Stage 2 Meaningful Use Menu Objectives: Family Health History

The third new menu objective for eligible professionals (EP) of the Stage 2 rules for meaningful use focuses on collecting family health history.

The objective reads as follows: Record patient family health history as structured data. The measuring criteria for the objective is over 20 percent of all unique patients seen by the EP during the EHR reporting period.

According to Office of the National Coordinator for Health Information Technology, the objective is important because capturing family health history can improve efficiencies by minimizing the collection of information across settings. Health history information can be used to establish clinical decision support interventions for screening and prevention of chronic conditions based upon patient risk indicators.

Naomi Levinthal, consultant and healthcare IT adviser at The Advisory Board, said in the short term, the menu objective "definitely helps providers understand the family health history of [for instance] heart disease because that can definitely play a role in some of the things that a provider would want to be on the lookout for with a patient that's very much at high risk for that."

Levinthal said meeting the family history menu objective could be one of the easier objectives for practices since some are already in the habit of collecting this data.

The menu objective excludes EPs without an office visit during the reporting period.

"An EP with no office visit during the reporting period can be excluded from this, but when a EP looks at all of the objectives they have available for them to report on for the menu set, the exclusion alone can't count anymore toward the total number that you need," Levinthal said. "That wasn't the case before calendar year 2014, so even if you meet the exclusion you still have to choose something else that you can report on."

In addition to the exclusion, Levinthal said the objective has a kind of odd loophole. "Even if you list that the patient's family health history is unknown, it can still count toward the objective," Levinthal said. "So it's not necessarily that you need to find 20 percent of patients who can tell you something interesting about their family health history, it's even that your due diligence to collect this information can get you there."

Levinthal said the only EPs eligible to report on the objective would have to be either in their third year or fourth year of participation in the meaningful-use incentive program.

The structured data requirement equates to the two approved technical standards: SNOMED's code or the HL7 pedigree standard. This allows for a discrete field to be selected so that a report can be run on the data.

Levinthal said meeting the objective might require practices to change a few procedures. "You may be collecting family health history, but if your vendor is not certified for it, then you will not be able to report on it, so first and foremost make sure of that," she said. "And then secondly, you want to think through the work flow requirements if you haven't already been collecting the data."