Meaningful Use Stage 2: Deep Dive

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Meaningful Use Stage 2:Deep Dive

Casey JohnsonProduct Marketing

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Meaningful Use is designed to create infrastructure that supports reform

Stage 1:Data capture and sharing

Stage 2:

Advanced processes

Stage 3:

Improved outcomes

Hundreds of thousands of providers participated in Meaningful Use Stage 1

As of August 2014

490,952 MU-registered caregivers

Over

$25 billion in incentive paymentsJune 2014 EHR Registration and Payment Report

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Attested in 2011 or 2012?

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Must meet Stage 2 MU in 2015

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Stage 2 has more core measures, fewer menu measures, and higher thresholds

Stage 1 Stage 2

5 of 9

Menu

13 Core

Higher thresholds

3 of 6 Menu

17 Core

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Almost all of the Stage 1 measures appear in Stage 2

• CPOE• Demographics• Vitals• Smoking Status• Structured Labs• Patient Lists• Preventive Reminders• Clinical Summary• Patient Education• Medication Reconciliation• Immunizations• Syndromic Surveillance• Security Analysis

Retained Stage 1 Measures Consolidated Stage 1 Measures

• eRxo eRx, Drug Formulary

• Interventionso Clinical Decision Support,

Drug/Drug, Drug/Allergy• Patient Access

o Timely Access, E-Copy of Health Information

• Summary of Careo Summary of Care,

Problems, Medications, Medication Allergies, Exchange Clinical Information

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Stage 2 introduces six new measures

Imaging Results

(Menu)

Secure Messages

(Core)

Family History

(Menu)

Specialized Registry

(Menu)

Cancer Cases(Menu)

Progress Notes

(Menu)

In 2015, you must be on a 2014 Certified EHR

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The MU reporting periods were changed to allow time for upgrades

*Only for providers who are beyond their first year of MU

Meaningful Use Start

Year

Reporting Period by Stage of Meaningful Use

2011 2012 2013 2014 2015 2016

2011 1 1 1 2 2 2

90 days Full year Full Year Quarter Full Year

2012 1 1 2* 2 2

90 Days Full Year Quarter Full Year

2013 1 1* 2 2

90 Days Quarter Full Year Full Year

2014 1 1 2

Full Year Full Year

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Only 15% of professionals eligible for Stage 2 have attested.

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47% of those attestations were “hardship exemptions”.

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But beware… the penalties can really add up

Year eRx PQRSMeaningful

Use Total2015 -2.0% -1.5% -1.0% -4.5%

2016 -2.0% -2.0% -2.0% -6%

2017 -2.0% -2.0% -3.0% -7%

2018 -2.0% -2.0% up to -5% up to -9%

2019 -2.0% -2.0% up to -5% up to -9%

Overview of penalties

Preparing for Stage 2 MU

1 Upgrade (or replace?) your EHR

2 Perform at Stage 2 thresholds

3 Create a patient engagement strategy

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Step #1: Upgrade to the 2014 certified version of your EHR

Understand your vendor’s 2014 certification approach

2013 20142Q 3Q 4Q 1Q 2Q 3Q 4Q

Upgrade EHRPracticeStage 2

MU

Perform Stage 2

MU

Perform Stage 2

MU

Perform Stage 2

MU

Perform Stage 2

MU

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Step #1: Upgrade to the 2014 certified version of your EHR

• athenaClinicals certified as a 2014 Edition Complete EHR on June 21, 2013

• 2014 certified version of athenaClinicals released to all practices at once

• athenaClinicals physicians will begin practicing Stage 2 MU on October 1, 2013

2013 20142Q 3Q 4Q 1Q 2Q 3Q 4Q

Upgrade EHRPracticeStage 2

MU

Perform Stage 2

MU

Perform Stage 2

MU

Perform Stage 2

MU

Perform Stage 2

MU

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Ask a few key questions ofyour EHR vendor

Is your vendor able to deploy the 2014 Certified Edition to all clients at once?1Will your vendor certify as a Complete EHR or a Modular EHR?2Does the vendor provide MU support and training as part of the regular pricing without additional fees?3Do they provide the required interfaces for free and without interruption? How many connections? When will they be available? 4

How can I switch if 2015 requires full-year reporting?

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Check In Intake Exam Sign-Off Checkout Fulfilled Outside of atheanaNet

Security Plan (free self-service support of intensive

consultation for additional fee)

Fulfilled outside of 5-Stages

Demographics CPOE E-Copy of Health Info Patient Lists

Timely Access(Communicator

)eRx Clinical

Summaries Send Care Reminders

Patient Education Fulfilled by Core athenahealth Service

Clinical Quality MeasuresSummary of

Care Transitions

Immunization Registry TestSyndromic Surveillance

(HIE department)

