stage2mu final-120925161818-phpapp01
DESCRIPTION
Meaningful use stage 2 infrastructure waveTRANSCRIPT
Meaningful Use Stage 2 – The Infrastructure Wave
Adele AllisonNational Director of Government Affairs
September 25, 2012
888.879.7302 • www.SuccessEHS.com
Stage 2 MU – Infrastructure Wave
• Meaningful Use Look-Back• Incentive Program Highlights• Stage 1 Changes• Stage 2 Measures• Clinical Quality Measures• Health IT Considerations• Questions
888.879.7302 • www.SuccessEHS.com
Meaningful Use – Authority • ARRA Signed 2/17/09 in Denver, CO• Purpose: Stimulate the economy through investments in
infrastructure, unemployment benefits, transportation, education, and healthcare.
• $45B in HITECH Funding: o $20B in Medicare Incentiveso $14B in Medicaid Incentives
PROGRAM 2012 2013 2014 2015 2016 2017
Medicaid EHR Incentive Program
CarrotsYear 1: $21,250
Year 1: $21,250
Year 1: $21,250
Year 1: $21,250
Year 1: $21,250
Year 1: $21,250
Years 2-6: $8,500
Years 2-6: $8,500
Years 2-6: $8,500
Years 2-6: $8,500
Years 2-6: $8,500
Years 2-6: $8,500
Medicare EHR Incentive Program**
Carrots Up to
$18,000Up to
$15,00Up to
$12,000Up to
$8,000Up to
$4,000
Sticks
-1.0% -2.0% -3.0%** Meaningful Use incentives will vary based upon the EP’s year initiated and allowable charges.
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Summing-up HITECH Goals
1. Adopt and Use Certified EHR Technology (CEHRT)
2. Capture DATA – Vitals, Problems, Allergies, etc.
3. Move DATA – Interoperability
4. Report DATA – CQMs and PQRS • $27B in “Carrots”• Stage 1 Meaningful Use = Marks 11 and and 22• Stage 2 Meaningful Use = Marks 33 and and 44
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Meaningful Use – State of the Union • 55% of Physicians had “adopted” any CEHRT
o Among Physicians Under age 50 → 64% adoption rateo Over age 50 → 49% adoption rateo Hosted CEHRT → 41%o 29% of Solos as compared to 86% among large practices (11+ MDs)
• 58% of PCPs have adopted CEHRT• 55% of Medical Specialists have adopted CEHRT• 48% of Surgical Specialists have adopted CEHRT• 75% Physicians with CEHRT report meeting MU1• 85% are somewhat (47%) or very (38%) satisfied• 75% of CEHRT adopters → “It’s enhanced patient care”• 50% with no CEHRT plan to purchase in next 12 months
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Polling the Audience
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Meaningful Use – State of the Union • ↑↑ $3.6 Billion in Medicare Incentives Paid – Hospitals/Providers• ↑ $3.3 Billion in Medicaid Incentives Paid – Hospitals/Providers• ↑ 287,000 hospitals / providers registered• 47 States have launched Medicaid Programs
o D.C. – September 2012o MN – September 2012o NH – September 2012o Hawaii, Guam, Am. Samoa - Unknowno Puerto Rico and Virgin Islands – Unknown
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Meaningful Use – State of the Union • Active Registrations
o Hospitals → 3,973o Medicare Eligible Providers → 192,016o Medicaid Eligible Providers → 91,130
• Hospital Attestation → $4,523,283,457• Medicare EP Stage 1 Attestation → $1,267,068,609$1,267,068,609
• Medicaid EP Year 1 & Year 2 Attestation →→ $1,140,158,421$1,140,158,421
Program to Date Eligible Professionals Payments13,623 Internal Med. 14,467 Family Med. 5,095 Cardiology 2,860 OB/Gyn 2,897 Gastro
1,938 Urology 1,605 ENT 2,465 Gen’l Surgery 2,850 Ortho 2,019 Neurology
16,548 Other
Program to Date Eligible Professionals PaymentsAIU 39,612 Physicians 9,223 Nurse Prac. 1,159 Mid-Wives 3,366 Dentists 608 Physician Asst.
