Topic

Level

Presenter(s):Dr. Carol Choi, D.O.Dr. Jessica Kasirsky, D.O.Wendy Hofner

MU and HQM 101

100

Safe Harbor Provisions/Legal Disclaimer

This presentation may contain forward-looking statements within the meaning of the federal securities laws, including statementsconcerning future prospects, events, developments, the Company’s future performance, management’s expectations, intentions, estimates, beliefs, projections and plans, business outlook and product availability. These forward-looking statements do not represent a commitment, promise or legal obligation to deliver any material, code or functionality. The development, release and timing of any features or functionality described for our products remains at our sole discretion. Future products developed beyond what is contemplated by existing maintenance agreements, will be priced separately. This roadmap does not constitute an offer to sell any product or technology. We believe that these forward-looking statements are reasonable and are based on reasonable assumptions and forecasts, however, undue reliance should not be placed on such statements that speak only as of the date hereof. Moreover, these forward-looking statements are subject to a number of risks and uncertainties, some of which are outlined below. As a result, actual results may vary materially from those anticipated by the forward-looking statements. Among the important factors that could cause actual results to differ materially from those indicated by such forward-looking statements are: the volume and timing of systems sales and installations; the possibility that products will not achieve or sustain market acceptance; the impact of incentive payments under The American Recovery and Reinvestment Act on sales and the ability of the Company to meet continued certification requirements; the development by competitors of new or superior technologies; the timing, cost and success or failure of new product and service introductions, development and productupgrade releases; undetected errors or bugs in software; changing economic, political or regulatory influences in the health-care industry or applicable to our business; changes in product-pricing policies; availability of third-party products and components; competitive pressures including product offerings, pricing and promotional activities; the Company's ability or inability to attract and retain qualified personnel; uncertainties concerning threatened, pending and new litigation against the Company; general economic conditions; and the risk factors detailed from time to time in the Company’s periodic reports and registration statements filed with the Securities and Exchange Commission.

Agenda

• Meaningful Use, what is it?• Registration • Objectives• HQM

MU Basics

Meaningful Use Basics

Meaningful Use Basics

• American Recovery and Reinvestment Act of 2009 specifies 3 components:

• Use of CEHRT in a meaningful manner• Electronic exchange of health information to improve quality

of health care• Use of CEHRT to submit clinical quality and other measures

Meaningful Use Basics

• Stage 1 of the MU program began in 2011• Stage 2 of the MU program began in 2014• 2015 – Medicare eligible professionals and hospitals

must meet MU or they may be subject to a Medicare payment adjustment

Meaningful Use Basics

• Two options under the program:• Medicare• Medicaid

• Under Medicaid providers must meet eligibility thresholds

• No longer able to switch from Medicare or Medicaid

Meaningful Use Basics

• Medicare eligible professionals include:• Doctors of medicine or osteopathy• Doctors of dental surgery or dental medicine• Doctors of podiatry• Doctors of optometry• Chiropractors

Meaningful Use Basics

• Medicaid eligible professionals include:• Physicians (primarily doctors of medicine and doctors of

osteopathy)• Nurse practitioners• Certified nurse-midwives• Dentists• PAs who furnish services in an FQHC or Rural health clinic

led by a PA• *In certain states optometrists are eligible

Meaningful Use Basics

Meaningful Use Basics

Meaningful Use Basics• First step?

• https://ehrincentives.cms.gov/hitech/login.action• Medicare Guide: https://www.cms.gov/Regulations-and-

Guidance/Legislation/EHRIncentivePrograms/Downloads/EHRMedicareEP_RegistrationUserGuide.pdf

• Medicaid Guide: http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EHRMedicaidEP_RegistrationUserGuide.pdf

Meaningful Use Basics

• Get your EHR Certification ID at: http://oncchpl.force.com/ehrcert

Meaningful Use Basics

• Any other products (third party patient portal)?• What EHR versions used during reporting period?

• https://knowledge.nextgen.com/pe/action/km/viewelement?id=10286117 (Crystal Report that returns audit data including EHR versions)

Meaningful Use Basics

Meaningful Use Basics

What is Reported?

