Clinical Decision Support Alerts and Credentialed Medical Assistants

We have detailed who can perform computerized provider order entry (CPOE) for meaningful use objectives, as well as the potential costs of improper CPOE. Naturally, the broader question in this discussion is why only licensed health care professionals or credentialed medical assistants are allowed to perform CPOE.

These rulings are made with patient protection as the primary goal. One way the limits on CPOE help ensure that protection involves a function of the CPOE system known as clinical decision support alerts.

Robert Anthony of the Centers for Medicare and Medicaid Services spoke about these alerts and their importance for patient safety in his presentation. The full text and video are below:

“The purpose of this really is to make sure that when information goes into a system, and it is done obviously prior to any action being taken on the orders … that somebody who has some clinical expertise or authority is able to see any of the clinical decision support alerts that pop up and say, ‘You may not want to prescribe this medication because of a contraindication.’ Then they can take action on that for patient safety, whereas I as a lay person might see a clinical decision alert, have no idea what that means, and ignore it completely. So that’s really the whole idea behind having a licensed health professional or a CMA (AAMA) to look at that.”

About Donald A. Balasa

Donald A. Balasa, JD, MBA, chief executive officer and legal counsel for the American Association of Medical Assistants, keeps his eye on what is happening in the profession.
This entry was posted in Certification and the CMA (AAMA) Credential, On the Job, Scope of Practice and tagged , , , . Bookmark the permalink.

28 Responses to Clinical Decision Support Alerts and Credentialed Medical Assistants

  1. Sharon Johnston says:

    In over all the years that I have been a CMA with AAMA, I see a lot of programs, that are not CAAHEP approved, the students that come out, think they are certified medical assistants, and that really upsets me, they have only enough schooling sometimes a 12wk or 13 wk course and when doing a simple ekg, they have no idea of correct lead placement. Why are these programs allowed. Its not fair to CMA AAMA’s. I think employers need to know the difference of a qualified CMA AAMA then a person who goes through a 12 wk course.
    Sharon J CMA AAM

    • Thank you for your observations. They are valid. The number of “medical assisting programs” of a few weeks or months duration was one of the reasons why the Certifying Board of the AAMA, in 1995, changed the eligibility pathway for the CMA (AAMA) Certification Examination. As of June of 1998, only graduates of CAAHEP or ABHES accredited medical assisting programs have been eligible for the CMA (AAMA) Certification Examination.

      These short academic programs are allowed because the United States Congress and the United States Department of Education (USDE) have not taken action to disallow such programs. The AAMA has attempted to persuade Congress and the USDE that they should take decisive action in regard to these programs. Our public policy efforts in recent years have focused on other issues, but perhaps we need to make this a higher priority again.

      I hope this is helpful.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

    • Dawn says:

      I have never heard of a 12 week course for AAMA CMA schooling. My schooling was 26months long and than we sat for the exam and one month later we got the results in the mail. Now with certifying, they take the test at a test facility and are certified right then and there.

      • Thank you for your comment. No CAAHEP or ABHES accredited medical assisting programs are twelve weeks in length. The reference was to a non-CAAHEP or ABHES accredited medical assisting program.

        I also surmise that the test that was referred to was not the CMA (AAMA) Certification Examination.

        I hope this is helpful.

        Donald A. Balasa, JD, MBA
        Executive Director, Legal Counsel

        American Association of Medical Assistants
        Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

        Visit us on Facebook! http://www.aama-ntl.org/facebook

        The CMA (AAMA): Health Care’s Most Versatile Professional

  2. Justin Henderson says:

    Hi Sharon,
    I think these schools are allowed because they meet the minimum requirements to give people training within their given states. In Washington State just one year ago the state made a law that anyone who wants to practice as an MA, must graduate from a CAAHEP and or ABHES approved school. Along with passing 1 out of 4 national tests that does include the CMA exam. State and federal laws are just now starting to look at medical assisting legitimately as they pertain to healthcare. We as Medical Assistants are becoming more and more useful and valuable to the healthcare system and the laws need to reflect that. I suspect you will start to see more and more states follow Washington and other states in implementing laws that govern MA’s like they do with nurses and doctors.
    I hope this helps.
    J.Henderson CMA (AAMA)

  3. Melissa brown says:

    Great win for CMA (AAMA)

  4. Kasi Crumbo says:

    You keep referring to “lay person” what exactly is a lay person?

  5. Cheryl Landin says:

    Where I work all Medical Assistants are grandfathered in; now they hire only Certified Medical Assistants. Will this change how things are done? When will this become effective? How will they know who is certified & who is not?

    • Thank you for your comments and questions. The CMS rule stating that only “credentialed medical assistants” (as well as licensed health care professionals) are permitted to enter medication, laboratory, and radiology orders into the CPOE system and have such entry count toward meeting the meaningful use requirements under the Medicare and Medicaid Incentive Programs went into effect January 1, 2013.

      In its auditing process, CMS auditors have the authority to check whether orders that are counted toward meeting the meaningful use thresholds have been entered by either credentialed medical assistants or licensed health care professionals.

