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Presenters: Jennifer Oelenberger: Director of System Analyst

Prepare for Meaningful Use Stage 2

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EHR Concepts takes pride in giving our clients resourceful information to prepare you for the next steps of upgrading and Meaningful Use.

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2014 MU Reporting

Things to remember: u  In 2014, the reporting period is 90 days regardless of what stage

you are in u Medicare the reporting period can be any 1 calendar quarter u Medicaid the reporting period can be any 90 days u  In 2014 Organizations must be on the 2014 edition of the EHR

and this goes for Stage 1 and Stage 2

High-level Changes

Functional Measures- 20 measures required u  17 core measures and 3 menu measures

CQM’s- must submit 9 out of 64 and out of 3 different domains u  There are 9 Adult recommendations / 9 Pediatric recommendations from CMS u  Six domains:

•  Patient and Family Engagement •  Patient Safety •  Care Coordination •  Population and Public Health •  Efficient Use of Healthcare Resources •  Clinical Processes/Effectiveness

u  Starting in 2014, all CQMs will be submitted electronically to CMS

Stage 2 Core Measures

u  CPOE: Stage 1 measure is more than 30% of medications. Stage 2 is more than 60% of medication, 30% of laboratory, and 30% of radiology orders created by the EP during the EHR reporting period are recorded using CPOE.

* Note- For reporting purposes, only licensed professionals including CMA’s can enter CPOE for it to count in the numerator for the EP * Note- if orderables have not been built for Lab and Rad, will need to do so

u  eRx: Stage 1 measure is more than 40%. Stage 2 is more than 50% of all permissible prescriptions written by the EP are compared to at least one drug formulary and transmitted electronically using Certified EHR Technology

u  Demographics: Stage 1 measure is more than 50%. Stage 2 is more than 80% of all unique

patients seen by the EP have demographics recorded as structured data

u  Vitals: Stage 1 measure is more than 50% of vitals for age 2 years and over. Stage 2 is more than 80% have blood pressure (for patients age 3 and over only) and height and weight (for all ages) recorded as structured data

u  Smoking Status: Stage 1 measure threshold was more than 50%. Stage 2 is more than 80% all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data

u  CDS: Stage 1 measure required one CDS rule. Stage 2 requires 5 clinical decision support interventions related to 4 or more clinical quality measures, if applicable, at a relevant point in patient care for the entire EHR reporting period. This measure also requires that the EP has enabled the functionality for drug- drug and drug-allergy interaction checks for the entire EHR reporting period

Core Measures cont…

Core Measures cont…

u  Electronic copy of Health Information: Stage 1 measure was more than 50% of patients seen who request an electronic copy of their health information are provided one within 3 business days. Stage 2 is more than 50% of all unique patients seen by the EP during the EHR reporting period are provided timely (available to the patient within 4 business days after the information is available to the EP) online access to their health information

u  Also, more than 5% of all unique patients seen by the EP during the EHR reporting period (or their

authorized representatives) view, download, or transmit to a third party their health information

* Note- Patient Portal is now required * Note- Health information including the following must be made available online: Patient name, provider's name and office contact information, current and past problem list, procedures. laboratory test results, current medication list and medication history, current medication allergy list and medication allergy history, vital signs (height, weight, blood pressure, BMI, growth charts), smoking status, demographic information (preferred language, sex, race, ethnicity, date of birth), care plan field(s), including goals and instructions, and any known care team members including the primary care provider (PCP) of record unless the information is not available in certified EHR technology (CEHRT), is restricted from disclosure due to any federal, state or local law regarding the privacy of a person’s health information, including variations due to the age of the patient or the provider believes that substantial harm may arise from disclosing particular health information in this manner.

Core Measures cont…

u  Clinical Summaries: Stage 1 required a clinical summary for more than 50% of all office visits within 3 business days. Stage 2 changes the requirement to within 1 business day.

u  Protect Health Information: This measure stays the same except that it now includes addressing the encryption/security of data at rest.

u  Lab test results: This measure went from being a menu measure to being a core measure and the threshold changed from more than 40% to more than 50%.

u  Patient list: This measure went from being a menu measure to a core and otherwise stayed the same.

Core Measures cont…

u  Patient reminders: This measure went from being a menu measure to a core and changed from more than 20% of all unique patients 65 years or older or 5 years old or younger, to more than 10% of patients with two or more office visits in the last 2 years

u  Patient Education: This measure went from being a menu measure to a core and otherwise stayed the same

* Note- Patient education needs be identified by CEHRT

u  Med Reconciliation for TOC: This measure went from being a menu measure to a core and otherwise stayed the same

Core Measures cont…

u  Summary of Care for TOC: This measure went from being a menu measure to a core. Three parts to this measure:

1.  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% of transitions of care and referrals

2.  Summary of Care record must be electronically transmitted to a recipient using direct messaging for more than 10% of all transition/referrals

3.  Must conduct at least one successful electronic exchange of Summary of Care record with a different EHR developer than the sender’s EHR

Core Measures cont…

u  Immunization Registry: This measure went from being a menu measure to a core and changed from performing one test submission to successful ongoing submission for the entire EHR reporting period.

u  Secure Messaging: New measure for Stage 2. A secure message needs to be sent using the electronic messaging function of CEHRT by more than 5 % of unique patient seen during the EHR reporting period.

* Note- Patient Portal required; message must contain relevant health information

Stage 2 Menu Measures

u  Syndromic Surveillance: Measure changed from performing one test submission to successful ongoing submission for the entire EHR reporting period.

u  Electronic Notes: New measure for Stage 2. Enter at least one electronic progress note created, edited and signed by an EP for more than 30% of unique patients * Note- electronic note must be text searchable

u  Imaging Results: New measure for Stage 2. More than 10% of all scans and tests whose result is an image ordered by the EP for patients seen during the EHR reporting period are incorporated into or accessible through Certified EHR Technology

Menu measures cont…

u  Family History: New measure for Stage 2. More than 20% of all unique patients seen by the EP during the EHR reporting period have a structured data entry for one or more first-degree relatives or an indication that family health history has been reviewed

u  Cancer Registry: New measure for Stage 2. Successful ongoing submission of cancer

case information from Certified EHR Technology to a cancer registry for the entire EHR reporting period.

u  Specialized Registry: New measure for Stage 2. Successful ongoing submission of

specific case information from Certified EHR Technology to a specialized registry for the entire EHR reporting period.

Preparing can start now!

u  Implement a patient portal u  Discuss strategies for getting community using portal u  Implement Orders/Result interfaces u  Discuss CPOE workflow in regards to non-certified/non-licensed team

members u  Choose appropriate CDS for your specialties u  Discuss strategies for appropriate reminders and related workflows u  Immunization registry- on-going submission

Helpful Links

•  http://cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Participation-Timeline.html#.Ujh6rhY_WQm

•  http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/

Stage_2.html •  http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/

Downloads/Stage2_MeaningfulUseSpecSheet_TableContents_EPs.pdf

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Email: info@ehrconcepts.com Phone: 1.888.674.0999 Website: www.ehrconcepts.com jennifer@ehrconcepts.com