Modified Stage 2• All providers in Modified Stage 2 for

2015• Special rules for providers

scheduled for Stage 1 in 2015 only• CPOE Lab and Radiology may also

be excluded in 2016 for providers just starting Meaningful Use

Modified Stage 2• CPOE for meds, labs and radiology*• E-prescribing*• DUR and CDS*• Electronic access Measure 1• Electronic access Measure 2 **• *Providers scheduled for Stage 1 may use Stage 1

objective.• ** Providers scheduled for Stage 1 may exclude.

Modified Stage 2• Security Risk Analysis• Patient Education*• Medication Reconciliation*• Summary of Care**• Secure Electronic Messages**• *Providers scheduled for Stage 1 may exclude if not a

planned Menu selection.• ** Providers scheduled for Stage 1 may exclude.

Modified Stage 2• Public Health Reporting*

• Immunizations• Syndromic Surveillance• Specialized Registry

• *Providers scheduled for Stage 1 must report on ‘1’; scheduled Stage 2 must report on ‘2’

• 9 Clinical Quality Measures

Self-Attestation• DUR Checks• Clinical Decision Support• Security Risk Analysis• Secure Electronic Messages• Public Health Reporting

Self-Attestation• Self-attestation measures require the

provider ‘attest’ that they have completed the objective

• Proof must be saved to prove objective was completed:• Screen shots• Documentation from practice or state• Reports

Metric Objectives• CPOE (Meds, Labs, Radiology)• E-prescribing• Electronic Access Measure 1 and 2• Patient Education• Medication Reconciliation• Summary of Care

Metric Objectives• Requires entry of numerator and

denominator for attestation• Threshold must be met• *Save all reports used for attestation

Generate Data

HQM• NextGen Health Quality Measures• Web-based reporting tool• *Request MU Program• *If aligning PQRS/MU reporting

please inform HQM via Support Incident

HQM

HQM

HQM

HQM

HQM

HQM

HQM

HQM

HQM

HQM

HQM

• Summary Report – used for attestation:• Provides ‘raw’ data for numerator, denominator,

threshold• Provider Patient Report – good for tracking

back to specific patients for troubleshooting• Measure Goal Report – good for a provider

‘score’ card

Summary Report

Provider Patient Report

Measure Goal Report

Check List

Prior to Reporting Period

• Audit Binder created • Obtain certification ID• Advanced Audit enabled

• No settings disabled under education• No settings disabled under interoperability

• Request HQM programs

Prior to Reporting Period

• NextGen Patient Portal in use• PHR enabled

• E-Rx enabled for all providers• Formularies installed and functioning for all

providers• All providers with relationship to ‘self’ in System

Admin

Prior to Reporting Period

• All externally credentialed staff designated in System Admin

• Drug/Drug and Drug/Allergy interactions enabled with a screen shot of setting

• 5 Clinical decision support rules selected prior to reporting period

Prior to Reporting Period

• Direct Interface or NG Share in place and utilized

• Review Public Health options – register intent and start interface process

• Select 9 CQMs for reporting across three care domains

Prior to Reporting Period

• White papers downloaded and staff trained on workflow

• Security risk analysis started

• Lab vendor sending LOINC codes with lab results

Prior to Reporting Period

• Registered for complimentary webinars or viewed recordings.

• MU 101: https://knowledge.nextgen.com/pe/action/km/viewelement?id=10317934

• MU Q&A: https://knowledge.nextgen.com/pe/action/km/viewelement?id=10197204

• Modified Stage 2: https://knowledge.nextgen.com/pe/action/km/viewelement?id=10331045&channelID=10144856&portalPageId=1020

• Recordings available: https://knowledge.nextgen.com/pe/action/changedeviceview?deviceType=full&portalPageId=10160189&channelID=10144856

During Reporting Period

• Run reports weekly

• Gather additional screen shots for self-attestation items

• Finish security risk analysis

End of Reporting Period

• Export all reports used for attestation

• Gather all documentation and place all in audit binder

• Attest by 2/29/16

Glossary

• EP = Eligible Professional• CEHRT = Certified Electronic Health Record Technology• DUR = Drug Utilization Review• CDS = Clinical Decision Support• ONC = Office of the National Coordinator

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