges in achieving meaningful use given their scope of practice. As FAQ 10527 asserts, the same meaningful use criteria apply to all eligible professionals (EPs). There are elements of flexibility in many of the measures; the best course of action for specialists and dentists is learning more about the criteria to determine whether they can be achieved given the clinical workflow and selected certified EHR technology.
Visiting each individual measure page for the core and menu measures, linked from http://www.tn.gov/tenncare/mu_epstage1.shtml , is a great way to understand the parameters and exclusions for each measure. Each measure should be evaluated for whether it can be met in the ways specified in the CMS technical specification or whether the dentist would qualify for an exclusion. Exclusions may be claimed only where available and applicable. For example, one cannot choose the exclusion to Menu Measure 5 because he or she did not meet the measure--providing timely electronic access to patient health information, unless he qualifies for the exclusion by not ordering or creating lab tests or information that would be contained in the problem list, medication list, or medication allergy list. An exclusion is only an option for not achieving the measure and still achieving meaningful use when the exclusion applies to the EP’s activities and scope of practice during the reporting period.