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Solutions: Overcoming Challenges to Meaningful Use in Practices

Providers Experience Difficulty with Problem Lists

Providers participating in the Meaningful Use incentive program must maintain up-to-date problem lists of current and active diagnoses based on ICD-9-CM or SNOMED CT clinical coding standards. At least 80 percent of all unique patients must have at least one entry, or an indication of none, recorded as structured data. Some providers face problems with this measure due to uncertainty about the requirements, limited knowledge about how the EHR system handles problem list data, limited commitment from clinical staff, lack of clarity about staff roles, and inadequate procedures for problem list maintenance.


  1. Review and understand the requirements for meeting this measure
    Providers need to design and implement workflows that support the capture of problem lists.
  2. Understand how the EHR system manages data for this measure
    Limited classification of clinical problems can lead to undercoding or overcoding.
  3. Explain the value of problem lists and get buy in from clinical staff
  4. Identify the individuals responsible for problem list maintenance
    Practices can encounter problems if it is unclear who is responsible for maintaining the problem list.
  5. Define procedures and accountability for problem list maintenance
    Problem lists are demanding to maintain, and may contain inaccurate information if not maintained properly.