Meaningful Use Modified Stage 2 Roadmap Eligible Hospitals

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1 Evident is dedicated to making your transition to Meaningful Use as seamless as possible. In an effort to assist our customers with implementation of the software conducive to meeting Meaningful Use requirements, Evident has created a general guideline. Each facility should have contacted their Evident Sales Account Manager to receive their matrix and should have filled out a questionnaire and returned it prior to moving forward with Meaningful Use. In this roadmap we will outline changes to the EHR reporting period for the Medicare and Medicaid EHR Incentive Programs in 2015, 2016, : For (Modified Stage 2), CMS has confirmed no changes to the individual certification requirements for the objectives and measures of Meaningful Use for an EHR reporting period in using EHR technology certified to the 2014 certification criteria. However, for Stage 3, eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) will use EHR technology certified to the 2015 Edition criteria for an EHR reporting period will eliminate the distinction between core and menu objectives and all retained objectives will be required for the program (with exception to some Stage 1 measures which will be discussed below). Objectives and measures that are redundant, duplicative or topped out have been removed. The removal of these measures is in no way intended as withdrawal of best practices or to discourage providers from conducting and tracking these activities for their own quality improvement goals (CMS). Important Dates and Reporting: Reporting periods will now align to the calendar year. CMS has now created a new progression using the existing objectives and measures. 2015: For 2015 only, a 90 continuous day reporting period for all providers, hospitals, and CAHs has been finalized. The 90-day period can be any 90 continuous days from Oct. 1, 2014 Dec. 31, Attestation time frame will be Jan. 4, 2016 Feb. 29, Previous Stage 1 Users: Now attest to a modified version of Stage 2 with accommodations/exclusions for Stage 1 in Current Stage 2 Users: Now attest to a modified Stage 2 in : All participants in the program can adopt a 90 continuous day reporting period from Jan. 1, Dec. 31, All Participants must report on Modified Stage 2 measures no matter what stage their timeline indicates. Those that would be scheduled for Stage 1 would be required to meet Stage 2 specifications with no exclusions (some exceptions apply). 2017: All participants in the program can adopt a 90 continuous day reporting period from Jan. 1, Dec. 31, Revision Date: 04/05/2017 1

2 Quality Measures: Continuing in 2015, there is no longer a separate objective for reporting hospital clinical quality measures (CQMs) as a part of Meaningful Use. It is important to note, however, that eligible hospitals will still be required to report on clinical quality measures in order to achieve Meaningful Use. There are no changes to the CQM selection or reporting scheme in The CQM requirements previously established for all providers seeking to demonstrate Meaningful Use Incentive is defined in earlier rulemaking. Applications needed for Clinical Quality Measures: Core Measures Set-Up for objective: For further information on this objective as well as set up for this objective, please review the Quality Measures Setup and Data Collected for Quality Measures and Quality Measures Roadmap documents. How to achieve Objective: This objective is achieved by running the Quality Measures report. Information on this report will be reflective of documentation that has been put in the system to calculate Quality Measures. Path to Quality Measures report: Hospital Base Menu > Other Applications and Functions > Indicator Measurement/Core Measures > Quality Measures. Please retain a copy of this report from attestation for auditing purposes. Objectives, Measures and Set-Up Objectives and Measures: Protect Electronic Health Record Conduct or review a security risk analysis in accordance with requirements in 45 CFR, including addressing the security (to include encryption) of the ephi created or maintained in the CEHRT in accordance with requirements under 45 CFR, and implement security updates as necessary and correct identified security deficiencies as part of the risk management process. A review must be conducted each reporting period and any security updates and deficiencies that are identified should be included in the risk management process and implemented or corrected as dictated by that process. How to achieve Objective: This objective will be met by each site performing a security risk analysis. Evident recommends the following for meeting this objective. Review the guidance from the OCR regarding compliance with HIPAA Security Rule. Revision Date: 04/05/2017 2

