IMS Meaningful Use Webinar

Presented on:

May 9 – 11:00am – 12:00pm (PDT)

May 13 – 12:00pm – 1:00pm (EST)

This Webinar Will Be Recorded!

Please send questions that you may have after the session to:

info@suitemed.com

Meaningful Use: Today’s Topics

• Meaningful Use in a Nutshell

• EHR Incentive Programs

• Meaningful Use Stage 1 Requirements

• Eligibility Defined

• Incentive Registration Overview

• Incentive Attestation Overview

• IMS Meaningful Use Report Overview

• MU Requirements: Core and Menu

• Additional Resources

Meaningful Use in a Nutshell

• Introduced as part of American Reinvestment and

Recovery Act 2009

• Focus to improve health care through use of

health information technology

• Three main EHR components

– Use in a meaningful manner (ex: e-prescribing)

– Use for electronic exchange of health information to

improve quality of health care

– Use to submit clinical quality and other measures

Meaningful Use in a Nutshell

• Managed by the Centers for Medicare &

Medicaid Services (CMS)

• Five year program

– Stage 1 sets the baseline for electronic data capture and

information sharing (2011 and 2012).

– Stage 2 (2013) and Stage 3 (2014-15) will continue to

expand on this baseline and be developed through

future rule making.

EHR Incentive Programs – Medicare

• Provides incentive payments to eligible professionals

(EP), eligible hospitals, and critical access hospitals

(CAH) that demonstrate meaningful use (MU) of certified

EHR technology.

– Participation can begin as early as 2011

– EP can receive up to $44k over 5 years; additional incentives for

Health Professional Shortage Areas

– Maximize benefits; begin in 2011

– After 2015, adjusted reimbursements if not successfully

demonstrating MU

EHR Incentive Programs – Medicaid

• Provides incentive payments to EPs, eligible hospitals,

and CAHs as they adopt, implement, upgrade, or

demonstrate MU of certified EHR technology in their first

year of participation and demonstrate MU for up to five

remaining participation years.

– Voluntarily offered by individual states and territories and may

begin as early as 2011, depending on the state.

– EP can receive up to $63,750 over the six years that they choose

to participate in the program.

– There are no payment adjustments under the Medicaid EHR

Incentive Program.

EHR Incentive Programs – Terms

• Adopted - Acquired and installed certified EHR

technology. (For example, can show evidence of

installation.)

• Implemented: Began using certified EHR technology. (For

example, provide staff training or data entry of patient

demographic information into EHR.)

• Upgraded: Expanded existing technology to meet

certification requirements. (For example, upgrade to

certified EHR technology or add new functionality to meet

the definition of certified EHR technology.)

Eligibility Defined

Eligibility Requirements for Professionals

• Incentive payments for EPs are based on individual practitioners.

• If part of a practice, each EP may qualify for an incentive payment if each

eligible professional successfully demonstrates meaningful use of certified

EHR technology.

• Each EP is only eligible for one incentive payment per year, regardless of

how many practices or locations at which he or she provide services.

• Hospital-based eligible professionals are not eligible for incentive

payments. An eligible professional is considered hospital-based if 90% or

more of his or her services are performed in a hospital inpatient (Place Of

Service code 21) or emergency room (Place Of Service code 23) setting.

Eligibility Defined - Medicare

• In addition to the eligibility requirements above, Medicare eligible

professionals must have Medicare Part B allowed charges and must be

enrolled in an “approved status” for Provider Enrollment, Chain and

Ownership System (PECOS).

• EPs under the Medicare EHR Incentive Program include:

– Doctor of medicine or osteopathy

– Doctor of dental surgery or dental medicine

– Doctor of podiatry

– Doctor of optometry

– Chiropractor

Eligibility Defined - Medicaid

• In addition to the eligibility requirements above, to qualify for an

incentive payment under the Medicaid EHR Incentive Program, an

eligible professional must meet one of the following criteria:

– Have a minimum 30% Medicaid patient volume*

– Have a minimum 20% Medicaid patient volume, and is a pediatrician*

– Practice predominantly in a Federally Qualified Health Center or Rural Health

Center and have a minimum 30% patient volume attributable to needy individuals

• EPs under the Medicare EHR Incentive Program include:

– Doctor of medicine or osteopathy

– Doctor of dental surgery or dental medicine

– Doctor of podiatry

– Doctor of optometry

– Chiropractor

* Children's Health Insurance

Program (CHIP) patients do not

count toward the Medicaid

patient volume criteria.

