the road to meaningful use and beyond: higher payment, better patient care
DESCRIPTION
The Road to Meaningful Use and Beyond: Higher Payment, Better Patient Care. Trudi Matthews Director of Policy and Public Relations HealthBridge Tri-State Regional Extension Center. Meaningful Use Basics. What do you need to know to get paid?. MU Definition. - PowerPoint PPT PresentationTRANSCRIPT
HealthBridge is one of the nation’s largest and most successful health
information exchange organizations.
Trudi MatthewsDirector of Policy and Public Relations
HealthBridge Tri-State Regional Extension Center
The Road to Meaningful Use and
Beyond: Higher Payment, Better Patient Care
Meaningful Use Basics
What do you need to know to get paid?
MU Definition
Meaningful use (MU) is defined as:
• Use of a certified Electronic Health Record
(EHR)
• Electronic exchange of health information
• Quality reporting
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Meaningful Use Stages
Stage 12011*
Stage 22013*
Stage 3TBD*
1. Capturing health information in a coded format
2. Using the information to track key clinical conditions
3. Communicating captured information for care coordination purposes
4. Reporting of clinical quality measures and public health information
Capture information….
1. Disease management, clinical decision support
2. Medication management3. Support for patient access to their
health information4. Transitions in care 5. Quality measurement 6. Research7. Bi-directional communication with
public health agencies
Report information…
1. Achieving improvements in quality, safety and efficiency
2. Focusing on decision support for national high priority conditions
3. Patient access to self-management tools
4. Access to comprehensive patient data
5. Improving population health outcomes
Leverage information to improve outcomes…
*Indicates “payment year” in which each Stage is first introduced. Actual compliance timeframe depends on an EP’s first payment year.
MU Final Rule
• Moved away from “all or nothing approach.” • 15 core requirements for Eligible Professionals • 14 core requirements for Hospitals.• “Menu” of 10 additional requirements – have to
chose 5 of the 10.
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Eligible Professionals Eligible Hospitals
Must meet 15 core + 5 menu Must meet 14 core + 5 menu
MU Final Rule
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• Thresholds must be met for many requirements(e.g., 40% e-prescribing)
• Reporting by attestation required in 2011, electronic reporting to CMS required in 2012.
• Quality measures required for reporting:• 6 for EPs – 3 core* + 3 menu• 15 measures for hospitals
*3 alternative core measures available for those EPs that cannot report on 3 core measures.
The Challenges
• The final government regulations are complex (864 pages long).
• As many as 30% of all EHR implementations fail.
• EHR Use is not enough – Reporting and electronic interchange are key requirements
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Meaningful Use (MU) Final Rule – EPs – Core Set **
Core1. Use computerized order entry for medication orders.2. Implement drug-drug, drug-allergy checks.3. Generate and transmit permissible prescriptions electronically.4. Record demographics.5. Maintain an up-to-date problem list of current and active diagnoses.6. Maintain active medication list.7. Maintain active medication allergy list.8. Record and chart changes in vital signs.9. Record smoking status for patients 13 years old or older.10. Implement one clinical decision support rule. 11. Report ambulatory quality measures to CMS or the States.12. Provide patients with an electronic copy of their health information upon request.13. Provide clinical summaries to patients for each office visit.14. Capability to exchange key clinical information electronically among providers and
patient authorized entities.15. Protect electronic health information (privacy & security)
REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .
3. Generate and transmit permissible prescriptions electronically.
Meaningful Use (MU) Final Rule – EPs – Core Set **
Core1. Use computerized order entry for medication orders.2. Implement drug-drug, drug-allergy checks.3. Generate and transmit permissible prescriptions electronically.4. Record demographics.5. Maintain an up-to-date problem list of current and active diagnoses.6. Maintain active medication list.7. Maintain active medication allergy list.8. Record and chart changes in vital signs.9. Record smoking status for patients 13 years old or older.10. Implement one clinical decision support rule. 11. Report ambulatory quality measures to CMS or the States.12. Provide patients with an electronic copy of their health information upon request.13. Provide clinical summaries to patients for each office visit.14. Capability to exchange key clinical information electronically among providers and
patient authorized entities.15. Protect electronic health information (privacy & security)
REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .
