BEHIND THECURTAINSWhat and Why You Need to Know AboutMeaningful Use Stage 2

Ready or Not: Questions on What

? Are Meaningful Use Stage 2 fears exaggerated?

? Why is so much effort dedicated to Meaningful Use compliance?

? Are feelings of being forced to change affecting compliance?

? Why does the government want to push Meaningful Use compliance so much?

Is Meaningful Use compliance too complicated? Consider ease-of-use Data transfer Too many clicks Notes function Specialty-specic templates too tough to create

Ready or Not: Why You Need to Know

? Not complying means you miss out in incentive money.? Meaningful Use compliance means your practice is more efcient.

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More revenue Happier patients Better physician-patient relationship

Meaningful Use Stage 2 compliance could mean an increase in patients.

Meaningful Use Rundown

Two organizations within HHS work to create MU Criteria: Centers for Medicare and Medicaid Services (CMS)

Ofce of the National Coordinator for Health IT (ONC)

Two Federal Advisory Committees entice stakeholders,make suggestions: The HIT Policy Committee

The HIT Standards Committee

Who determines Meaningful Use?

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Use of certied EHRs in a meaningful manner Use of certied EHRs for electronic exchange of info Use of certied EHRs to submit clinical quality & more

The Recovery Actspecies 3 componentsof Meaningful Use:

Proposed Stage 2 Criteria1. Proposed Stage 2 requirements were released on February 23rd, 2012 during the HIMSS Conference. ? Eligible providers who met Stage 1 certication in 2011 have until 2014 to meet Stage 2, as opposed to 2013. Their 2012 counterparts have until 2016. ? Like Stage 1, Stage 2 requires core objectives & selections from a second menu. ? There are 17 required core objectives for clinicians, 16 for hospitals & CAHs. ? Clinicians meet 3 of 5 menu objectives, hospitals and CAHs meet 2 of 4.

2. No changes to eligibility requirements, but to be considered: ? Half or more of the eligible provider’s patient encounters during the EHR reporting period must occur at a practice or location running a certied EHR system. ? Eligible providers must submit quality measures beginning in 2013.

Revisions to Medicaid IncentivesDenition of Medicaid patient encounter updated:

1 Include encounters for patients enrolled in a Medicaid program, including Title XXI-funded Medicaid expansion encounters 1 Look-back period for patient volume more exible – not tied to calendar year.

Attribution ? Patients seen by NPs or Pas under the EP’s supervision can be counted by both NP and PA and supervising EP as long as policy is consistent for entire EHR reporting period.

ONC’s Revised EHR Criteria ? Change in terminology: no longer ‘Stage 1 certication.’ Will be replaced by ‘editions,’ i.e., 2011 Edition vs. 2014 Edition. ? NPRM includes ‘new,’ ‘revised’ and ‘unchanged’ certication criteria. ? Removal of ‘possession’ requirement for measures that are optional for each Stage.

Themes Dominating Stage 21. Improve quality, safety, efciency, reduce health disparities

2. Engage patients and families in their health care

3. Improve care coordination

4. Improve population and public health

5. Ensure adequate privacy and security protections for PHI

6. Quality measures for eligible professionals

Improve Quality, Safety, Efficiency

60%? More than 65 percent (Stage 1 was 40%) of all permissible prescriptions written by the EP are compared to at least one drug formulary and transmitted electronically using Certied EHR Technology.

? More than 80 percent (Stage 1 was 50%) of all unique patients seen by the EP have demographics recorded as structured data.

Improve Quality, Safety, Efficiency

80%? More than 80 percent (Stage 1 was 50%) of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data

? Implement 5 clinical decision support interventions (Stage 1 was one) related to 5 or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period.

? The EP has enabled and implemented the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period. (Stage 1 required implementation)

Improve Quality, Safety, Efficiency

More than 10 percent of all unique patients who have had an ofce visit with the EP within the 24 months prior to the beginning of the EHR reporting period were sent a reminder, per patient preference (Stage 1 was 20%, menu set).

More than 40 percent of all scans and tests whose result is an image ordered by the EP during the EHR reporting period are accessible through Certied EHR Technology (New).

Generate at least one report listing patients of the EP with a specic condition (Stage 1 was same).

Engage Patients and Families

? More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timely (within 4 business days after the information is available to the EP) online access to their health information subject to the EP's discretion to withhold certain information (Stage 1 was 10%).

? More than 10 percent 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 (New).

Improve Care Coordination

80%? The EP refers their patient to another setting of care or provider of care provides a summary of care record for more than 65 percent of transitions of care and referrals. (Stage 1 was 50%)

? The EP that transitions or refers their patient to another setting of care or provider of care electronically transmits a summary of care record using certied EHR technology to a recipient with no organizational afliation and using a different Certied EHR Technology vendor than the sender for more than 10 percent of transitions of care and referrals. (Stage 1 was one test)

Improve Population, Public Health

? Successful ongoing submission of electronic immunization data from certied EHR technology to an immunization registry or immunization information system for the entire EHR reporting period (Stage 1 was a single test).

Improve Population, Public Health? Successful ongoing submission of electronic syndromic surveillance data from certied EHR technology to a public health agency for the entire EHR reporting period (Stage 1 was a single test).

? Successful ongoing submission of cancer case information from certied EHR technology to a cancer registry for the entire EHR reporting period (New).

? Successful ongoing submission of specic case information from certied EHR technology to a specialized registry for the entire EHR reporting period (New).

PHI: Ensure Privacy and Protection

Quality Measures? Option 1a: EPs would report 12 clinical quality measures from those listed in Table 8 of the rule text, including at least 1 measure from each of the 6 domains: Patient and Family Engagement. Patient Safety. Care Coordination. Population and Public Health. Efcient Use of Healthcare Resources. Clinical Process/Effectiveness.

? Option 1b: EPs would report 11 core clinical quality measures listed in Table 6 plus 1 menu clinical quality measure from Table 8.

? Option 2: Submit and satisfactorily report clinical quality measures under the Physician Quality Reporting System's EHR Reporting Option.

Quality Measures? Table 6 of the proposed rule text is based upon analysis of several factors that include: ✘ conditions that contribute the most to Medicare and Medicaid beneciaries' morbidity and mortality; ✘ conditions that represent national public/population health priorities; ✘ conditions that are common to health disparities; ✘ those conditions that disproportionately drive healthcare costs that could improve with better quality measurement; ✘ measures that would enable CMS, States, and the provider community to measure quality of care in new dimensions with a stronger focus on parsimonious measurement; ✘ measures that include patient and/or caregiver engagement.

?? Table 8 of the proposed rule text lists all of the clinical quality measures that we are considering for EPs to report for the EHR Incentive Programs beginning with CY 2014.

Curtain Call: Stage 2 and Beyond

Saves money✗

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Saves timeSaves effortHappy patients

Why is Stage 2 benecial for you?

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