Eligibility Defined – Both???

What if an EP can qualify for Medicare and Medicaid?

• Professionals eligible for both the Medicare and Medicaid EHR Incentive Programs

must choose which incentive program they wish to participate in when they register.

Before 2015, an eligible professional may switch programs only once after the first

incentive payment is initiated. Most eligible professionals will maximize their incentive

payments by participating in the Medicaid EHR Incentive Program.

MU Stage 1 Requirements

• In 2011 and/or 2012, EP must meet 20 of 25 MU

objectives

– 15 Core Objectives – EP must meet ALL of these to qualify

– 10 Menu Objectives – EP must choose 5 from this list to qualify

• EP is also required to report discipline specific clinical quality

measures (CQM). EP must report on 6 total clinical quality measures:

3 required core measures (substituting alternate core measures where

necessary) and 3 additional measures (selected from a set of 38

clinical quality measures). For more information on CQM, visit:

http://www.cms.gov/QualityMeasures/

Incentive Registration Overview

• Medicare registration opened January 3, 2011, so EPs may

register at any time

• Medicaid registration varies by state and open date can be

found: http://www.cms.gov/apps/files/statecontacts.pdf

• EP must either register personally or designate a third

party to register on their behalf*

– If a third party will be registering for one or more EP, they must

first create an account at the Identity & Access Management

System (I&A) site

https://nppes.cms.hhs.gov/NPPES/IASecurityCheck.do* NOTE: Medicaid third-party registration availability may vary at the state level

Incentive Registration Overview

Steps to Registration

1. Gather required information ahead of time

a) NPI Number

b) NPPES Number (also known as PECOS number)

c) Payee Tax ID Number (if benefits to be reassigned)

d) Payee NPI (if benefits to be reassigned)

2. Decide which program to register for

– Medicare – Review the Medicare EP Registration User Guide

– Medicaid – Review the Medicaid EP Registration User Guide

3. Follow the instructions within the appropriate guide above to

complete the registration process

Incentive Attestation Overview

• Medicare attestation opened April 18, 2011

• Medicaid attestation varies by state and information can

be found: http://www.cms.gov/apps/files/statecontacts.pdf

• EP must either attest personally or designate a third party

to register on their behalf*

– If a third party will be attesting for one or more EP, they must first

create an account at the Identity & Access Management System

(I&A) site

https://nppes.cms.hhs.gov/NPPES/IASecurityCheck.do* NOTE: Medicaid third-party attestation may vary at the state level

Incentive Attestation Overview

Medicare – Requirements for Incentive Payment

• EP must be registered for the Medicare EHR Incentive Program

• Must meet Meaningful User criteria using certified EHR technology

• On the CMS Registration and Attestation System, EP must

successfully attest to meeting meaningful use criteria using EHR

technology

Medicaid – Requirements for Incentive Payment

• EP will follow a similar process to the above, using their state’s

specific Attestation System

Incentive Attestation Overview

When to Attest

• Medicare

– In the first year, must have met MU criteria for one consecutive 90-day reporting

period

– For all subsequent years, attestation must be met for the entire calendar year

– IMPORTANT NOTE: If your initial attestation fails in the first year, you may

select a different 90-day that may partially overlap a previously reported 90-day

period and attest again. (Tip: Plan to attest initially no later than September 15,

2011 to allow 2 weeks to make EHR or clinic process adjustments if needed and

still have a full 90-day period for qualification in case overlap is not possible.)

• Medicaid

– In the first year, must attest to adopting, implementing or upgrading EHR

– Must check at the state level to find out when participation may begin

Incentive Attestation Overview

Steps to Attestation

1. If not yet registered, register for the EHR Incentive Program

2. Thoroughly review the CMS Attestation User Guide

http://www.cms.gov/EHRIncentivePrograms/Downloads/EP_Attestation_User_Guide.pdf

3. Verify that all of the necessary measures to demonstrate MU and

qualify for an EHR incentive payment have been met with the CMS

MU Attestation Calculator

http://www.cms.gov/apps/ehr/

4. Following CMS Attestation User Guide instructions, EP or

designated third-party representative shall complete attestation

Incentive Attestation Overview

General Notes

• Core and Menu Requirements in the CMS Attestation User Guide

might not appear in the same order as shown in the IMS Meaningful

Use Report. Be mindful of this!!