3 TruBridge offers Security Risk Analysis (SRA) Services that are designed to assist sites in complying with the HIPAA Security Rule. For more information on this service, please contact your TruBridge Sales Account Manager. For further information on this objective as well as websites to assist with your risk analysis, please review the Security Objective & Measure Roadmap. Clinical Decision Support (must meet 2 measures) Use Clinical Decision Support to improve performance on high-priority health conditions. Measure 1: Implement five clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period. Absent four clinical quality measures related to an eligible hospital or CAH s patient population, the clinical decision support interventions must be related to high-priority health conditions. It is suggested that one of the five clinical decision support interventions be related to improving healthcare efficiency. Alternate Objective and Measure: For an EHR reporting period in 2015 only, eligible hospital or CAH who is scheduled to participate in Stage 1 in 2015 may satisfy the following in place of Measure 1: Objective: Implement 1 CDS rule relevant to specialty or high clinical priority, or high priority hospital condition, along with the ability to track compliance with that rule. Measure: Implement 1 CDS rule. Measures 2: The eligible hospital or CAH has enabled the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period. Application needed to meet Objective: Point of Care, CPOE, Lab, Radiology, Pharmacy, Clinical Vocabulary, Clinical Monitoring and InfoButton. Set-Up for Objective: Clinical Decision and the rules must be activated from the following path: Hospital Base Menu > Master Selection > Business Office Tables > Table Maintenance > Clinical > CDS Alert Configuration. Drug-Drug, Drug-Allergy Clinical Monitoring options must be set up via Nursing, Pharmacy, and/or ChartLink. The following are clinical monitoring options that must also be used: Allergy Checking Drug Interaction Checking How to achieve Objective: This objective is met with real time alerting of the system based on CDS alerts and configurations. Override Reasons report and Clinical Monitoring reports are available to assist with tracking compliance. In addition to Override Reasons and Clinical Monitoring reports, the system will now track when each CDS alert was activated/ deactivated. This can be found by choosing the specific alert in CDS alert configuration (Table Maintenance) and choosing Status History. Revision Date: 04/05/2017 3

4 Drug-Drug, Drug-Allergy must be used in addition to the 5 CDS alerts to meet this objective. The EHR must also have the ability to offer diagnostic or therapeutic reference information based on Problems, Medications, Medication Allergies, Laboratory tests/values, and Vital Signs and a combination option. This will be achieved with the use of the InfoButton. Please retain a copy of all alerts activated and the status history/view audit to show alerts were on for the entire reporting period for auditing purposes. CPOE (must meet 3 measures): Use CPOE for medication, laboratory, and radiology orders directly entered by any licensed healthcare professional that can enter orders into the medical record per state, local, and professional guidelines. Measure 1: More than 60% of medication orders created by authorized providers of the eligible hospitals emergency department (ED)/inpatient (IP) during the reporting period are recorded using CPOE. Alternate Exclusions and Specifications: Alternate Measure 1: For Stage 1 in 2015, more than 30% of all unique patients with at least 1 medication in their medication list admitted to the hospital or CAH s inpatient or ED (POS 21 or 23) during the EHR reporting period must have at least 1 medication order entered using CPOE; or more than 30% of medication orders created during the reporting period, or created by the authorized providers of the eligible hospital for patients admitted to their IP or ED during the reporting period, are recorded using CPOE. Measure 2: More than 30% of Laboratory orders created by authorized providers of the eligible hospitals ED/IP during the reporting period are recorded using CPOE. Alternate Exclusions and Specifications: Alternate Measure 2: Hospitals scheduled to be in stage 1 in 2015 may claim an exclusion for measure 2 (laboratory orders) of the Stage 2 CPOE objective for a reporting period in 2015; and providers scheduled to be in Stage 1 in 2016, may claim an exclusion for measure 2 (laboratory orders) of the Stage 2 CPOE objective for a reporting period in Measure 3: More than 30% of Radiology orders created by authorized providers of the eligible hospital s ED/IP during the reporting period are recorded using CPOE. Alternate Exclusions and Specifications: Alternate Measure 3: Hospitals scheduled to be in Stage 1 in 2015 may claim an exclusion for measure 2 (radiology orders) of the Stage 2 CPOE objective for a reporting period in 2015; and providers scheduled to be in Stage 1 in 2016, may claim an exclusion for measure 2 (radiology orders) of the Stage 2 CPOE objective for a reporting period in Applications needed to meet Objective: CPOE, Laboratory, Radiology and Pharmacy How to achieve Objective: This objective is met by placing orders through Computerized Physician Order Entry. CPOE entails the provider s use of computer assistance to directly enter orders from a computer or mobile device. The order is also documented or captured in a digital, structured, and computable format for use in improving safety and organization. Telephone and verbal orders count for this objective. Revision Date: 04/05/2017 4