MU 741 Physicians 258 Nurse Prac. 21 Mid-Wives 12 Dentists 12 Physician Asst.
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Meaningful Use – Highest / Lowest• Top 5 States – Hospitals/Providers
• Lowest 5 States – Hospitals/Providers
State Medicare Medicaid Paid Count TotalTexas $268,799,000 $345,233,522 9,487 $614,032,521California $222,294,768 $353,096,067 9,083 $575,391,835Florida $268,485,118 $203,126,345 8,172 $471,611,464New York $215,608,873 $177,350,910 7,052 $392,959,783Pennsylvania $204,156,197 $146,275,623 7,973 $350,431,820
State Medicare Medicaid Paid Count TotalNorth Dakota $11,128,406 $3,021,084 262 $14,149,490Idaho $10,280,322 $2,678,361 197 $12,958,683South Dakota $7,104,719 $5,671,423 296 $12,776,142Wyoming $1,813,941 $5,893,626 126 $7,707,567District of Columbia $2,921,701 $0 177 $2,921,701
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CEHRT Impact• Gains in Population Health Management
o Cleveland Clinic Florida 9.6% Pre-CEHRT Hypoglycemia insulin order sets → dropped to
3.8% Post-CEHRT adoption 60% Pre-CEHRT Normal Blood Sugar rates → 65% Post-CEHRT
adoptiono SuccessEHS Customers
1,274 Clinic Sites using ePrescribing 1,102 Clinic Sites using Extended eRx
1,156 Clinic Sites using Clinical Event Manager 762 Clinic Sites using Patient Portal
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Measuring Knowledge
888.879.7302 • www.SuccessEHS.com
Stage 2 MU – Infrastructure Wave
• Meaningful Use Look-Back• Incentive Program Highlights• Stage 1 Changes• Stage 2 Measures• Clinical Quality Measures• Health IT Considerations• Questions
888.879.7302 • www.SuccessEHS.com
MU – Objectives & Measures• Objectives are broad spanning goals/activities• Measures are specific task(s) requirements• Meeting the measures = meeting the Objectives for that
Stage• Stage 1 MU (July, 2010)
o 15 Core Measures required by all EP’so 10 Menu 10 Menu Measures from which EP’s choose Measures from which EP’s choose 55o 13 Exclusion Clauses Clauses
• Stage 2 MU (August, 2012)
o 17 Core Measures required by all EP’so 6 Menu 6 Menu Measures from which EP’s choose Measures from which EP’s choose 33o 20 Exclusion 20 Exclusion ClausesClauses
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Incentive Payouts
• MU Incentives are not funded by Senate Appropriations• Incentives are an Entitlement• Money cannot “run out”
Calendar Year
First Calendar Year in which the EP Receives an Incentive Payment
2011 2012 2013 20142015 and
subsequent years
2011 $18,000
2012 $12,000 $18,000
2013 $8,000 $12,000 $15,000
2014 $4,000 $8,000 $12,000 $12,000
2015 $2,000 $4,000 $8,000 $8,000 $02016 $2,000 $4,000 $4,000 $0
TOTAL $44,000 $44,000 $39,000 $24,000 $0Shortage Area
Totals* $48,400 $48,400 $42,900 $26,400 $0
* Providers practicing in a federally identified shortage area are eligible for a 10% increase.