• The attestation process may take up to several hours to complete, but

does not have to be completed in one sitting. Your work will save as

you go and you can return to finish later

• Medicare incentive payments will be made 4 to 6 weeks after an EP

meets requirements and successfully attests

• Medicaid incentive payments are required to be issued with 45 days

of provider successfully attesting to adopting, implementing or

upgrading EHR technology in their first year

IMS MU Report Overview

MU Requirements – Core and Menu

• EP must meet and attest for the objectives

associated with all 15 Core Requirements

• EP must meet and attest for the objectives

associated with 5 of the 10 Menu Requirements

• CMS Core and Menu Requirement information:

http://www.cms.gov/EHRIncentivePrograms/Downloads/EP-MU-TOC.pdf

MU Requirements – Core and MenuCR01: Computerized Provider Order Entry for Medication

• Objective: Use computerized provider order entry (CPOE) for

medication orders directly entered by any licensed healthcare

professional who can enter orders into the medical record per state,

local and professional guidelines.

• Measure: More than 30 percent of all unique patients with at least one

medication in their medication list seen by the EP have at least one

medication order entered using CPOE.

• Exclusion: Any EP who writes fewer than 100 prescriptions during

the EHR reporting period.

(NOTE: Electronic prescription transmission IS NOT required for this.)

MU Requirements – Core and MenuCR01: Computerized Provider Order Entry for Medication

• IMS Related Activity

– Current Medications within the Visit Note must include at least one

medication

– Patient must have been prescribed a medication from within IMS during

the reporting period. Chart history should show that a prescription was

given to the patient on the specific date. (NOTE: Prescription does not

have to be sent electronically to meet this requirement)

MU Requirements – Core and MenuCR02: Drug Interaction Checks

• Objective: Implement drug-drug and drug-allergy interaction checks.

• Measure: The EP has enabled this functionality for the entire EHR

reporting period.

• Exclusion: No exclusion.

MU Requirements – Core and MenuCR02: Drug Interaction Checks

• IMS Related Activity

– User Parameters for Prescription set to “Yes” for:

• Patient Allergy Check Required

– Cross Sensitive Allergy Check

– Inactive ingredient based Allergy Check

• Drug Drug Interaction Check Required

– Medium Severity Interaction Check

– Low Severity Interaction Check

• Drug Validation (NOTE: If this is not set to yes, interactions will not be

checked)

MU Requirements – Core and MenuCR02: Drug Interaction Checks

MU Requirements – Core and MenuCR03 – Transmit Permissible Prescriptions Electronically

• Objective: Generate and transmit permissible prescriptions

electronically.

• Measure: More than 40 percent of all permissible prescriptions

written by the EP are transmitted electronically using certified EHR

technology

• Exclusion: Any EP who writes fewer than 100 prescriptions during

the EHR reporting period.

NOTE: Please review the “Permissible Prescriptions” and “Additional

Information” sections in the following CMS Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/4PermissiblePrescriptions.pdf

MU Requirements – Core and MenuCR03 – Transmit Permissible Prescriptions Electronically

• IMS Related Activity

– Prescriptions should be sent by the EP to pharmacy electronically when

prescribed. Currently, this means a client must be registered for and submitting

prescriptions through either New Crop or Surescripts. Objective is achieved when

the Rx ID is assigned during the transmission process.

MU Requirements – Core and MenuCR04 – Record Demographics

• Objective: Record all of the following demographics: Preferred

language*; Gender; Race; Ethnicity; Date of birth

• Measure: More than 50 percent of all unique patients seen by the EP

have demographics recorded as structured data.

• Exclusion: No exclusion.

* Preferred language is the language by which the patient prefers to

communicate

MU Requirements – Core and MenuCR04 – Record Demographics

• IMS Related Activity

– Patient demographics are created for every patient in IMS. Date of Birth

(DOB) and Gender are required fields. EP should verify that Race,

Ethnicity, and Language have been captured or documented as “Patient

declined”.

MU Requirements – Core and MenuCR05 - Maintain Problem List

• Objective: Maintain an up-to-date problem list of current and active

diagnoses.

• Measure: More than 80 percent of all unique patients seen by the EP

have at least one entry or an indication that no problems are known

for the patient recorded as structured data.

• Exclusion: No exclusion.