11. Report ambulatory quality measures to CMS or the States.
Meaningful Use (MU) Final Rule – EPs – Core Set **
Core1. Use computerized order entry for medication orders.2. Implement drug-drug, drug-allergy checks.3. Generate and transmit permissible prescriptions electronically.4. Record demographics.5. Maintain an up-to-date problem list of current and active diagnoses.6. Maintain active medication list.7. Maintain active medication allergy list.8. Record and chart changes in vital signs.9. Record smoking status for patients 13 years old or older.10. Implement one clinical decision support rule. 11. Report ambulatory quality measures to CMS or the States.12. Provide patients with an electronic copy of their health information upon request.13. Provide clinical summaries to patients for each office visit.14. Capability to exchange key clinical information electronically among providers and
patient authorized entities.15. Protect electronic health information (privacy & security)
REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .
14. Capability to exchange key clinical information electronically among providers and patient authorized entities.
Menu: 1. Implement drug-formulary checks.2. Incorporate clinical lab-test results into certified EHR as structured data.3. Generate lists of patients by specific conditions to use for quality improvement,
reduction of disparities, research, and outreach.4. Send reminders to patients per patient preference for preventive/ follow-up care5. Provide patients with timely electronic access to their health information (including
lab results, problem list, medication lists, allergies)6. Use certified EHR to identify patient-specific education resources and provide to
patient if appropriate.7. Perform medication reconciliation as relevant8. Provide summary care record for transitions in care or referrals.9. Capability to submit electronic data to immunization registries and actual
submission.10. Capability to provide electronic syndromic surveillance data to public health
agencies and actual transmission.*Language from the final rule has been changed in places for brevity. ** These requirements are for eligible professionals (EPs). A table that includes
hospital requirements is available at www.healthbridge.org.
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Meaningful Use (MU) Final Rule – EP – Menu Set
3. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research and outreach.
Menu: 1. Implement drug-formulary checks.2. Incorporate clinical lab-test results into certified EHR as structured data.3. Generate lists of patients by specific conditions to use for quality improvement,
reduction of disparities, research, and outreach.4. Send reminders to patients per patient preference for preventive/ follow-up care5. Provide patients with timely electronic access to their health information (including
lab results, problem list, medication lists, allergies)6. Use certified EHR to identify patient-specific education resources and provide to
patient if appropriate.7. Perform medication reconciliation as relevant8. Provide summary care record for transitions in care or referrals.9. Capability to submit electronic data to immunization registries and actual
submission.10. Capability to provide electronic syndromic surveillance data to public health
agencies and actual transmission.*Language from the final rule has been changed in places for brevity. ** These requirements are for eligible professionals (EPs). A table that includes
hospital requirements is available at www.healthbridge.org.
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Meaningful Use (MU) Final Rule – EP – Menu Set
8. Provide summary care record for transitions in care or referrals.
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CMS Incentive Program Timeline
• Registration with CMS begins in January, • EPs will be required to register for
participation in either the Medicare or the Medicaid incentive program.
• Medicaid Incentive Payments should start by June.
• Full Medicare incentive requires completion by December, 2012
Tri-State Regional Extension Center An Overview
REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .
What is the Tri-State REC?
• New federally-funded collaboration led by HealthBridge
• GOAL: Help eligible professionals • implement technology • achieve meaningful use and • qualify for incentives
REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .
Who Do We Serve?
Who Do We Serve?
• Priority Primary Care Practitioners
(PPCP)• Primary Care = FPs, OB/Gyn, Peds, Int. Med• Additional focus on:
• Small practices (<10 prescribers; physicians, PAs, ARNPs)
• Community health centers • Rural clinicians and those with critical
access hospitals• Practices and clinics that serve the
underserved
REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .
• Meaningful Use Strategy and Planning• EHR Selection Support
• Standard RFP• Pre-negotiated Prices and Terms for five Supported
Vendors
• EHR Implementation Support
• Workflow and process improvement
• Health Information Exchange Support
• Quality Reporting Support
What Services Do We Provide?
REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .
REC Supported Vendors
• Allscripts - Professional • Athenahealth - AthenaNet • eClinicalWorks - eCW EHR • GE Healthcare - Centricity • NextGen Healthcare - NextGen EHR
ALSO: • REC will work with any practice regardless of vendor. • REC will work with practices that choose a hospital
supported EHR.
REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .
Bottom line: REC will help practices and health centers• maximize funding• minimize expenses and • improve quality and efficiency of the practice • REDUCE RISK of PROJECT FAILURE
Why Work with the Tri-State REC?
REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .
Greater Cincinnati Beacon CollaborationAn Overview
Beacon Community Program: Overview
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Extend advanced health IT and exchange infrastructure
Leverage data to inform specific delivery system and payment strategies
Demonstrate a vision of the future where:• Hospitals, clinicians and patients are meaningful users of health IT; and,• Communities achieve measurable & sustainable improvements in health care quality, safety, efficiency, and population health.
17 Beacon Communities
Beacon Community Programs
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GCBC Activities
HIT/HIE Interventions – HealthBridge • Core Infrastructure Enhancements
• Master Patient Index, • Repository & • Enhanced Connectivity to EHRs
• Alert system for ER & Hospital visit/discharge to ambulatory providers
• Disease registries & EHRs with clinical decision support
• Summary record exchange• Patient portal availability • Race, ethnicity and language data enhancement
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Contact Us
• For answers to your questions, additional information or to sign up to work with us:• Call 513-469-7222• Visit our website, www.healthbridge.org• Email [email protected]
REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .
An Equal Opportunity University
KY REC
Tri-State REC
Kentucky REC
An Equal Opportunity University
Vision StatementThe long-term vision of Kentucky Regional Extension Center is to improve the quality and value of health care for the people of Kentucky and to serve as a model for other areas that face similar challenges.
Mission StatementThe Kentucky Regional Extension Center based at the University of Kentucky will assist primary care providers and critical access/rural hospitals with EHR adoption, HIE participation, and achievement of meaningful use.
Strategic Framework
An Equal Opportunity University
Provide a comprehensive, coordinated array of services and strategies which will address barriers and enhance support for EHR adoption by priority primary care providers (PPCPs) throughout the state of Kentucky
Tailor the needs of each practice by combining well-developed educational resources and systems, UK’s state-of-the-art continuing education resources, experience in EHR Adoption and implementation, and on-site PCPP consultation and coaching during the EHR adoption process
REC Goals & Services
An Equal Opportunity University
• Complete Practice Readiness Assessment
• Identify Target Improvement Opportunities
• Address Practice Readiness Barriers
Initiation Phase
• Conduct a Practice Workflow Assessment
• Perform MU Gap Analysis • Create a MU Work Plan
Planning
• Demonstrate MU to CMS
Achieving Meaningful Use
Menu of KY REC Services
Estimated 50.5+ hours needed per practice from recruitment to MU
An Equal Opportunity University
Primary Care Physicians
• FPs, OB/Gyn, Peds, Int. Med• Small practices (<10 prescribers; physicians, PAs, ARNPs) • Community health centers • Practices and clinics that serve the underserved
Critical Access Hospitals
FQHCs/ PCCs
Targeted Providers
An Equal Opportunity University
The KY REC does not target specialty providers, however, we do want to help you. • We can help you find the best price for your EHR • Let us introduce you to a technology consultant
Specialty Providers
An Equal Opportunity University
*Medicaid EHR incentives will be managed by states
Medicare Incentive Payment Schedule
2010 2011
Fall 2010 Certification of EHR vendors willstart
April 2011Attestation of meaningful usebegins
Jan. 2011Registration withCMS can begin. This will be donethrough PECOS
May 2011CMS paymentsWill begin
2011-2012Clinicians can begin using a certified EHR in a meaningfulManner (must use for 90 days)
An Equal Opportunity University
Medicare Incentives
An Equal Opportunity University
Medicaid Incentives
An Equal Opportunity University
We look forward to working with
you.