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Incentive Payouts
Calendar YearFirst Calendar Year in which the EP Receives an Incentive Payment
2011 2012 2013 2014 2015 2016
2011 $21,2502012 $8,500 $21,2502013 $8,500 $8,500 $21,2502014 $8,500 $8,500 $8,500 $21,2502015 $8,500 $8,500 $8,500 $8,500 $21,2502016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,2502017 $0 $8,500 $8,500 $8,500 $8,500 $8,5002018 $0 $0 $8,500 $8,500 $8,500 $8,5002019 $0 $0 $0 $8,500 $8,500 $8,5002020 $0 $0 $0 $0 $8,500 $8,500
2021 $0 $0 $0 $0 $0 $8,500
TOTAL $63,750 $63,750 $63,750 $63,750 $63,750 $63,750
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MU2 Highlights• Published in the Federal Register September 4, 2012• Delayed Stage 2 by one year to CY2014• CY2014 attesters (MU1 or MU2) → any quarter
o 3 month reporting period for ‘Care attesting Stage 1/2 in 2014o First year ‘Caid EPs either any 90-days or quarters, by state option
• Everyone gets 2 years in each Stage• Changes to Quality measures with expectation they will be
electronically submitted• Patient Engagement → Big theme• Stage 2 allows for batch or group reporting• Production HIE will be required
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MU2 Launch Date• MU2 begins for EP in CY2014• MU1 or MU2 EPs in 2014 → quarter EHR reporting period• MU1 Latecomers starting after 2014 → full year EHR
reporting period• Quarters / Yearly reporting supports data integrity with
other Federal initiatives (E.g. PQRS, ACOs)First
Payment Year
Stage of Meaningful Use2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
2011 1 1 1 2* 2 3 3 TBD TBD TBD TBD2012 1 1 2* 2 3 3 TBD TBD TBD TBD2013 1 1* 2 2 3 3 TBD TBD TBD2014 1* 1 2 2 3 3 TBD TBD2015 1 1 2 2 3 3 TBD2016 1 1 2 2 3 32017 1 1 2 2 3*3-month quarter EHR reporting period for Medicare; continuous 90-day EHR reporting period (or
3-months at state option) for Medicaid. All first year EPs in 2014 use any continuous 90-days.
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Medicare Penalties
• Applies to EPs treating Medicare Part B PFS Patients• HITECH requires Payment Adjustment if no MU by 2015• Adopt, Implement or Upgrade (AIU) is NOT MU• Payment Adjustment based on prior year’s reporting period
– 2 year lag• Any MU in 2013 = No Adjustment in 2015• Medicare MU registration & attestation by 10.1.2014 = No
Adjustment in 2015• This means 90-day reporting period no later than 7.1.2014• EP must continue to meet MU annuallyannually to avoid
adjustments in subsequent years
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Medicare Penalties • Penalties are cumulative with other CMS Programs
• EP Hardship Exceptions1. Infrastructure → E.g. Lack of Broadband2. New EP → 2-year limited exception3. Unforeseen Circumstances → E.g. Natural Disaster4. Lack of Face-to-Face or F/up Need with Patients → E.g. Pathology,
Radiology, Anesthesiology 5. Multiple Locations and Lack of control over availability of CEHRT
for more than 50% of patient encounters
2015 2016 2017 2018 2019 2020+EP subject to MU adjustment only 99% 98% 97% 96% 95% 95%
EP also subject to eRx adjustment 98% 98% 97% 96% 95% 95%
EP also subject to PQRS adjustment 96.5% 96% 95% 94% 93% 93%
EP also subject to Value-Based Modifiers (VBM)
+/-TBD
+/-TBD
+/-TBD
+/-TBD
+/-TBD
+/-TBD
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Medicaid Patient Volume Expansion• Required Thresholds
o Pediatricians → 20% - 30%o FQHC / RHC → 30% using “Needy” Encounter in Numeratoro All Other → 30%
• Calculations from auditable data source and documentation• MU2 → Look-back period now the 12-months preceding
attestation, not CY• Includes encounters for anyone enrolled in Medicaid
o Medicaid CHIP expansion encounters (except standalone Title 21)o Encounters with Zero-pay claims
• Zero-pay encounters includeo Denied due to Max-out Service Limito Denied for non-coverage under Medicaid Programo Paid at $0 due to another payer’s paymento Denied for lack of timely submission