NOTE: Please review the “Additional Information” section in the following

related CMS Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/3MaintainProblemList.pdf

MU Requirements – Core and MenuCR05 - Maintain Problem List

• IMS Related Activity

– Patient Diagnosis must either:

• Be entered within the Visit Note for the specific encounter and be visible

within the “Active Diagnosis” tab in the Diagnosis Visit Note Template and

also within Chart View on the Dx tab.

Or

• Be entered within the Visit Note for the specific encounter and recorded with

the “Mark as No Known Problem” button if the patient does not have any

current problems.

MU Requirements – Core and MenuCR06 - Active Medication List

• Objective: Maintain active medication list.

• Measure: More than 80 percent of all unique patients seen by the EP

have at least one entry (or an indication that the patient is not

currently prescribed any medication) recorded as structured data.

• Exclusion: No exclusion

MU Requirements – Core and MenuCR06 – Active Medication List

• IMS Related Activity

– Current Medications within the Visit Note should include the following:

• A list of all active medications that the patient is currently taking

Or

• It must be documented that the “Patient is not taking any

medication.”

MU Requirements – Core and MenuCR07 - Medication Allergy List

• Objective: Maintain active medication allergy list.

• Measure: More than 80 percent of all unique patients seen by the EP

have at least one entry (or an indication that the patient has no known

medication allergies) recorded as structured data.

• Exclusion: No exclusion.

MU Requirements – Core and MenuCR07 - Medication Allergy List

• IMS Related Activity

– Drug Allergy within the Visit Note should include the following:

• A list of all known drugs that patient is allergic to

Or

• It must be specifically documented that patient has “No Known Drug

Allergies”

MU Requirements – Core and MenuCR08 - Record Vital Signs

• Objective: Record and chart changes in the following vital signs:

Height; Weight; Blood pressure; Calculate and display body mass

index (BMI); Plot and display growth charts for children 2-20 years,

including BMI

• Measure: For more than 50 percent of all unique patients age 2 and

over seen by the EP, height, weight, and blood pressure are recorded

as structured data.

• Exclusion: Any EP who either see no patients 2 years or older, or

who believes that all three vital signs of height, weight, and blood

pressure of their patients have no relevance to their scope of practice.

MU Requirements – Core and MenuCR08 - Record Vital Signs

• IMS Related Activity

– Vital Signs must be completed for a minimum of Height, Weight and

Blood Pressure. If any one or more of the elements are missing, the

requirement will not be met.

MU Requirements – Core and MenuCR09 – Record Smoking Status

• Objective: Record smoking status for patients 13 years old or older.

• Measure: More than 50 percent of all unique patients 13 years old or

older seen by the EP have smoking status recorded as structured data.

• Exclusion: Any EP who sees no patients 13 years or older.

MU Requirements – Core and MenuCR09 – Record Smoking Status

• IMS Related Activity

– Within the Meaningful Use Report window, ensure that the EP has

defined the appropriate Social History value to be recorded as capturing

this data.

– For all patients over 13 years of age, Social History within the Visit Note

should include the following:

• Smoking Status recorded as positive within the Question selected in

Parameter

Or

• Smoking Status recorded as negative within the Question selected in

Parameter

MU Requirements – Core and MenuCR10 - Clinical Decision Support Rule

• Objective: Implement one clinical decision support rule relevant to

specialty or high clinical priority along with the ability to track

compliance with that rule.

• Measure: Implement one clinical decision support rule.

• Exclusion: No exclusion.

NOTE: Please review the “Additional Information” section in the following related CMS

Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/11ClinicalDecisionSupportRule.pdf

MU Requirements – Core and MenuCR10 – Clinical Decision Support Rule

• IMS Related Activity

– Within IMS, there are a number of features available that qualify as

clinical decision support rules. Essentially, this means that based on

findings during a patient visit, IMS will offer diagnostic or treatment

options to the provider.

• The “link with” functionality within IMS can be configured to assist EP’s by providing

reference information and other tools to support decisions within clinical workflow.

• Proper use of alerts and reminders qualify as CDS rules. Incorporating clinical

guidelines or protocols into IMS workflow would also qualify.

• Defining appropriate Health Maintenance rules for specific patient populations is another

option.

• EP’s may use order sets to improve CPOE.

• The use of reports and dashboards to aid in clinical decision support would also qualify.

MU Requirements – Core and MenuCR11 - Clinical Quality Measures (CQMs)

• Objective: Report ambulatory clinical quality measures to CMS.