5 Measure 1: Medication: DENOMINATOR: Number of medication orders created by the EP or authorized providers in the eligible hospital's or CAH's inpatient or emergency department during the EHR reporting period. Medication Orders Placed NUMERATOR: The number of medication orders in the denominator recorded using CPOE. Medication orders placed that have been recorded using CPOE. Measure 2: Radiology DENOMINATOR: Number of radiology orders created by the EP or authorized providers in the eligible hospital's or CAH's inpatient or emergency department during the EHR reporting period. Radiology Orders Placed NUMERATOR: The number of radiology orders in the denominator recorded using CPOE. Number of Radiology Orders Placed that have been recorded using CPOE. Measure 3: Laboratory DENOMINATOR: Number of laboratory orders created by the EP or authorized providers in the eligible hospital's or CAH's inpatient or emergency department during the EHR reporting period. Laboratory Orders Placed NUMERATOR: The number of laboratory orders in the denominator recorded using CPOE. In 2013, CMS added an optional alternate measure to the objective for CPOE. Number of Laboratory Orders Placed that have been recorded using CPOE. E-Prescribing Generate and transmit permissible prescriptions electronically (erx). More than 10% of hospital discharge medication orders for permissible prescriptions (for new, changed, and refilled prescriptions) are queried for a drug formulary and transmitted electronically using certified EHR technology. Exclusion: Any eligible hospital or CAH that does not have an internal pharmacy that can accept electronic prescriptions and is not located within 10 miles of any pharmacy that accepts electronic prescriptions at the start of the reporting period. Revision Date: 04/05/2017 5

6 Alternate Exclusion: The eligible hospital or CAH may claim an exclusion for the erx objective and measure if for a reporting period in 2015 they were either scheduled to demonstrate Stage 1, which does not have an equivalent measure, or if they are scheduled to demonstrate Stage 2 but did not intend to select the Stage 2 erx objective for a reporting period in 2015; and, the eligible hospital or CAH may claim an exclusion for the erx objective and measure for a reporting period in 2016 if they were either scheduled to demonstrate Stage 1 in 2016 or if they are scheduled to demonstrate Stage 2 but did not intend to select the Stage 2 erx objective for a reporting period in Applications needed to meet Objective: Medication Management Set-Up for Objective: The Prescription Entry sub-fields will need to be set up under the Medication Management Tab in Table Maintenance (Table Maintenance, Clinical, Medication Management, and Prescription Entry). How to meet Objective: This objective will be met when launching the e-scribe application after discharge medication reconciliation has been performed and processed. DENOMINATOR: Number of new, changed, or refill prescriptions written for drugs requiring a prescription in order to be dispensed other than controlled substances for IP/ED patients discharged during the EHR reporting period. New, Changed or refilled prescriptions that were written during the reporting period. NUMERATOR: The number of prescriptions in the denominator generated, queried for a drug formulary and transmitted electronically. Number of prescriptions in the denominator that were generated through electronic prescription application (and queried for a drug formulary- automatically) and transmitted electronically. Health Information Exchange: (Formerly Summary of Care) The eligible hospital or CAH who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care provides a summary care record for each transition of care or referral. A transition of care for electronic exchange is one where the referring entity is under a different billing identity within the Medicare and Medicaid Incentive Program than that of the receiving provider and where the providers do not share access to the same EHR. In cases where the providers do share access to the same EHR, a transition or referral may still count toward the measure if the referring provider creates the document via CEHRT and sends the document electronically. All summary of care documents used to meet this objective must include the following information (if known) upon sending: Patient Name Referring or Transitioning Provider s Name Procedures Revision Date: 04/05/2017 6