888.879.7302 • www.SuccessEHS.com
Measuring Knowledge
888.879.7302 • www.SuccessEHS.com
Stage 2 MU – Infrastructure Wave
• Meaningful Use Look-Back• Incentive Program Highlights• Stage 1 Changes• Stage 2 Measures• Clinical Quality Measures• Health IT Considerations• Questions
888.879.7302 • www.SuccessEHS.com
Stage 1 Changes – CY2013-14
• Core CPOE Denominatoro Currently: # of Unique Patients with 1 Rx seen by EPo “New” Option: # of orders for Rx during EHR Reporting Periodo CY2013 and beyond → EPs can use either
• Core Vitals Exclusion Clauseo Currently: BP and Height/Weight not relevanto “New”: EP can split to exclude 1 onlyo CY2013 → EPs can use either exclusiono CY2014 → New Exclusion Only
• Core Vitals Age Requirementso Currently: See no patients age 2+o “New”: Sees no patients age 3+o CY2013 → EPs can use either exclusiono CY2014 → New Exclusion Only
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Stage 1 Changes – CY2013-14
• Core Test of Exchanging Key Clinical Information → Removed from Stage 1 effective CY2013
• Core ePrescribing Exclusion → Added where EP not within 10 mile radius of ePharmacy effective CY2013
• 3 Menu Measures → Data submission to Public Health for Immunizations, Reportable Labs and Syndromic Surveillanceo Removed “except where prohibited” o Encouraging submission even if not state required
• 2 Measures → Core Electronic Copy and Menu Timely Electronic Accesso 2014 Edition Vendor Certification = obsoleteo Replaced: CY2014 Stage 2 measure of Patient View, Download and Transfer
• Core Submission of CQMs Eliminated and Incorporated into definition of “Meaningful EHR User”
• Stage 1 EPs must choose 5 Menu Measures if available
888.879.7302 • www.SuccessEHS.com
Measuring Knowledge
888.879.7302 • www.SuccessEHS.com
Stage 2 MU – Infrastructure Wave
• Meaningful Use Look-Back• Incentive Program Highlights• Stage 1 Changes• Stage 2 Measures• Clinical Quality Measures• Health IT Considerations• Questions
888.879.7302 • www.SuccessEHS.com
Stage 2 Measures – 17 Core 17 Core Objectives
No. Objective Measure Threshold
New, Revised, Expanded,
Consolidated or Unchanged
Exclusions Health IT Needs
1Computerized Provider Order
Entry (CPOE)
Use CPOE for medication, lab and radiology orders entered by any professional permitted by law
60% Rx (↑ from 40%), 30% Labs, 30% Radiology
Expanded
EP has < 100 Rx, lab, radiology orders collectively
Orders Management Orders Audit Trails Delinquency Alerts
2
Generate and Transmit
Permissible Prescriptions Electronically
Using a certified EHR technology and compared to at least 1 drug formulary (still excludes controlled substance [Sch. II-V] and OTC)
50% (↑ from 40%)Expanded and Consolidated
EP writes < 100 Rx; or,
No pharmacy w/in 10 miles of the practice
Rx Database Interaction Alerting eRx (E.g.,
Surescripts) Formulary Checking
3Record Patient Demographics
Gender, race, ethnicity, DOB, and preferred language as structured data
80% (↑ from 50%) ExpandedNone
Patient Administration
Master Patient Index
4Record Vital Signs and Chart Changes
Height & weight (all ages), blood pressure (ages 3+), BMI (all ages), and growth charts for children (0-20) as structured data
80% (↑ from 50%)Revised and Expanded
No pts. age 3+ Ht., Wt., BP
irrelevant BP only irrelevant
Vitals Capture Tool Detailed Entry Normal Ranges and
Graphing Automated BMI and
Growth Charts
5Record Smoking
StatusPatients age 13 and older as structured data
80% (↑ from 50%) Expanded
EP does not see pts. age 13+
Smoking Status Alerting to lack of
Documentation
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Stage 2 Measures – 17 Core
17 Core Objectives
No. Objective Measure Threshold
New, Revised, Expanded,
Consolidated or Unchanged
Exclusions Health IT Needs
6Implement Clinical Decision Support
and Track Compliance
Implement CDS to improve on high-priority condition:1.5 CDS interventions for 5 or more CQMs during entire reporting period; and2.Enable drug-drug and drug-allergy checks for entire reporting period.