Vitals Up-to-Date Problems Exchange Clinical Data Test

Drug-Drug InteractionsSmoking

Drug FormularyActive Meds

Clinical Decision Support ToolsActive Allergies

Structured Lab ResultsMed Rec

Step #2: Evaluate your current workflow to maximize performance…

Criteria Integrated within athenahealth’s 5 Stage Patient Workflow

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…and increase your Stage 1 performance to meet the Stage 2

thresholds

Objective MeasureThresholds

Stage 1 Final

Stage 2 Final

CPOE Use CPOE for medication, lab, and radiology orders 30% meds

60% meds,30% labs & radiology

eRx Generate and transmit permissible prescriptions electronically 40% 50%

Demographics Record demographics 50% 80%

Vitals Record and chart changes in vital signs 50% 80%

Smoking Status Record smoking status for patients 13 years or older 50% 80%

InterventionsImplement CDS interventions at the point of care; enable drug/drug and drug allergy interaction checks

One Five

Structured Labs Incorporate lab results as structured data 40% 55%

Patient Lists Generate lists of patients by specific conditions One One

Preventive Reminders

Send reminders for preventative/follow-up care

20% patients, >65 years or <5 years

10% unique patients

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Performance on Meaningful Use Stage 2 Behavioral measures

Covering period: Q1 2014

100% 89%

99%

99%

99%

100%

99%

95%

80%

1. CPOE for Medication, Laboratory, and Radiology Orders

2. E-prescribing (eRx)

3. Record Demographics

4. Record Vital Signs

5. Record Smoking Status

6. Clinical Decision Support Rule

7. Patient Electronic Access

8. Clinical Summaries

9. Protect Electronic Health Information (N/A)

10. Clinical Lab Test Results

11. Patient Lists (N/A)

12. Preventive Care Reminders

13. Patient-Specific Education Resources

14. Medication Reconciliation

15. Summary of Care

16. Immunization Registry Data Submission

17. Use Secure Electronic Messaging

75%

92%

99%

89%

90%

33%

98%Providers who satisfied required 3 of 6 menu measures:

If provider is failing MU Patient Engagement measures, auto-launch registration upon check-in

Three new workflows to register the patient when in-office

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Performance on Meaningful Use Stage 2 Behavioral measures

As of 12/31/2014

100%

100%

100%

100%

100%

99%

99%

1. CPOE for Medication, Laboratory, and Radiology Orders

2. E-prescribing (eRx)

3. Record Demographics

4. Record Vital Signs

5. Record Smoking Status

6. Clinical Decision Support Rule

7. Patient Electronic Access

8. Clinical Summaries

9. Protect Electronic Health Information (N/A)

10. Clinical Lab Test Results

11. Patient Lists (N/A)

12. Preventive Care Reminders

13. Patient-Specific Education Resources

14. Medication Reconciliation

15. Summary of Care

16. Immunization Registry Data Submission

17. Use Secure Electronic Messaging99%

100%

Providers who satisfied required 3 of 6 menu measures:

100%

100%

100%

100%

100%

100%

100%

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Step #3: Create a patient engagement strategy that leverages technology

© National eHealth Collaborativehttp://www.nationalehealth.org/stages-patient-engagement-framework

• Clinical Summary• Patient Education

• NEW! Patient Access• NEW! Secure

Messaging

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Step #3: Create a patient engagement strategy that leverages technology

© National eHealth Collaborativehttp://www.nationalehealth.org/stages-patient-engagement-framework

• Implement a patient portal solution that allows patients to fully engage with their demographic, financial, and health information

• Market your patient portal solution by highlighting the benefits to your patients

• Make sure your patient portal is (or will be) 2014 MU certified!

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Our approach to Stage 2 Meaningful Use

Software Knowledge Service• athenaClinicals received

2014 Edition MU certification on 6/21/13

• All athenahealth clients using a 2014 Edition MU certified EHR today

• Any software changes to support MU will be pushed to all clients immediately

• Centrally monitor the performance of every provider within your practice to tell them if they are ahead or behind in meeting MU criteria

• Identify insights based on high and low performers nationwide and roll out to network

• Coach on Meaningful Use program performance with intervention for poor performance

• Take on the technical work required to satisfy health information exchange measures

• Management of registration and attestation with CMS

• Incentive payment tracking and processing

US Patent # 7,720,70

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75.7% of our providers attested to MU Stage

2 (through December 2014)

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athenahealth’s award-winning services can help you thrive through

change

33“2013 Best in KLAS Awards: Software & Services,” January, 2014. © 2014 KLAS Enterprises, LLC. All rights reserved. www.KLASresearch.com

#1 Overall

Software Vendor

#1 Overall

Physician Practice Vendor

#1 PatientPortal

#1 Practice

Management System(1-10, 11-75 physicians)

#2 EHR

(1-10, 11-75 physicians)

2013 Best in KLAS

• 59,000+ providers on athenaNet®

• Clients ranging from 1 to 5,000+ providers

• 50 states and 104 medical specialties• $11.7 billion in client collections per year• Acquired Epocrates March, 2013

And we were also ranked as the most likely to keep up with regulations

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© 2014 KLAS Enterprises, LLC. All rights reserved. www.KLASresearch.com

How confident are you in your RCM vendor’s ability to keep up with regulatory and government demands?

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0% athenahealth Kareo NextGen Cerner eClinicalWorks

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5

2

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2

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Prel

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ConfidentVery Confident Unsure

UnconfidentVery Unconfident

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As the largest cloud-based network of physicians, we can serve you better.

Meaningful Use Stage 2: Deep Dive

Healthcare

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