Eligible Professionals (EP) Meaningful Use Final Objectives and Measures for Stage 1, 2011

Transcription

1 Eligible Professionals (EP) Meaningful Use Final Objectives and Measures for Stage 1, On demand webinars are best heard through a headset or earphones (ipod for example) that can be plugged into your laptop or desktop. Download the handouts that accompany this presentation. Other related links and documents found in Final Rules section in the subscribers library. 2 Bill Oravecz is Managing Partner of WTO Associates LLC. His engagement teams help various healthcare and life science organizations by enhancing their effectiveness and productivity through their 5-Point Analysis Approach. WTO s Healthcare IT Practice helps clients with the Adoption of EHR Systems, Meaningful Use, Privacy & Security of patient records and compliance issues. Bill has 26 years of healthcare technology and IT solutions delivery experience through various senior management positions with major IT services and healthcare technology firms. He holds a MBA from University of Connecticut and a SM in Radiology from The Pritzker School of Medicine at the University of Chicago. You can reach him at: woravecz@wto-associates.com 3

2 On February 17, 2009 the American Recovery and Reinvestment Act of 2009 aka the Stimulus Bill, was signed into law. Included in this law is $19.2 Billion intended to be used to increase the use of Electronic Health Records (EHR) by physicians and hospitals; this portion of the bill is called the HITECH Act (Health Information Technology for Economic and Clinical Health Act). The government firmly believes in the benefits of using electronic health records and is investing federal resources in the form of financial incentives to proliferate its use. On July 13, 2010, the Department of Health and Human Services (HHS) released the final rules that defines and outlines the incentive programs for meaningful user of electronic health records (EHR). The Centers for Medicare & Medicaid Services (CMS) will administer the rules. An Eligible Professional (EP), Eligible Hospital (EH), or Critical Access Hospitals (CAH ) who, for an EHR reporting period for a payment year, demonstrates meaningful use of certified EHR technology in the form and manner consistent with our standards.

3 Balance the sometimes competing considerations of improving health care quality, encouraging widespread EHR adoption, promoting innovation, and avoiding imposing excessive or unnecessary burdens on health care providers, while at the same time recognizing the short timeframe available under the HITECH Act for providers to begin using certified EHR technology. Stage 1 - current criteria Stage 2 criteria updated by end of 2011 Stage 3 criteria updated by end of 2013 Focuses on: electronically capturing health information in a structured format using the captured information to track key clinical conditions and communicating that information for care coordination purposes (whether that information is structured or unstructured, but in structured format whenever feasible) implementing clinical decision support tools to facilitate disease and medication management; using EHRs to engage patients and families and reporting clinical quality measures and public health information.

4 Establishes the functionalities in certified EHR technology that will allow for continuous quality improvement and ease of information exchange. This in turn will create a strong foundation to build on in later year Five Health Outcome Priorities 1. Improving quality, safety, efficiency and reducing health disparities. 2. Engage patients and families in their healthcare 3. Ensure adequate privacy and security protections for personal health information. 4. Improve care coordination. 5. Improving population and public health. CORE SET (15 objectives) Eligible Professionals must meet all Core Objectives to qualify as a meaningful EHR user. MENU SET (10 objectives) In addition to the Core Objectives, Eligible Professionals must meet all but five (5) Menu Objectives to qualify as a meaningful EHR user. One (1) Menu Objective must be selected from Priority Four Improving population and public health.

5 Improving quality, safety, efficiency and reducing health disparities - 11 Objectives 1. Objective: Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. Measure: More than 30% of unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE 2. Objective: Implement drug-drug and drug-allergy interaction checks Measure: The EP has enabled this functionality for the entire reporting period

6 3. Objective: Generate and transmit permissible prescriptions electronically (erx) Measure: More than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology 4. Objective: Record demographics: preferred language, gender, race, ethnicity, date of birth Measure: More than 50% of all unique patients seen by the EP have demographics recorded as structured data 5. Objective: Maintain an up-to-date problem list of current and active diagnoses Measure: More than 80% of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data

7 6. Objective: Maintain active medication list Measure: More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data 7. Objective: Maintain active medication allergy list Measure: More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data 8. Objective: Record and chart changes in vital signs: Height, Weight, Blood pressure, Calculate and display BMI, Plot and display growth charts for children 2-20 years, including BMI Measure: For more than 50% of all unique patients age 2 and over seen by the EP, height, weight and blood pressure are recorded as structured data

8 9. Objective: Record smoking status for patients 13 years old or older Measure: More than 50% of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data 10. Objective: Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance that rule Measure: Implement one clinical decision support rule 11. Objective: Report ambulatory clinical quality measures to CMS or the States Measure: For 2011, provide aggregate numerator, denominator, and exclusions through attestation as discussed in section II(A)(3) of the final rule. For 2012, electronically submit the clinical quality measures as discussed in section II(A)(3) of the final rule

9 Engage patients and families in their healthcare - 2 Objectives 12. Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies), upon request Measure: More than 50% of all patients of the EP who request an electronic copy of their health information are provided it within 3 business days 13. Objective: Provide clinical summaries for patients for each office visit Measure: Clinical summaries provided to patients for more than 50% of all office visits within 3 business days

10 Improve care coordination - 1 Objective 14. Objective: Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, diagnostic test results), among providers of care and patient authorized entities electronically Measure: Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information Improving population and public health - No Core Objectives

11 Ensure adequate privacy and security protections for personal health information - 1 Objective 15. Objective: Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities Measure: Conduct or review a security risk analysis per 45 CFR (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process In addition to the Core Objectives, Eligible Professionals must meet all but five (5) Menu Objectives to qualify as a meaningful EHR user. One (1) Menu Objective must be selected from Priority Four Improving population and public health.

12 Improving quality, safety, efficiency and reducing health disparities - 4 Objectives 1. Objective: Implement drug formulary checks Measure: The EP has enabled this functionality and has access to at least one internal or external drug formulary for the entire EHR reporting period 2. Objective: Incorporate clinical lab test results into certified EHR technology as structured data Measure: More than 40% of all clinical lab tests results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data

13 3. Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach Measure: Generate at least one report listing patients of the EP with a specific condition 4. Objective: Send reminders to patients per patient preference for preventive/ follow up care Measure: More than 20% of all unique patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period Engage patients and families in their healthcare 2 Objectives

14 5. Objective: 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 Measure: More than 10% of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP s discretion to withhold certain information 6. Objective: Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate Measure: More than 10% of all unique patients seen by the EP are provided patient-specific education resources Improve care coordination -2 Objectives

15 7. Objective: The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation Measure: The EP performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP 8. Objective: The EP, 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 should provide summary of care record for each transition of care or referral Measure: The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50% of transitions of care and referrals Improving population and public health - 2 Objectives EP must select at least one objective from the outcome as a Menu selection

16 9. Objective: Capability to submit electronic data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable law and practice Measure: Performed at least one test of certified EHR technology's capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP submits such information have the capacity to receive the information electronically) 10. Objective: Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice Measure: Performed at least one test of certified EHR technology's capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP submits such information have the capacity to receive the information electronically) The final rules have been released and these objectives are set for stage 1 EP should be familiar with all of the objectives they will have to perform especially during their EHR selection process Physicians and Practice Administrators should be identifying how and if the practice is currently performing any of these objectives

17 Thank you for joining us! 49