      I hope this is helpful.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

  6. Kathy says:

    Can an EMT enter orders and have it count towards CPOE for Meaningful Use? If not, can an EMT apply for the ABROE recognition offered by AAMA?

    • Thank you for your question. Note the following from CMS:
      [EHR Incentive Programs] When meeting the meaningful use measure for computerized provider order entry (CPOE) in the Electronic Health Records (EHR) Incentive Programs, does an individual need to have the job title of medical assistant in order to use the CPOE function of Certified EHR Technology (CEHRT) for the entry to count toward the measure, or can they have other titles as long as their job functions are those of medical assistants?
      If a staff member of the eligible provider is appropriately credentialed and performs similar assistive services as a medical assistant but carries a more specific title due to either specialization of their duties or to the specialty of the medical professional they assist, he or she can use the CPOE function of CEHRT and have it count towards the measure. This determination must be made by the eligible provider based on individual workflow and the duties performed by the staff member in question. Whether a staff member carries the title of medical assistant or another job title, he or she must be credentialed to perform the medical assistant services by an organization other than the employing organization. Also, each provider must evaluate his or her own ordering workflow, including the use of CPOE, to ensure compliance with all applicable federal, state, and local law and professional guidelines. Created: 08/20/2013 (FAQ9058)
      EMTs are licensed in every state. It is likely that EMTs have, or can acquire, the knowledge necessarily to enter medication, laboratory, and radiology orders into the CPOE system. However, this determination must be made by the delegating eligible provider.

      I hope this is helpful.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

    • And, an EMT is eligible for the ABR-OE.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

  7. Judy Reineck says:

    If someone was interested in becoming a MA, what school in Dallas would you recommend they go to?

  8. Yomaira Reyes says:

    I am a medical assistant and have been one for a little over ten years. Upon graduating it was not required nor mandated that a certification be obtained immediately and unfortunately I did not pursue this. I would like to know if there are any exemptions at this time or exceptions to the rule for the state of Georgia, which allows the Medical Director to oversee my daily duties and expertise and in doing so can provide a letter advising of my qualifications. And if so, can this letter be placed in my employee file in order to avoid legal ramifications following any audits? I am a graduate from an accredited institution and currently taking the steps needed to obtain my certification, but prior to receipt of the certification I would like to protect the facility in which I’m employed.

    • Thank you for your question. I will send to your e-mail address the Georgia medical assisting law.

      Although increasing numbers of employer prefer to hire, or insist on hiring, CMAs (AAMA), and there are legal advantages in doing so (I will you one of articles that explains this), Georgia law does not require medical assistants to be CMAs (AAMA), and there is no difference in legal scope of practice between CMAs (AAMA) and other medical assistants.

      I hope this is helpful.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

      • cheryl says:

        I too went to school in Georgia for medical assistant -in 1986 I graduated from the program . I then moved to New Jersey , at the time there was no place to take the certification exam . I have been working in this field a long time, unfortunately I can not get my transcipts from the technical school I graduated from. I can not afford the $ to take the course again , nor do I have the time . am I eligible for the ABR-OE?

      • Thank you for your question. Whether you are eligible for the ABR-OE depends on whether the program from which you graduated was CAAHEP or ABHES accredited. Could you please provide us the name of the program and its address? We will then be able to reply to you.

        Donald A. Balasa, JD, MBA
        Executive Director, Legal Counsel

        American Association of Medical Assistants
        Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

        Visit us on Facebook! http://www.aama-ntl.org/facebook

        The CMA (AAMA): Health Care’s Most Versatile Professional

  9. Dee says:

    WHat if you are just a CNA…what are your limites? What if you took a accredited program but never sat for the exam?

    • Thank you for your question about whether a CNA is considered a credentialed medical assistant. That is a complicated question. I will respond to your e-mail address.

      An individual who graduated from a CAAHEP or ABHES accredited medical assisting program is eligible for the CMA (AAMA), but is not eligible for the ABR-OE.

      I will e-mail you now.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

  10. Schweers says:

    Woah! I’m really digging the template/theme of this blog. It’s simple, yet effective. A lot of times it’s very difficult to get that “perfect balance” between superb usability and visual appeal. I must say that you’ve done a great job with this. Additionally, the blog loads extremely fast for me on Firefox. Outstanding Blog!

  11. Cathy says:

    Is an RMA considered credentialed? I have coworkers that took different standardized tests and now consider themselves RMAs.

    • It is my opinion that, under the CMS meaningful use rule, the RMA(AMT) is considered a “credentialed medical assistant.” There are other RMA credentials. Can you tell me which RMA credentials are at issue?

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

  12. Sherry says:

    Regarding: “If a staff member of the eligible provider is appropriately credentialed and performs similar assistive services as a medical assistant but carries a more specific title due to either specialization of their duties or to the specialty of the medical professional they assist, he or she can use the CPOE function of CEHRT and have it count towards the measure.”

    Would passing the MSCAT assessment through American College of Medical Scribe Specialists (ACMSS) be appropriate for being able to enter CPOE?

  13. Paula says:

    Hello, is this blog still running, and is Donald Balasa still replying?

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