• Measure: Successfully report to CMS ambulatory clinical quality

measures selected by CMS in the manner specified by CMS.

• Exclusion: No exclusion.

NOTE: Please review the “Additional Information” section in the

following related CMS Guide: http://www.cms.gov/EHRIncentivePrograms/Downloads/10ClinicalQualityMeasures-CQMs.pdf

MU Requirements – Core and MenuCR11 - Clinical Quality Measures (CQMs)

• IMS Related Activity

– IMS provides a PQRI/NQF reporting tool for tracking of quality

measures. This tool allows each EP to define clinical quality measures

relevant to their specialty for reporting.

PQRI was presented during our March Webinar series. If you were not

able to attend, you may view the recorded session by clicking the link

below. You will be prompted for contact information and then access

to the recording will appear:

Lunch & Learn Webinar: IMS v14 - PQRI - Physician Quality Reporting Initiative

MU Requirements – Core and MenuCR12 - Electronic Copy of Health Information

• Objective: Provide patients with an electronic copy of their health

information (including diagnostic test results, problem list, medication lists,

medication allergies) upon request.

• Measure: More than 50 percent of all patients who request an electronic copy

of their health information are provided it within 3 business days.

• Exclusion: Any EP that has no requests from patients or their agents for an

electronic copy of patient health information during the EHR reporting

period.

NOTE: Please review the “Additional Information” section in the following

related CMS Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/12ElectronicCopyofHealthInformation.pdf

MU Requirements – Core and MenuCR12 - Electronic Copy of Health Information

• IMS Related Activity

– EP shall create a Reminder Category specific to this purpose. Reminder Category

shall contain all Reminder Tasks that inform staff that patient requires a copy of

their health information in electronic format (CD, USB drive, portal, etc). (NOTE:

only one category will be reported on, so it is important that ONLY health

information request related reminders are stored within this category.)

– EP shall create and configure one or more health information request Reminder

Tasks assigned to the above category for use specific to these tasks

– EP will associate the Reminder Category created to the “Reminder Category for

CR12” field within the MU Report “Set Parameter” window

– As Patient Reminders are “Set Done”

MU Requirements – Core and MenuCR13 - Clinical Summaries

• Objective: Provide clinical summaries for patients for each office

visit.

• Measure: Clinical summaries provided to patients for more than 50

percent of all office visits within 3 business days.

• Exclusion: Any EP who has no office visits during the EHR

reporting period.

NOTE: Please review the “Definition of Terms” and “Additional Information”

sections in the following related CMS Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/13ClinicalSummaries.pdf

MU Requirements – Core and MenuCR13 - Clinical Summaries

• IMS Related Activity

– EP shall create a Document Sub-Category that will contain all clinical summary

letter options. Document Sub-Category can be named “CR13 Clinical Summaries”

within IMS for ease of identification. (NOTE: For Meaningful Use, only one sub-

category will be reported on, so it is important that ONLY clinical summary letters

are stored within this sub-category. It is equally important that ALL are stored

within this sub-category. Letters not assigned to this sub-category will not be

factored into the objective requirements.)

– Within the Meaningful Use Report window, EP will associate the Document Sub-

Category as the “Letter Category for CR13”

– As EP or clinic staff create and “Save” the Clinical Summary Letter, the Objective

will be achieved

MU Requirements – Core and MenuCR14 - Electronic Exchange of Clinical Information

• Objective: Capability to exchange key clinical information (for

example, problem list, medication list, medication allergies, and

diagnostic test results), among providers of care and patient authorized

entities electronically.

• Measure: Performed at least one test of certified EHR technology’s

capacity to electronically exchange key clinical information.

• Exclusion: No exclusion.

NOTE: Please review the “Definition of Terms” and “Additional Information”

sections in the following related CMS Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/14ElectronicExchangeofClinicalInformation.pdf

MU Requirements – Core and MenuCR14 - Electronic Exchange of Clinical Information

• IMS Related Activity

– IMS provides functionality for the Import and Export of Continuity of Care

Documents (CCD). The Export (CCD) utility provides options for exporting Payer,

Diagnosis, Allergy, Vitals, Medication/Rx, Lab Results, Immunization, Procedures,

Family History, and Social History information. The file is created in XML format

to share with other authorized entities. The Import (CCR) utility allows the EP to

import patient information from XML files and then assign to the appropriate patient

for view as a Document.