5 Rules and Rx alerting by attestation
Expanded and Consolidated
2nd measure only – EP writes < 100 Rx
Evidence-based guidelines
Population Management Tool
Point-of-Care Alerting for non-adherence
Static and Customizable Interventions
7Incorporate Clinical
Lab Test Results into EHR
Incorporated as structured data – positive/negative or numerical format – within the EHR
55% (↑ from 40% and made Core) Expanded
EP orders no lab tests during EHR reporting period
Bidirectional Lab Interface for in-house and/or reference labs
8Generate Lists of
Patients by Condition
1 List with a Specific Condition for use in quality improvement, reduction of disparities, research or outreach
By attestation (Made Core) Unchanged
None
Evidence-based guidelines
Population Management Tool
Action Tracking and Escalation
Patient Portal Alerting Form letter merging Phone Lists
9Send Reminders to
Patients
Preventative and follow-up care for all patients based on clinically relevant info for anyone with an OV in past 24 months
10% (↓ from 20%, all patients and Made
Core)Expanded
EP has no office visit in previous 24 months
Evidence-based guidelines
Population Management Tool
Action Tracking and Escalation
Patient Portal Alerting Form letter merging Phone Lists
10Timely Electronic Access to Health
Information
Patients can view online, download and transfer info within 4 days of being available to EP, subject to EPs discretion to withhold certain info
1. 50% of all pts., and
2. 5% of pts. access
New
EP has no orders / creates info required
>50% visit in county with >50% with 3Mbps broadband available
Advanced Patient Portal Robust Portal Integration
to CEHRT Access Tracking Patient Administration
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Stage 2 Measures – 17 Core
17 Core Objectives
No. Objective Measure ThresholdNew, Revised,
Expanded, Consolidated or
Unchanged
Exclusions Health IT Needs
11Provide Patients with
Clinical Summaries
For each office visit to patients within 1 business day, which includes up-to-date lists of problems, medications and Rx allergies (paper and electronic must be avail. to pt.)
50% (Unchanged)Expanded and Consolidated
EP has no office visit during EHR reporting period
Advanced Patient Portal Robust integration of
Portal to CEHRT
12Use of secured messaging with
Patients
Send secured messages to patients seen during reporting period 5% New
EP has no office visit during EHR reporting period
Advanced Patient Portal Messaging Capabilities
13Use EHR for Patient-
Specific Education Resources
Provide patient-specific education resources to all patients
10% (Unchanged but made Core and “if
appropriate” removed)
Expanded
EP has no office visit during EHR reporting period
Integrated Patient Education Tools
Static and Customizable forms
Multi-language
14Perform Medication
ReconciliationDuring transitions of care (TOC) into care of EP 50% (Made Core) Unchanged
EP not recipient of any TOC during EHR reporting period
HIE (Direct or Exchange) Rx History
15Provide Summary of
Care Record
Patients referred or transitioned to another provider or setting and electronically transmit to a different system.
1. 50% of TOC or referrals (Made core)
2. 10% electronically transmitted
Expanded and New
EP neither transfers nor refers patient during EHR reporting period < 100 times
CCDA HIE (Direct or Exchange) HIE Tracking
16
Submission of Electronic
Immunization Data to Registry / Information
Systems
Ongoing submission
During Entire EHR Reporting Period
(Made Core)Expanded
EP does not admin. immunizations,
No electronic registry available*
No timely provision of information on available registry
No registry that accepts CEHRT standards available*
Immunization Registry Interface or HIE submission to Immunization Registry
CEHRT Immunization Guideline Adherence Tracking Tool
Detailed Immunization Tool
17Implement Systems to
Protect Privacy and Security of Patient
Data
Conduct/review a security risk analysis; implement security updates as necessary and correct security deficiencies; encrypt data at rest in accordance with 45 CFR 164.312(a)(2)(iv) and 45 CFR 164.306(d)(3)
During Reporting Period by attestation
Expanded
None Thin-Client CEHRT
Operations Encryption Technology (Optional) Data-hosting Internet Access
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Stage 2 Measures – 3 of 6 Menu
3 of 6 Menu Objectives
No. Objective Measure Threshold
New, Revised, Expanded,
Consolidated or Unchanged
Exclusions Health IT Needs
1Imaging Results and Information
Are accessible through the CEHRT 10% New
EP does not perform diagnostic interpret. of scans/test whose result is an image during reporting period, or
EP orders imaging results < 100 times
