AWARDS and Meaningful Use

Alex AttinsonRachel Miller

ConnectedCare Team

– Created by three human service agencies

–Web based EHR used by more than 900 agencies in 25 states

– Behavioral Healthcare functionality:• Demographics• Notes• Plans• Outcomes, reporting, billing

Who We Are

• Behavioral Health vs. Hospitals– Smaller budgets; chronic cash flow

crises–Many clinical workers, few EPs if any– Part-time / shared EPs

• MU Objectives– Alignment with behavioral health– Relevant CQMs

Behavioral Health and MU

Interested

Eligible and Able

Adopt, Implemen

t, Upgrade

• AWARDS is a complete, ambulatory 2014 Edition

• Majority Medicaid– Some mixed

Medicare/Medicaid volume

– Choose Medicaid• AIU• More Money• More flexible

Meaningful Use Clients

• Eligibility– MU not designed for Behavioral Healthcare– Who on staff qualifies?– Can I claim them?– Medicaid/Medicare volume

• Resource allocation– EHR features, vendor support– EP access to technology– MU content expertise

• REC, internal, external consultant

• Cost/Benefit Analysis– Does MU overlap with mission of the agency?– Can we afford it?

Early Challenges

• Implementation team / MU leadership

• Resources: staff and hardware• Staff resistance• Computer skills• Training • Workflow/process changes• Data quality

General Challenges

• Message to agencies:–Meaningful Use is not easy…– Attestation is not easy…• Job well done for getting to attestation

• Meaningful Use ‘14 – Stage 1– Non-reportable objectives: screenshots– Reportable objectives: Objectives Report– Clinical Quality Measures: Quality Measures

Report

The 2014 Edition

• 2011/2014 CHERT Flexibility Rule• Mandatory 90-day 2014 reporting

period• Possible 90-day 2015 reporting

period• Role specific vitals recording• RECs that provide one-on-one

support• Possible incentives for BH

organizations

CMS Relief

• Patients and EPs– Record encounters, associate patients with EPs

• Always be ready for an audit• Know your exclusions– Ex: is blood pressure in the scope of practice?

• Selecting your Menu Set Objectives– Public Health objectives

• View, Download, Transmit– Connected to a HISP/DIRECT

Attesting with AWARDS

• Ex: Consumer meets with psychiatrist• In AWARDS, the touch point is the Psych

Note• Maintain existing functionality• Maximize functionality from that screen– Record encounter– E-Rx (reconciliation, medications, allergy,

formulary)– Update medical record (vitals, problem list,

smoking)– Generate Clinical Summary– VDT: DIRECT or offline generation of electronic

doc

Workflow in BH Agencies

Workflow in BH Agencies

Psych Note Clinical Summary Electronic Document/VDT

Clinical Summary

Clinical Summary

VDT – Electronic Document

Meaningful Use Dashboard

Core• Controlling High Blood Pressure - CMS165v2 (NQF 0018)• Tobacco Use: Screen and Cess. - CMS138v2 (NQF 0028)• Body Mass Index (BMI) Screen - CMS69v2 (NQF 0421)• Documentation of Current Med. - CMS68v3 (NQF 0419)• Use of High-Risk Medications - CMS156v2 (NQF 0022)• Use of Imaging Studies for Low Back Pain - CMS166v3 (NQF

0052)

Behavioral Heath Specialty• Anti-depressant Medication Man. - CMS128v2 (NQF 0105)• Weight Assessment and Counseling - CMS155v2 (NQF 0024)• Major Depressive Disorder - CMS161v2 (NQF 0104)

Clinical Quality Measures

• Codify medical encounters and vocabulary

• RxNorm, SNOMED CT, ICD, CPT, LOINC

• AHRQ Value Sets – eCQM

• QRDA Physicians Quality Reporting System

• Extensible framework for new CQMs

Codified Data

eCQM Value Sets

QRDA Cat I & III

Clinical Quality Measures

Codified Data Entry

AHRQ Value Sets

PQRS Reporting

• Interoperability– Secure messaging– RHIO subscriptions– Health Homes– DSRIP and ACO• CQMs as a part of Care Plan Reporting

• EPCS• Opt-out consent for data exchange

Stage 2 and Beyond

Q & A

Questions?

• www.footholdtechnology.com

• ConnectedCare Team: mu@footholdtechnology.com

• Alex Attinson: alex@footholdtechnology.com

• Rachel Miller – Senior Project Manager: rachel@footholdtechnology.com

Foothold Technology