MU Requirements – Core and MenuCR15 - Protect Electronic Health Information

• Objective: Protect electronic health information created or maintained

by the certified EHR technology through the implementation of

appropriate technical capabilities.

• Measure: Conduct or review a security risk analysis in accordance with

the requirements under 45 CFR 164.308(a)(1) and implement security

updates as necessary and correct identified security deficiencies as part

of its risk management process.

• Exclusion: No exclusion.

NOTE: Please review the “Definition of Terms” and “Additional Information”

sections in the following related CMS Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/15ProtectElectronicHealthInformation.pdf

MU Requirements – Core and MenuCR15 - Protect Electronic Health Information• IMS Related Activity

– Security - Manages access to patient data at a User and Group level. Provides user level access

via Username/Password with additional parameters to enforce: 1) minimum characters for

password, 2) case sensitivity, 3) enforced alpha-numeric passwords, 4) lockouts after number of

failed login attempts, 5) password resets every set number of days and 6) historically unique

passwords. Grouping and Grants, can further limited access.

– Lock Session – protects data when a user must step away from the workstation

– Audit Log - allows the EP to determine when specific patient related data elements were

accessed or modified within the database and by which specific user.

• Other Requirements

– The security within the EHR depends a great deal on the security practices within the clinic

setting. Please review http://edocket.access.gpo.gov/cfr_2010/octqtr/45cfr164.308.htm for other

EP requirements outside of the EHR such as defining security management processes, assigning

a security official, limiting personnel and information access, providing security awareness

training, handling security incidents, establishing contingency plans, and periodically evaluating

security policies and procedures.

MU Requirements – Core and MenuMN01 - Drug Formulary Checks

• Objective: Implement drug formulary checks.

• Measure: The EP has enabled this functionality and has access to at

least one internal or external formulary for the entire EHR reporting

period.

• Exclusion: Any EP who writes fewer than 100 prescriptions during the

EHR reporting period.

Additional Information

• At a minimum an EP must have at least one formulary that can be queried. This

may be an internally developed formulary or an external formulary. The

formularies should be relevant for patient care during the prescribing process.

MU Requirements – Core and MenuMN01 - Drug Formulary Checks

• IMS Related Activity

– Formularies should be setup at the Carrier and/or Plan level in IMS

– When prescribing, EP should take action based on formulary specific

action specified

MU Requirements – Core and MenuMN02 - Clinical Lab Test Results

• Objective: Incorporate clinical lab test results into EHR as structured

data.

• Measure: More than 40 percent of all clinical lab test results ordered by

the EP during the EHR reporting period whose results are either in a

positive/negative or numerical format are incorporated in certified EHR

technology as structured data.

• Exclusion: An EP who orders no lab tests whose results are either in a

positive/negative or numeric format during the EHR reporting period.

NOTE: Please review the “Additional Information” section in the following

related CMS Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/2ClinicalLabTestResults.pdf

MU Requirements – Core and MenuMN02 - Clinical Lab Test Results

• IMS Related Activity

– Although incorporation of an HL7 interface with compatible lab companies

will help to ensure the successful input of the required Lab Result data, it is

not required. Essentially, the EP should ensure that any Labs defined

within IMS have results entered as structured data. Linking a faxed results

page to a Lab Order will not qualify for this requirement. The EP or a staff

member must associate the returned results to the order by entering the

values manually.

MU Requirements – Core and MenuMN03 - Patient Lists

• Objective: Generate lists of patients by specific conditions to use for

quality improvement, reduction of disparities, research, or outreach.

• Measure: Generate at least one report listing patients of the EP with a

specific condition.

• Exclusion: No exclusion.

MU Requirements – Core and MenuMN03 - Patient Lists

• IMS Related Activity

– Patient Special Search - Within IMS, the Patient Special Search feature

allows real-time generation of patient lists by specific conditions. The

Patient Special Search is found within the Utilities menu.

– EMR Reports - IMS also provides specific EMR reports that will also

generate the conditions requested

MU Requirements – Core and MenuMN04 -Patient Reminders

• Objective: Send reminders to patients per patient preference for

preventive/follow-up care.

• Measure: More than 20 percent of all patients 65 years or older or 5

years old or younger were sent an appropriate reminder during the EHR

reporting period.

