Certification and the CMA (AAMA) Credential, On the Job, Scope of Practice

General Entry vs. CPOE in the Electronic Health Record

As discussions about the CMS Stage 2 rule continue, one question that persists is whether non-credentialed medical assistants–and by extension, lay people–can enter orders into the electronic health record (EHR). What entries can such workers make, if any?

Robert Anthony of the CMS Health IT Initiatives Group touched on this topic during our joint presentation at last year’s AAMA Annual Conference. In short, the only meaningful use objective that carries a requirement as to who physically enters orders is computerized provider order entry (CPOE). The full text of Mr. Anthony’s response follows, with video:

For all of these objectives except computerized provider order entry, there really isn’t a requirement about who enters that information into an EHR, or who takes a particular action at all. Anybody can really do that. The only objective that there are any requirements around who does the actual entering for the EHR is that CPOE.

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There are two different processes here. One is for entering something like blood pressure, or height/weight. Anybody can do that. Absolutely anybody can do that. In fact, there are many systems that are part of larger organizations where they’re not entering that information at all;they’re actually  getting that information from another system, especially demographic information that’s being loaded from a practice management system automatically. But when it comes to CPOE, we are very specific about who enters that information. The information either has to be entered by a licensed health care professional–and has to be done prior to any action being taken on the order–or it has to be entered by a [credentialed] medical assistant. You can’t have a lay person who enters that, somebody who goes through and just clicks a button. You have to have the actual licensed health care professional or [credentialed medical assistant].