7 Encounter Diagnosis Immunizations Laboratory Test Results Vital Signs (Height, weight, BP and BMI) Smoking Status Functional Status (including activities of daily living), Cognitive and Disability Status. Demographic Information (Language, sex, race, ethnicity, date of birth) Care Plan Field (including goals and instructions) Care Team (including primary care provider and record of any additional known care team members beyond referring and transitioning provider and receiving provider) Discharge Instructions In circumstances where there is no information available to populate one or more of the fields listed (either because not known, or EH can be excluded from recording such information), the fields may be left blank and still meet the objective and its associated measure. Problems, medications and medication allergies are still required for the patient to be in the numerator of this objective. In the event there are no current problems, medications or medication allergies for the patient; the eligible hospital/cah must record or document within the required fields that there are no problems, medications, medication allergies recorded for the patient to satisfy the measure of this objective. Measure: The eligible hospital or CAH that transitions or refers their patient to another setting of care or provider of care must 1- use CEHRT to create a summary of care record; and 2- electronically transmit such summary to a receiving provider for more than 10% of transitions of care and referrals. Alternate Exclusion: Exclusion may be claimed for the Stage 2 measure that requires the electronic transmission of a summary of care document if for a reporting period in 2015, they were scheduled to demonstrate Stage 1, which does not have an equivalent measure. Applications needed to meet Objective: Point of Care, Lab, Radiology, Physician Documentation, Clinical Vocabulary, Direct Messaging with 3rd party HISP provider Network Address, Medication Management, Clinical Monitoring and Electronic File Management. Measure: Each facility will have to go through onboarding for Direct Messaging. (More information to follow). Once the Direct Messaging address has been obtained through the onboarding process, that address will be listed in the following location: Hospital Base Menu > Master Selection > Business Office Tables > Table Maintenance > Control > Physicians > Physician (Evident Community Physician) > Page 5 > Direct Address. Revision Date: 04/05/2017 7

8 The accepting provider that will be receiving the referral or summary of care can be pre-defined and set up in the following table: Hospital Base Menu > Master Selection > Business Office Tables > Table Maintenance > Business Office > Referring Physician. How to Meet Measure: To meet the measure, the summary of care document, specifically the referral/transitions summary (referral/transition of care summary) must be sent electronically via the above mentioned Submit to Provider option through Direct Messaging. It is suggested the referral/transitions summary be set up in the virtual chart. DENOMINATOR: Number of transitions of care and referrals during the EHR reporting period in which an eligible hospital or CAH s inpatient or emergency department was the transferring or referring provider This is calculated from the number of discharges where the transfer/referral widget was addressed or number of discharges where the follow up care question was addressed. NUMERATOR: Number of transitions of care and referrals in the denominator where a summary of care record was provided and exchanged electronically. Problems, Medications and Medication Allergies were also documented (or no known). Once your CCD-Transfer Summary/Referral is successfully sent, there is an indication of Success in the CCDA transmission log. The path to this log is found via the following path: Server Menu > Special Functions > Audit Log > CCDA Transmission Log. Patient Education Resources Use clinically relevant information from CEHRT to identify patient-specific education resources and provide those resources to the patient. Measure: More than 10% of all unique patients admitted to IP/ED during the reporting period are provided patient-specific education resources identified by the CEHRT. Alternate Exclusion: Exclusion may be claimed for patient-specific education if in 2015 they were scheduled to demonstrate Stage 1 but did not intend to select the Stage 1 patient-specific education menu objective. Applications need to meet Objective: Point of Care, Patient Education Documents and InfoButton. Set Up for Objective: LOINC codes will need to be set up on Laboratory items in order to utilize the Patient Lab Information Documents. Revision Date: 04/05/2017 8

9 How to meet Objective: This objective will be met by the use of Patient Education Documents and InfoButton. When an education document is given and saved, this will be recorded onto the patient s account. Patient Education by Problem List, Patient Lab Information Documents, and Patient Drug Information education documents will be used to meet this objective. Custom education documents can also be used to meet this objective if your custom document is tied to lab tests or problems via the classification code area (patient education maintenance) in table maintenance (clinical, update user defined documents). The above selections are the only education documents that will count in the numerator for this measure. DENOMINATOR: Number of unique patients admitted to the eligible hospital s or CAH s inpatient or emergency department during the EHR reporting period. Number of unique patients admitted during the reporting period. NUMERATOR: Number of patients in the denominator who are provided patient education specific resources. Medication Reconciliation The EP, EH or CAH that receives a patient from another setting of care or provider of care or believes an encounter is relevant performs medication reconciliation. Measure: Perform medication reconciliation on more than 50% of transitions of care in which a patient is admitted to the EH or CAH s ED or IP. Alternate Exclusion: Exclusion may be claimed if or a reporting period in 2015, they were scheduled to demonstrate Stage 1 but did not intend to select the Stage 1 medication reconciliation menu objective. Applications needed to meet Objective: Medication Management. Set Up for Objective: Medication and Pharmacy information will need to be set up under the Medication Management Tab in Table Maintenance (Table Maintenance, Clinical, Medication Management). How to meet Objective: This objective will be met with the use of Medication Reconciliation through the ChartLink, Pharmacy or Point of Care Applications. Admission and Discharge Reconciliations are strongly encouraged and are considered best practice. DENOMINATOR: Number of transitions of care during the EHR reporting period for which the eligible hospital s or CAH s inpatient or emergency department was the receiving party of the transition. Number of transitions of care during the reporting period where the hospital was the receiving party of the transition. NUMERATOR: Number of transitions of care (admissions and discharges) in the denominator where medication reconciliation was performed. Revision Date: 04/05/2017 9

