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Meaningful Use 3

For 2018, NHSN Antimicrobial Use (AU) and Antimicrobial Resistance (AR) (AUR) reporting have been identified as a new option for public health registry reporting under Meaningful Use Stage 3 (MU3).

Refer to the certification criterion (§ 170.315(f)(6)) in the Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 3 and Modifications to Meaningful Use in 2015 Through 2017.

Beginning January 2017, a facility enrolled in the National Healthcare Safety Network (NHSN) has the option to register their intent to satisfy the AUR-MU3 objective.

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AUR-MU3 Guidance

  • Meaningful Use Stage 3 – Guidance for NHSN Facilities, July 2017 [PDF – 292 KB]
  • The NHSN user interface includes an AUR-MU3 registration of intent page.
    • Only the NHSN Facility Administrator will have user rights to register the facility’s AUR-MU3 intent.
  • Perquisites for registering intent and sending electronic AUR CDA data:
  • Facilities that have registered their intent shall receive a monthly status report of R1 Normative AUR data successfully uploaded to NHSN. An email shall be sent to the Facility Administrator and two optional emails as designated on the AUR-MU3 registration page.
  • For more detailed information on NHSN CDAs, view the NHSN CDA Submission Support Portal (CSSP) site
  • Download AU and AR ToolKits
    • ToolKits include xml samples, helpful hints, vocabulary, business rule information, important links, etc.

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AUR-MU3 Validation Tool

In order to qualify as certified technology, an Electronic Health Record (EHR) or EHR Module must be capable of creating Clinical Document Architecture (CDA) documents for Antimicrobial Use and Resistance conformant to the HL7 Implementation Guide for CDA ® Release 2—Level 3: Healthcare Associated Infection Reports, Release 1—US Realm—August 2013. (To download an Implementation Guide, you are required to login to the HL7 site.)

The following CDAs must all be successfully generated.

  • Antimicrobial Resistance Option (ARO) Report (Numerator) specific document template in Section (pages 69-72)
  • Antimicrobial Resistance Option (ARO) Summary Report (Denominator) specific document template in Section (pages 54-56)
  • Antimicrobial Use (AUP) Summary Report (Numerator and Denominator) specific document template in Section (pages 56-58)

You may self-validate your files prior to sending them to the ONC Health IT Certification Program. View installation instructions for the NHSN AUR MU3 Validation Tool.

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ONC Certification

To certify your Health IT Module in the ONC Health IT Certification Program for NHSN Antimicrobial Use and Resistance reporting, contact ICSA Labs (

Learn more about Meaningful Use Incentives and Certification.

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