PACS Results Interface
PACS Portal for image retrieval
2Patient Family Health History
Structured data entry for one or more first-degree relatives 20% New
EP has no office visits during reporting period
Structured Knowledge Base for documentation
Family Health History clinical concepts
3Record Electronic
Notes
At least 1 note created, edited and signed by EP for patients with at least 1 OV during EHR reporting period
30% New
No office visits during reporting period, or
>50% visit in county with >50% with 3Mbps broadband available
Structured Knowledge Base for documentation,
Voice Recognition, Customizable Forms,
and/or Ability to type note
4Submission of
Electronic Syndromic
Surveillance Data
Ongoing data submission to Public Health agencies (where agencies can accept electronic data)
During Entire EHR Reporting
PeriodExpanded
EP does not collect any data,
No electronic registry available*
No timely provision of information on available registry
No registry that accepts CEHRT standards available*
Public Health Registry Interface or HIE submission to Public Health Registry
CEHRT Surveillance tracking tools
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Stage 2 Measures – 3 of 6 Menu
*Exclusion does not apply if data can be accepted through a designated HIE
3 of 6 Menu Objectives
No. Objective Measure Threshold
New, Revised, Expanded,
Consolidated or Unchanged
Exclusions Health IT Needs
5Submission of Cancer Cases
Ongoing data submission to a state cancer registry
During Entire EHR Reporting Period New
EP does not diagnose or directly treat CA
No public health agency is capable of receiving data
No timely provision of information on available registry
No registry that accepts CEHRT standards available
State Cancer Registry Interface or HIE submission to State Cancer Registry
CEHRT Cancer tracking tools
6Submission of
Specialized CasesOngoing data submission to a specialized registry
During Entire EHR Reporting Period New
EP does not diagnose or directly treat CA
No public health agency is capable of receiving data
No timely provision of information on available registry
No registry that accepts CEHRT standards available
Specialized Registry Interface or HIE submission to Specialized Registry
CEHRT Specialized Case tracking tools
888.879.7302 • www.SuccessEHS.com
Measuring Knowledge
888.879.7302 • www.SuccessEHS.com
Stage 2 MU – Infrastructure Wave
• Meaningful Use Look-Back• Incentive Program Highlights• Stage 1 Changes• Stage 2 Measures• Clinical Quality Measures• Health IT Considerations• Questions
888.879.7302 • www.SuccessEHS.com
Clinical Quality Measures (CQMs)• Removed as MU Measure → Now Part of Definition of
“Meaningful EHR User”• Electronic reporting by CY2014 for ‘Care regardless of Stage• PQRS will be the vehicle for Clinical Reporting for ‘Care• Clinical Reporting will drive VBM under ACA• Reporting will be reported publicly on “Physician Compare”• ACA requires CMS to align MU with other Federal programs
(E.g. PQRS and eRx)
• No change in ‘Care CQMs through CY2013 → 2 Reporting Methodso Manual calculation / Attestation on CMS websiteo eReporting under PQRS EHR Incentive Program Pilot
• ‘Caid EPs → Look to State on process and timelines
888.879.7302 • www.SuccessEHS.com
Clinical Quality Measures (CQMs)• Prior to CY2014 → Manual attestation of 6:44 CQMs• CY2014 and Beyond → Electronic submission of 9:64 CQMs
o First year EP → Aggregated data for All Payers through attestationo Subsequent Years, 2 Options
Electronic reporting of Aggregate data for All Payers, or Individual Continuity-of-Care Document (CCD) on Medicare only through
PQRS EHR Direct using CEHRT
• 9 CQMs must include 1 measure in 3 Nat’l Quality Strategy Domains, minimal (Core Sets of 9 Recommended)1. Patient and Family Engagement2. Patient Safety3. Care Coordination4. Population and Public Health5. Efficient Use of Healthcare Resources6. Clinical Processes / Effectiveness
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EHR Direct Reporting & CMS• CMS wants EHR Direct Submission of Quality Data• Claims-based / Registry-based = bit of data only• EHR-based = Continuity of Care Document (CCD) on each
individual Patient• Stage 1 MU Final Rule:
• 20 Vendors CMS EHR Direct Qualified → 15 ONC CEHRT as Complete EHRs → Only 9 eRx Incentive Program through EHR Direct
• 51 Data Submission Vendors → The 2012 Reality
“… the HIT Policy Committee proposed the goal as, ‘Report to patient registries for quality improvement, public reporting, etc.’ We have modified this care goal, because we believe that patient registries are too narrow a reporting requirement to accomplish the goals of quality improvement and public reporting.”