• Exclusion: An EP who has no patients 65 years old or older or 5 years

old or younger with records maintained using certified EHR

technology.

NOTE: Please review the “Additional Information” section in the following

related CMS Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/4PatientReminders.pdf

MU Requirements – Core and MenuMN04 -Patient Reminders

• IMS Related Activity

– EP shall create a Document Sub-Category specific to this purpose that will contain

all Patient Reminder letters that apply to the preventative/follow-up needs associated

with patients 5 and under or 65 and older. Document Sub-Category can be aptly

named “MN04 Patient Preventative Reminder Letters” within IMS for ease of

identification. (NOTE: For Meaningful Use, only one sub-category will be reported

on, so it is important that ONLY letters meeting requirements for this measure are

stored within this sub-category. It is equally important that ALL relevant letters are

stored within this sub-category. If the letters are not assigned to this sub-category,

they will not be factored into the objective requirements.)

– Within the Meaningful Use Report window, EP will associate the Document Sub-

Category as the “Letter Category for MN04”

– As EP or clinic staff create and “Save” the Patient Reminder Letter, the Objective

will be achieved

MU Requirements – Core and MenuMN05 - Patient Electronic Access• Objective: Provide patients with timely electronic access to their health information

(including lab results, problem list, medication lists, and allergies) within 4 business days

of the information being available to the EP.

• Measure: At least 10 percent of all unique patients seen by the EP are provided timely

(available to the patient within four business days of being updated in the certified EHR

technology) electronic access to their health information subject to the EP’s discretion to

withhold certain information.

• Exclusion: Any EP that neither orders nor creates lab tests or information that would be

contained in the problem list, medication list, medication allergy list (or other

information as listed at 45 CFR 170.304(g)) during the EHR reporting period.

NOTE: Please review the “Additional Information” section in the following related CMS

Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/5PatientElectronicAccess.pdf

MU Requirements – Core and MenuMN05 - Patient Electronic Access

• IMS Related Activity

– IMS Patient Portal is designed to meet these requirements. If the EP is not using

Patient Portal, this Menu Requirement is not an available option.

MU Requirements – Core and MenuMN06 - Patient-specific Education Resources

• Objective: Use certified EHR technology to identify patient-specific

education resources and provide those resources to the patient if

appropriate.

• Measure: More than 10 percent of all unique patients seen by the EP

are provided patient-specific education resources.

• Exclusion: No exclusion.

MU Requirements – Core and MenuMN06 - Patient-specific Education Resources

• IMS Related Activity

– EP’s who are using the Micromedix companion in conjunction with IMS “Link

with” functionality will meet this requirement. With “Link with” technology, care

plan information is presented when relevant diagnosis, lab, prescription,

examination findings or procedures are encountered during a patient visit.

– EP may also use “Educational Handouts” direct to achieve same goal from within

Visit Note.

MU Requirements – Core and MenuMN07 - Medication Reconciliation

• Objective: The EP who receives a patient from another setting of care

or provider of care or believes an encounter is relevant should perform

medication reconciliation.

• Measure: The EP performs medication reconciliation for more than 50

percent of transitions of care in which the patient is transitioned into the

care of the EP.

• Exclusion: An EP who was not the recipient of any transitions of care

during the EHR reporting period.

MU Requirements – Core and MenuMN07 - Medication Reconciliation

• IMS Related Activity

– To comply with the Medication Reconciliation requirements, EP must ensure that

the referring provider is recorded within the Case associated with the transitioning

patient. EP must also ensure that the status of the patient’s current medication is

recorded within IMS. Although not specifically stated that current medications must

be recorded on the first visit, it is highly recommended that the EP do this to ensure

the information is in the chart and so that compliance is achieved.

MU Requirements – Core and MenuMN08 - Transition of Care Summary

• Objective: The EP who transitions their patient to another setting of

care or provider of care or refers their patient to another provider of

care should provide summary care record for each transition of care or

referral.

• Measure: The EP who transitions or refers their patient to another

setting of care or provider of care provides a summary of care record

for more than 50 percent of transitions of care and referrals.

• Exclusion: An EP who neither transfers a patient to another setting nor

refers a patient to another provider during the EHR reporting period.

MU Requirements – Core and MenuMN08 - Transition of Care Summary

• IMS Related Activity

– IMS provides a Referral Tracking utility for this purpose. Within the Referral

Tracking utility, the printing or faxing of a letter or form signifies that a Transition

of Care Record has been provided for that patient.