10 Number of admissions and discharges of patients in the denominator where medication reconciliation was performed (Reconcile). Clinical Information Reconciliation can also be utilized in the EHR. This enables a user to electronically reconcile data that represent a patient s active medication, problem and medication allergies into one single list to review accuracy and upon a user s confirmation, automatically update the list. If a facility wishes to utilize this function, please contact Evident for further information. Patient Electronic Access (formerly view, download, transmit) Provide patients the ability to view online, download or transmit their health information within 36 hours of hospital discharge. Measure 1: More than 50% of all unique patients discharged from the IP/ED during the EHR reporting period have their information available online within 36 hours of discharge. It is Evident s interpretation that Measure 1 can be met once the patient possesses all information necessary to log into the portal and view all of their information. Access is defined as the following: When a patient possesses all of the necessary information needed to view, download, or transmit their information. This could include providing patients with instructions on how to access their health information, the website address they must visit for online access, a unique and registered username or password, instructions on how to create a login, or any other instructions, tools, or materials that patients need in order to view, download, or transmit their information. Measure 2: At least 1 patient who is discharged from IP/ED of an eligible hospital or CAH (or patient authorized representative) views, downloads or transmits to a 3 rd party his or her health information during the reporting period. For a reporting period in 2017, more than 5% of unique patients discharged from IP/ED of an eligible hospital or CAH (or patient authorized representative) view, download or transmit to a 3 rd party their health information during the reporting period. Alternate Exclusion: Exclusion may be claimed for second measure if for a reporting period in 2015 they were scheduled to demonstrate Stage 1, which does not have an equivalent measure. Applications needed to meet Objective: Patient Portal, CCD Patient Summary Subscription, Direct Messaging with 3rd party HISP provider Network Addresses, Point of Care, Pharmacy, Laboratory, and Radiology. Set-Up for Objective: Purpose code must be created in Release of information for Patient Possesses Access. How to achieve Objective: (Objective can be met in 1 of 4 ways currently) 1. This objective can be met by having a valid address on the patient s registration visit screen (or their authorized provider) in the Census Application. Once the patient is then discharged, they will be sent an introductory to create a login name and user password and their patient/clinical summary (or CCD) will then be available on the patient portal for them to view. Revision Date: 04/05/

11 The patient portal address will be the following: The authorized representative entered in the census visit screen will also have access to the patient portal, giving the authorized representative access to the clinical information for the patient (visit they were the authorized representative on). The authorized representative should be verified each time a visit is created. 2. This objective can also be met by placing the patient portal launch onto the Point of Care Virtual Chart. The facility can follow this link and assist the patient in logging into the patient portal. Please note: This will only update the numerator of this objective if the launch is chosen previous to 36 hours after discharge (to meet Measure 1 of this objective). However this launch will stay on the virtual chart for the patient indefinitely so that the facility can instruct the patients how to log into their portal to also meet measure 2 of this objective. 3. This objective can also be met by giving the patient information regarding how to log onto the portal or education classes that will be conducted on how to log into the portal etc. Once this is done, Release of Information can be manually updated with PIA which is the code for Patient Possesses Information regarding portal that was created above. 4. This objective can be met in the same way as number 3. However, this can now be an automatic process. A custom patient education document can be created and tied to the Release of Information Code (Usually PIA is used) that is found in the Patient Possesses Information regarding field in the Release of Information Control Table. Once that patient education document is given, this ROI entry will be created to update statistics. Users of the EHR will have the ability to control what is viewable to the patient on the patient portal. This can be achieved by building the Patient Summary/CCD via Print Electronic Record, selecting edit and choosing the information you would like to include/exclude and save document. This will save a version of the document in Print Electronic Record and Electronic File Management with the changes that have been made to the document. The most recently edited version will be what the patient (or authorized representative) sees when logged into the Patient Portal. Any unresolved problems, allergies, and/or immunizations from previous visits will appear on the patient summary (unless hidden via the edit option). Measure 1: DENOMINATOR: Number of unique patients discharged from an eligible hospital or CAH's inpatient or emergency department during the EHR reporting period. Unique patients discharged during the reporting period. Measure 1: NUMERATOR: The number of patients in the denominator whose information is available online within 36 hours of discharge. Unique patients who have been provided access within 36 hours of discharge via the following: Provided address (patient or authorized provider) or Launch Portal from Virtual Chart or Provided education material and updated Release of Information Patient in Room Revision Date: 04/05/

