understanding meaningful use presented by: allison bryan ms, ches december 7, 2012 purdue research...
TRANSCRIPT
Understanding Meaningful Use
Presented by: Allison Bryan MS, CHESDecember 7, 2012
Purdue Research Foundation 2012
Review of Stage 1 and Stage 2
Meaningful Use
• Financial incentives for the “meaningful use” of certified EHR technology to improve patient care
• Providers have to meet thresholds for certain objectives– Required core objectives– Choice of menu objectives
• Meaningful use must be demonstrated for all patients, not just Medicare or Medicaid subscribers
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Stage 1
Capture Information
Stage 2
Report and Exchange Information
Stage 3 and Beyond…Leverage Information for Improved Patient Care
Meaningful Use Stages
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Improving quality, safety, efficiency and
reducing health
disparities(cont.)
Maintain active medication allergy list 80%+ of patients
Record and chart changes in selected vital signs (height, weight, BP, BMI, growth charts (2-20 yrs.)
50%+ of patients
Record smoking status for patients 13 years old or older
50%+ of patients
Implement one clinical decision support rule along with the ability to track compliance that rule
1 rule
Report ambulatory quality measures to CMS or the States
Aggregate numerator/
denominator
Policy Priority
Stage 1 Objectives Measure
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Engage patients and families in their healthcare
Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and medication allergies) upon request, within 3 days of request
50%+ of all patients who
request
Provide clinical summaries to patients for each office visit within 3 days of visit
50%+ of all office visits
Improve Care Coordination
Capability to exchange key clinical information (for example problem list, medication lists, medication allergies, diagnostic test results) among providers of care and patient authorized entities electronically
1 test of capability
Ensure adequate security and
privacy provisions for
personal health information
Protect electronic health information created or maintained by certified EHR technology through the implementation of appropriate technical capabilities.
Conduct or review a
security risk analysis
Policy Priority
Stage 1 Objectives Measure
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Security
Providers fined $100,00 for Internet privacy violations
o 2 physician cardiology practice
The physician practice was posting clinical and surgical appointments for its patients on an Internet-based calendar that was publicly accessible
OCR findings: Few policies and procedures to comply with the HIPAA Privacy and
Security Rules Limited safeguards in place to protect ePHI
Outcome: $100,000 penalty Required to adopt a Corrective Action Plan
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Security
Massachusetts provider settles HIPAA case for $1.5 million
o 300 Physician Eye and Ear Institute
Result of a theft of an unencrypted personal laptop containing ePHI of patients and research subjects
OCR findings: No thorough analysis of the risk to the confidentiality of ePHI
maintained on portable devices Did not Implement security measures sufficient to ensure the
confidentiality of ePHI Did not implement policies and procedures to restrict access to
ePHI to authorized users of portable devices Outcome:
$1.5 million penalty Required to adopt a Corrective Action Plan
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Menu Set
Policy Priority
Stage 1 Objectives Measure
Improving quality, safety,
efficiency and reducing
health disparities
Implement drug formularychecks
Functionality enabled
Incorporate clinical lab test results into certifiedEHR technology as structured data
40%+ of all clinical lab tests
ordered
Generate lists of patients by specific conditions to
use for quality improvement, reduction of disparities, research or outreach
At least 1 report of patients with
condition
Send reminders to patients 65 years or older of 5 years or younger per patient preference for preventive/ follow up care
20%+ of patients
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Policy Priority
Stage 1 Objectives Measure
Engage patients and families in
their healthcare
Improve Care Coordination
Provide patients with timely electronic access to their health information (including lab results, problem list,
medication lists, medication allergies) within four business days of the information being available to the EP
10%+ of patients
Use certified EHR technology to identify patient-specific
education resources and provide those resources to the patient if appropriate
10%+ of patients
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Improve carecoordination
Perform Medication Reconciliation when the EP or eligible hospital receives a patient from another setting of care or provider of care
50%+ of care transitions to
EP
Provide summary of care record for each transition of a patient to another setting of care or provider of care or referral to another provider of care
50%+ of care transitions from EP
Improve population
health
Capability to submit electronic data to immunization registriesor Immunization Information Systems and actual submission in accordance with applicable law and practice
At least 1 test
Capability to submit electronic syndromic surveillance data topublic health agencies and actual submission in accordance with applicable law and practice
At least 1 test
Policy Priority
Stage 1 Objectives Measure
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Progress to Date• Incentives according to CMS:
– More than 110,000 Eligible Professionals have received incentive payments from the Medicare and Medicaid EHR Incentive Programs
– From May 2011 to July 31, 2012, more than $3.6 billion in Medicare payments
– From January 2011 to August 31, 2012, more than $3.3 billion in Medicaid payments
• Release of Stage 2 Meaningful Use– Begins 2014
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Meaningful Use: Stage 2• Secure Messaging (Core)
– Use secure electronic messaging to communicate with patients on relevant health information
– Threshold: greater than 5%– 2 exclusions apply
• Timely Online Access: View, Transmit or Download (Core)
– 2 portions, must achieve both for Meaningful Use– Timely Online Access
• Measure: Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP or 36 hours after discharge from an inpatient or emergency department of an EH or CAH
• Threshold: greater than 50%– View Transmit or Download
• Measure: Number of unique patients seen by the EP during the reporting period (or authorized representative), who view, download, or transmit health information.
• Threshold: greater than 5%– 1 exclusion applies to each portion
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Meaningful Use: Stage 2
• Imaging Results (Menu)
– Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through CEHRT.
– Threshold: The resulting percentage must be more than 10 percent in order to meet this measure.
– 2 exclusions apply
• Family History (Menu)
– More than 20% of all unique patients seen by the EP during the EHR reporting periods have a structured data entry for one or more first-degree relatives
– 1 exclusion applies
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Meaningful Use: Stage 2
• Cancer Registry (Menu)
– Successful ongoing submission of cancer case information from CEHRT to a public health central cancer registry for the entire EHR reporting period.
– No threshold, pass/fail– 4 exclusions apply
• Specialized Registry (Menu)
– Successful ongoing submission of specific case information from CEHRT to a specialized registry for the entire EHR reporting period
– No threshold, pass/fail– 4 exclusions apply
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Summary
• Meaningful Use is here to stay• Advanced stages become more
challenging• Resources are available
– Allison Bryan• 765-496-9791• [email protected]
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