Meaningful Use 3 – In a nutshell

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CLOUDJAVA RWD

www.nalashaa.com

Who We AreA Software services company focussed on providing cutting edge, next generation software technology solutions to ISVs, System Integrators and End Customers.

New Jersey

HQ People

100+New Jersey

200+Bangalore

Clients

Spread across globally

Big Data

Analytics &Intelligence

Mobility

Cloud/Web

Pull data from heterogeneous data sources

Make sense of all these data

Extending applications to mobile platforms

High availability solutions using cloud

Technology Stack

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Our engagement approach

Conduct assessment Submit findings Plan Develop Certify

• Sign an NDA

• Demo of your system

over a 2 hour call

• Gap analysis for MU3

• Execution plan with

timelines

• Estimation of effort

for your solution

• Presentation of

findings

• Detailed analysis of MU3

requirements

• User stories development

• Technical design

• UX design

• Team structure and

responsibilities

• Sprint priorities defined

by you

• 2 weeks sprints

• End to end testing

• Demonstrable output

every sprint

• We collaborate with

your own teams

• Help you with

certification process

• Prepare test data for

certification

• Do mock-runs with

actual test procedures

• Demonstrate

capabilities during

certification

We will help you simulate certification process, be with you during the certification and help you achieve it

Proposal acceptance

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Is MU3 for real?

First Year Demonstrating Meaningful Use

Stage of Meaningful Use

2015 2016 2017 2018 2019 and Future Years

2016 NA Modified Stage 2 Modified Stage 2 or Stage 3 Stage 3 Stage 3

2017 NA NA Modified Stage 2 or Stage 3 Stage 3 Stage 3

2018 NA NA NA Stage 3 Stage 3

2019 and Future Years NA NA NA NA Stage 3

Source: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRincentivePrograms/

With clarity from CMS on MU3’s future, most EHR vendors have started implementing MU3 requirements

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MU3 criteria split

38%

7%36%

12%

7%

Ambulatory settings

Unchanged Criteria

Minimally revised criteria

Revised Criteria

New Criteria

Public Health Criteria

35%

7%35%

14%

9%

Inpatient settings

Around 50% of criteria are either new or revised – Implies significant changes to the codebase

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What are the changes?New measures and those that got revised…

6

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Information Capture

Capture additional demographics

Social, Psychological & behavioral, Sexual orientation and Gender identity

Access to UDIs for patient's implantable devices

Enable a user to

Identify (e.g., label documents as advance directives and birth plans), record (capture + store) and access (examine +

review) patient health information documents

Reference and link to patient health information documents

Record and access information directly and electronically shared by a patient

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CCDA Incorporate & reconcile clinical data from both V1.1 and V2.1 (ToC, Referral Note, Discharge Summary)

Minimum common clinical data set along with the patient matching information as CDA documents

CDA validation and verification

Tag patient data at document level in accordance with DS4P

Date based search on clinical data set; Real-time, automatic creation of documents as per user preferences

Care plans in structured format using CCDA

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Application Access

Patient Selection

Receive a request with sufficient information to uniquely identify a patient and return an ID/token to be used by an

application for subsequent requests for that patient’s data

Data Category Request and All Data Request

Respond to requests for patient data for each of the individual data categories or all data categories specified in the

Common Clinical Data Set and return the full set of data for that data category in a computable format.

Respond to requests for patient data associated with a specific date and date range

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Reporting

CQMs

Import function - QRDA 1 R3 for one/multiple patients and to calculate CQMs

Ability to export and create QRDA data files - QRDA I R3 and QRDA III

Filter CQM results at patient & aggregate levels, create a data file (QRDA I, III) and display human readable results

TIN, NPI, Type, Address, Insurance, age, gender, race/ethnicity, Problem list

Automated measures

Automated Numerator Recording and measure calculation – Test procedures changed

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PHA Reporting

Immunization registries (bidirectional)

Updated IGs for Immunization Messaging, Transmission to registries

Support for NDC code system for administered vaccines; CVX for historical vaccines

Syndromic surveillance

Updated SNOMED CT, LOINC codes and HL7 IG

Electronic Case Reporting

Reportable Lab results (EHs, CAH)

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PHR & CDR Reporting

Antimicrobial use and resistance reporting

Generate AUR for three specified sections:

Antimicrobial Resistance Option Report (Numerator),

Antimicrobial Resistance Option (ARO) Summary Report (Denominator) and

Antimicrobial Use (AUP) Summary Report (Numerator and Denominator) to CDC

National Health Care Surveys (NHCS)

Create health care survey information for electronic transmission to CDC

Transmission to Cancer Registries

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Revised measures

eRx

Expand eRx transactions; Codify e-Rx instructions in structured Sig format; eRx all meds in metric unit standard, Support

bidirectional transactions

Direct Project, Edge Protocol, and XDR/XDM

Adopt the new version of Applicability Statement for Secure Health Transport, Version 1.2

SNOMED CT updates

Problem list, Smoking status, Family Health history

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Revised measures

Information Integrity

SHA2 hashing algorithm

Audit modification of User Privileges and emergency access events relating to ePHI.

Ensure tamper-resistance

Clinical Decision Support

Diagnostic or therapeutic reference information using InfoButton standards based on a preferred language

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What’s the effort required?

2% 5%

15%

10%

11%

8%

30%

19%

Category wise effort distribution

Access to patient data through patient-centered HIE

Decision support

Population health

Patient Access to Self-management tools

Patient health information

Security

Transmission of Patient Information

Improving quality, safety, and efficiency

~600man days

$130K*

Translates to about

* Ballpark figure meant for budgeting purposes. Actual figure might slightly vary.

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Is there enough time?

MU3 development Certification System upgrade Provider training

Roughly the same as MU2

(6 months)

Paperwork, availability etc.

(1-2 months)

Will be phased

(1-2 months)

Dependency on provider schedule

(1-2 months)

Note: The timelines mentioned above are indicative and may vary across solution providers

Jun 2017

• For EHR vendors starting now, we see almost an year’s effort before MU3 reaches providers’ plate, i.e. around

Q4 2017, which doesn’t leave much time for any contingencies.

• With 25% weightage in MIPS, MU3 will be important; Address the components that you are clear about

• Integration with CDR state registries and PHA registries for e-Submission may be time-consuming

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For more information, contact amit.m@Nalashaa.com

Nalashaa Solutions llc.555, US Highway One South, Ste 170, Iselin, NJ 08830 +1-732-602-2560 Ext: 200

Thank You