12 Measure 2: DENOMINATOR: Number of unique patients discharged from an eligible hospital's or CAH's inpatient or emergency department) during the EHR reporting period. Unique patients discharged during reporting period. Measure 2: NUMERATOR: The number of unique patients (or their authorized representatives) in the denominator who have viewed online, downloaded, or transmitted to a third party the discharge information (CCD) provided by the eligible hospital or CAH. Unique patients in denominator who have done one of the following with Discharge Information (CCD) provided by the hospital: Viewed Online Downloaded Transmitted CCD-Patient Summary to a 3rd Party. Public Health Reporting The eligible hospital or CAH is in active engagement with a public health agency to submit electronic public health data from CHERT except where prohibited and in accordance with applicable law and practice. Please Note: a minimum of 90-day lead time is required for all interfaces. Hospitals and CAHs who are scheduled to attest to Stage 1 in 2015, they will be required to successfully attest (or be in active engagement) to any combination of 2 measures. Hospitals and CAHs who are in Stage 2 in 2015, and for all facilities in 2016 and 2017, would be required to successfully attest (be in active engagement) to any combination of 3 measures. Active Engagement is defined by the following: Completed Registration to Submit Data: Registration to submit data to the PHA must be done within 60 days of the beginning of the reporting period and not on the first day of the reporting period. Testing and Validation Production Immunization Registry Reporting- The EH/CAH is in active engagement with a public health agency to submit immunization data. Revision Date: 04/05/

13 Exclusion: Does not administer immunizations to any of the population for which data is collected by its jurisdiction s immunization registry or immunization information system during the reporting period. Operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting specific standards required to meet the CEHRT definition at the start of the reporting period; or operates in a jurisdiction where no immunization registry or immunization system has declared readiness to receive immunization data from the EH/CAH at the start of the reporting period. Applications needed to meet Objective: Point of Care, Pharmacy, and Immunization Interface A record of transmissions will need to be retained for auditing purposes. To electronically submit, an interface is required. Please complete an Interface Request Form and contact your Evident Sales Account Manager to initiate the development for your facility. Syndromic Surveillance Reporting- The EH/CAH is in active engagement with a public health agency to submit syndromic data. Exclusion: Does not have an emergency or urgent care department. Operates in jurisdiction for which no public health agency is capable of receiving electronic syndromic surveillance data from eligible hospitals or CAHs in the specific standards required to meet the CEHRT definition at the start of the reporting period; or operates in a jurisdiction where no public health agency has declared readiness to receive syndromic surveillance data from eligible hospitals or CAHs at the start of the reporting period. Applications needed to meet Objective: Syndromic Surveillance Interface and Clinical Vocabulary. How to meet Objective: This objective is met by entering in required state specific information on a patient account (such as chief complaint, working and final diagnosis) to be transmitted. Evident suggests making Chief Complaint a required field from Census. A record of transmissions will need to be retained for auditing purposes. To electronically submit, an interface is required. Please complete an Interface Request Form and contact your Evident Sales Account Manager to initiate the development for your facility. Specialized Registry Reporting- The eligible hospital or CAH is in active engagement to submit data to a specialized registry. Exclusion: Does not diagnose or treat any disease or condition associated with or collect any relevant data that is required by a specialized registry in their jurisdiction during the reporting period. Operates in a jurisdiction for which no specialized registry is capable of accepting electronic registry transactions in the specific standards required to meet the CEHRT definition at the start of the reporting period or; operates in a jurisdiction where no specialized registry for which the hospital or CAH is eligible has declared readiness to receive electronic registry transactions at the beginning of the reporting period. A record of transmissions will need to be retained for auditing purposes. To electronically submit, an interface is required. Please complete an Interface Request Form and contact your Evident Sales Account Manager to initiate the development for your facility. Revision Date: 04/05/