MU Requirements – Core and MenuMN09 - Immunization Registries Data Submission• Objective: Capability to submit electronic data to immunization registries or

immunization information systems and actual submission according to applicable law

and practice.

• Measure: Performed at least one test of certified EHR technology’s capacity to submit

electronic data to immunization registries and follow up submission if the test is

successful (unless none of the immunization registries to which the EP submits such

information has the capacity to receive the information electronically).

• Exclusion: An EP who administers no immunizations during the EHR reporting period

or where no immunization registry has the capacity to receive the information

electronically

NOTE: Please review the “Additional Information” section in the following related CMS

Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/9ImmunizationRegistriesDataSubmission.pdf

MU Requirements – Core and MenuMN09 - Immunization Registries Data Submission

• IMS Related Activity

– This menu option is currently not available in all areas. A status of

Registries associated with IMS follows:

• Currently available registries include: GRITS (Georgia), FL Shots (Florida),

NYSIIS (New York), and CAIR (California).

• Registries under development: NCIR Import (North Carolina), PA-SIIS

(Pennsylvania), AZ-SIIS (Arizona) and Texas.

• If a Registry is required that is not on the list, a request can be made.

MU Requirements – Core and MenuMN10 - Syndromic Surveillance Data Submission • Objective: Capability to submit electronic syndromic surveillance data to public health

agencies and actual submission according to applicable law and practice.

• Measure: Performed at least one test of certified EHR technology’s capacity to provide

electronic syndromic surveillance data to public health agencies and follow-up

submission if the test is successful (unless none of the public health agencies to which an

EP submits such information can receive information electronically).

• Exclusion: An EP who does not collect any reportable syndromic information on their

patients during the EHR reporting period or does not submit such information to any

public health agency that has the capacity to receive the information electronically.

NOTE: Please review the “Additional Information” section in the following

related CMS Guide:

http://www.cms.gov/EHRIncentivePrograms/Downloads/10SyndromicSurveillanceDataSubmission.pdf

MU Requirements – Core and MenuMN10 - Syndromic Surveillance Data Submission

• IMS Related Activity

– Syndromic Surveillance Data Submission is not currently an IMS option

available to EP’s.

References and Resources

CMS References and Source of Non-IMS Webinar Material• EHR Incentive Programs – http://www.cms.gov/EHRIncentivePrograms/

• Eligibility – http://www.cms.gov/EHRIncentivePrograms/15_Eligibility.asp#TopOfPage

• Registration –

http://www.cms.gov/EHRIncentivePrograms/20_RegistrationandAttestation.asp#TopOfPage

• Meaningful Use –

http://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp#TopOfPage

• Attestation – http://www.cms.gov/EHRIncentivePrograms/32_Attestation.asp#TopOfPage

• Medicare and Medicaid EHR Incentive Programs Overview –

http://www.cms.gov/EHRIncentivePrograms/35_Basics.asp#TopOfPage

• Medicaid State Information (including registration dates) –

http://www.cms.gov/EHRIncentivePrograms/40_MedicaidStateInfo.asp#TopOfPage

• EHR Incentive Programs Educational Materials (Highly Recommended) –

• http://www.cms.gov/EHRIncentivePrograms/55_EducationalMaterials.asp#TopOfPage

• Latest Information about Medicare and Medicaid EHR Incentive Programs –

• http://www.cms.gov/EHRIncentivePrograms/50_Spotlight.asp#TopOfPage

References and Resources

CMS Meaningful Use Documentation• EHR Medicare Registration User Guide –

http://www.cms.gov/EHRIncentivePrograms/Downloads/EHRMedicareEP_RegistrationUserGuide.

pdf

• EHR Medicaid Registration User Guide –

http://www.cms.gov/EHRIncentivePrograms/Downloads/EHRMedicaidEP_RegistrationUserGuide.

pdf

• Attestation User Guide for Medicare Eligible Professionals –

• http://www.cms.gov/EHRIncentivePrograms/Downloads/EP_Attestation_User_Guide.pdf

• Medicaid State Level Launch Information –

• http://www.cms.gov/apps/files/statecontacts.pdf

• Guide for Reading the EHR Incentive Program EP CQM Measures –

• http://www.cms.gov/QualityMeasures/Downloads/QMGuideForReadingEHR.pdf

IMS Meaningful Use Webinar

Thank you very much!