Aprima Medical Software, Inc. ASP.MD, Inc. AZZLY™
Digital Medical Solutions, Inc. e-MDs Epic
LSS Data Systems Medical Informatics Engineering SuccessEHS, Inc.
888.879.7302 • www.SuccessEHS.com
Clinical Quality Measures (CQMs)• 64 Measures were finalized in the Final Rule (Table 7)
• Preference given to NQF-endorsed Measureso Average 3-year endorsement processo Dentists – 0 Dental CQMs in Stage 1; NQF endorse 4 measures in Aug, 2011
• 2 Oral Health Measureso Primary Caries Prevention (FV as part of EPSDT) – NQF 1419o 6-month exams on children ages 1-17 – NQF 1335
• Note → White Paper on MU and Dental Slated for October, 2012
888.879.7302 • www.SuccessEHS.com
Stage 2 MU – Infrastructure Wave
• Meaningful Use Look-Back• Incentive Program Highlights• Stage 1 Changes• Stage 2 Measures• Clinical Quality Measures• Health IT Considerations• Questions
888.879.7302 • www.SuccessEHS.com
Fed. Programs & Patient Engagement • Behavioral Economics requires an Engaged Patient• Transition from Episodic Care to Long-Term Healing and
Wellness• Patient Engagement ↑ Quality and ↓ Costs• 4 Federal Initiatives with Patient Engagement Regulations
o Meaningful Use Stage 2 - 7 Measureso Accountable Care Organizations – 7 Measures7 Measureso NCQA Patient-Centered Medical Home – 66 Factorso Value-based Purchasing – CAPHS
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Patient Portal A Must
Pull Information ModelPush Information Model
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HIE and TOC / Referrals• 10% of Transitions or Care and Referrals → Electronic
Summary of Care Record• Problem Focus: 75% of PCPs → No info about a patient’s
hospitalization post-discharge = Readmissions• HIE Message (Direct) to PCP from the HospitalHIE Message (Direct) to PCP from the Hospital• Hospitalization Hospitalization CareCare GapsGaps
o Discharge Rx ReconciliationDischarge Rx Reconciliationo Lack of Understanding of Discharge Plan of CareLack of Understanding of Discharge Plan of Careo Non-compliance or Untimely Post-discharge Plan of CareNon-compliance or Untimely Post-discharge Plan of Careo No appointments with a PCPNo appointments with a PCPo Logistics (E.g. Transportation)Logistics (E.g. Transportation)o PCP unawareness of hospitalizationPCP unawareness of hospitalizationo Lack, delay or inadequate communication with downstream providerLack, delay or inadequate communication with downstream providero Lack or inadequate communication with home care provider Lack or inadequate communication with home care provider (includes family)(includes family)
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Transformation – Your IT Vendor
• Meaningful Use and Other Meaningful Use and Other DashboardsDashboards??o Metrics / Analytics by ProviderMetrics / Analytics by Providero Facilitates quick numerators/denominators for MU attestationFacilitates quick numerators/denominators for MU attestationo Practice analytics with drill-through detailsPractice analytics with drill-through details
• Patient Portal Patient Portal Inherent with System?Inherent with System?o Additional license or support feesAdditional license or support feeso Additional vendor and integration considerationsAdditional vendor and integration considerations
• Single database Single database solution for PM and EHRsolution for PM and EHR• EHR Direct EHR Direct PQRSPQRS• More than just first call More than just first call supportsupport
o Initiative Toolkits (E.g. MU, PCMH, PQRS)Initiative Toolkits (E.g. MU, PCMH, PQRS)o Consulting Support with domain expertsConsulting Support with domain experts
• Ongoing Client Educational Ongoing Client Educational OfferingsOfferings• REC and QIO REC and QIO AlignmentAlignment
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TOC, HIETOC, HIE