14 Electronic reportable Laboratory Results Reporting- The eligible hospital or CAH is in active engagement with a public health agency to submit electronic reportable laboratory (ELR) results. Exclusion: Does not perform or order laboratory tests that are reportable in their jurisdiction during the reporting period. Operates in a jurisdiction for which no public health agency is capable of accepting the specific ELR standards required to meet the CEHRT definition at the start of the reporting period; or operates in a jurisdiction where no public health agency has declared readiness to receive electronic reportable laboratory results from EH/CAH at the start of the reporting period. Applications needed to meet Objective: Reportable Laboratory Results Interface, Laboratory with Micro Analyzer OR with Discrete Reference Lab Interface with Micro OR a Discrete Element Lab Interface with Micro. Set Up for Objective: LOINC needs to be loaded on both the item and in the Reference Range Table for Laboratory items that a hospital is reporting. SNOMED needs to be loaded in the Reference Range Table for lab items that a hospital is reporting. Security Switch 109 is needed for employees to access the reportable option via Order Entry Maintenance Screen. Specimen Information prompt should be activated in page 5 of Order Entry Information as Specimen Information is required on reportable lab items. How to meet Objective: This objective is met by locking onto the Order Entry Maintenance Screen of the Lab Item to report and choosing Reportable. In order to transmit electronic laboratory results successfully, the user must associate a problem as well as enter in specimen information on the lab item to transmit. A record of transmissions will need to be retained for auditing purposes. To electronically submit, an interface is required. Please complete an Interface Request Form and contact your Evident Sales Account Manager to initiate the development for your facility. Statistics Reporting: Stage 1 statistics report will be utilized for those facilities that will be in Stage 1 for Stage 2 statistics report will be utilized for those facilities that will be in Stage 2 for 2016 and This report contains all information that is required on percentage based objectives. Revision Date: 04/05/

15 MU Stats Filters must be set up for the Emergency Method or Observation Services depending on the reporting method the facility will use (see below under Patient Types). Filters will need to be added by the system administrator for the patient types that are required by CMS that a facility wishes to report. Patient Types: CMS has defined patient types that are to be reported by the eligible hospital or CAH. Before attesting the eligible hospital or CAH will have to indicate which method they are choosing. They are as follows: All ED Visits Method: For the hospital Meaningful Use objectives, the denominator is all unique patients admitted to an inpatient (Place of Service 21) or emergency department (Place of Service 23), which means all patients admitted to an inpatient department (Place of Service 21) and all patients admitted to an emergency department (Place of Service 23) are to be included. Or an alternate method can be used: Observation Services Method: If the eligible hospital elects to use the alternate method for calculating emergency department patients, the denominator is all unique patients admitted to an inpatient department (Place of Service 21) and all patients that initially present to the emergency department and are treated in the emergency department's observation unit or otherwise receive observation services, which includes patients who receive observation services under both Place of Service 22 and Place of Service 23. If further information is needed, please visit Attestation: Hospitals/CAHs who are scheduled to be in Stage 1 in 2015 may opt to use the alternate exclusions and specifications for 2015 only, but are not required to use them. The Medicare and Medicaid Incentive Program registration and attestation system will automatically identify those that are eligible for alternate exclusions and specifications. Upon attestation, these facilities will be offered the option to attest to the Stage 2 Objective and measure and the option to attest to the alternate specification or claim the alternate exclusion if available. The facility can then independently select the option available to them for each measure for which an alternate specification or exclusion may apply. The registration system is currently open; however, no participants can attest until Jan. 4, Feb. 29, Attestation Disclaimer: Meaningful Use attestation confirms the use of a certified Electronic Health Record (EHR) to regulatory standards over a specified period of time. Evident and TruBridge Meaningful Use certified products, recommended processes and supporting documentation are based on Evident s interpretation of the Meaningful Use regulations, technical specifications and vendor specifications provided by CMS, ONC and NIST. Each client is solely responsible for its attestation being a complete and accurate reflection of its EHR use during the attestation period and that any records needed to defend the attestation in an audit are maintained. With the exception of vendor documentation that may be required in support of a client s attestation, Evident and TruBridge bear no responsibility for attestation information submitted by the client. Revision Date: 04/05/