Modified Stage 2 Meaningful Use: Objective #3 Computerized Provider Order Entry (CPOE) Massachusetts Medicaid EHR Incentive Payment Program
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1 Modified Stage 2 Meaningful Use: Objective #3 Computerized Provider Order Entry (CPOE) Massachusetts Medicaid EHR Incentive Payment Program July 7, 2016 Today s presenter: Al Wroblewski, PCMH CCE, Client Services Relationship Manager
2 Disclaimer This presentation was current at the time it was presented, published or uploaded onto the web. This presentation was prepared as a service to the public and is not intended to grant rights or impose obligations. This presentation may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage attendees to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their contents. 2 Massachusetts ehealth Institute
3 Reminder The attestation deadline for Program Year 2015 is August 14, Massachusetts ehealth Institute
4 Agenda What is Meaningful Use (MU) Objective #3 all about? Steps to meet MU Objective #3 1. Do the right thing 2. Ensure data is entered correctly 3. Ensure data is captured correctly 4. Ensure Certified EHR Technology (CEHRT) can report data correctly (EHR dashboard) 5. Generate supporting documentation 6. Retain supporting documentation Attesting for MU Objective #3 Common Issues Questions and Answers 4
5 What is MU Objective #3 all about?
6 6 What is MU Objective #3 all about?
7 What is MU Objective #3 all about? Computerized Order Entry (CPOE) Objective Measures Alternate Measure Exclusions Alternate Exclusions Use computerized provider order entry for medication, laboratory, and radiology orders directly entered by any state, local, and professional guidelines. An EP, through a combination of meeting the thresholds and exclusions (or both), must satisfy all three measures for this objective: Measure 1: More than 60% of medication orders created by the EP during the EHR reporting period are recorded using computerized provider entry. Measure 2: More than 30% of laboratory orders created by the EP during the EHR reporting period are recorded using computerized provider order entry. Measure 3: More than 30% of radiology orders created by the EP during the EHR reporting period are recorded using computerized provider order entry. Alternate Measure 1: For Stage 1 provider in 2015, more than 30% of all unique patients with at least one medication in their medication list seen by the EP during the EHR reporting period have at least one medication order entered using CPOE; or more than 30% of medication orders created by the EP during the EHR reporting period are recorded using computerized provider order entry. Measure 1: Any EP who writes fewer than 100 medication orders during the EHR reporting period. Measure 2: Any EP who writes fewer than 100 laboratory orders during the EHR reporting period. Measure 3: Any EP who writes fewer than 100 radiology orders during the EHR reporting period. Alternate Exclusion for Measure 2: Providers scheduled to be in Stage 1 in 2015 may claim an exclusion for measure 2 (laboratory orders) of the Stage 2 CPOE objective for an EHR reporting period in Alternate Exclusion for Measure 3: Providers scheduled to be in Stage 1 in 2015 may claim an exclusion for measure 3 (radiology orders) of the Stage 2 CPOE objective for an EHR reporting period in
8 What is MU Objective #3 all about? Computerized Provider Order Entry (CPOE) - Attestation Requirements DENOMINATOR The number of orders created by the EP during the EHR reporting period NUMERATOR The number of orders in the denominator recorded using CPOE THRESHOLD The resulting percentage must be more than the amount required for an EP to meet this measure What is MU Objective #3 all about? EXCLUSION Any EP who writes fewer than 100 orders during the EHR reporting period ALTERNATE EXCLUSION EPs scheduled to attest to Stage 1 who did not plan to report on radiology or lab orders 8
9 What is MU Objective #3 all about? Computerized Provider Order Entry (CPOE) Additional Information May choose only to use patients whose records are in CEHRT CPOE must create first record Interventions may occur before order entry in certain situations What is MU Objective #3 all about? Any licensed and credentialed healthcare professional may do the order entry Modified Stage 2 attesters must meet all three thresholds or take exclusions 9
10 What is MU Objective #3 all about? Computerized Provider Order Entry (CPOE) Additional Information Orders involving tele-health or remote communications may be included Standing orders may, but do not have to be excluded from the numerator and denominator What is MU Objective #3 all about? This objective does not specify how the order is to be filled or carried out 10
11 Steps to meet MU Objective #3
12 Meeting MU Objective #3 1. Do the right thing Use computerized provider order entry for medication, laboratory, and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local, and professional guidelines. Measure 1: More than 60% of medication orders created by the EP during the EHR reporting period are recorded using CPOE. (30% for EPs scheduled to attest to Stage 1) Measure 2: More than 30% of laboratory orders created by the EP during the EHR reporting period are recorded using CPOE. (alternate exclusion for Stage 1 EPs) Measure 3: More than 30% of radiology orders created by the EP during the EHR reporting period are recorded using CPOE. (alternate exclusion for Stage 1 EPs) 12
13 Meeting MU Objective #3 2. Ensure data is entered correctly Who can enter the data? Where does CPOE data entry fit into the workflow? 13
14 Meeting MU Objective #3 3. Ensure data is captured correctly Is there any faulty logic in the EHR? i.e. if you uncheck a box on an apparently unrelated screen, does the EHR stop capturing CPOE data correctly? 14
15 Meeting MU Objective #3 4. Ensure CEHRT can report the data correctly (EHR dashboard) Test EHR reports (or regularly check EHR dashboard) to ensure accuracy 15
16 Meeting MU Objective #3 5. Generate supporting documentation An EHR-generated MU dashboard or report for the selected EHR reporting period that shows the following data elements for all CPOE measures: EP s name Numerator Denominator Resulting percentage 16
17 Meeting MU Objective #3 6. Retain supporting documentation Attestation purposes vs. audit purposes 17
18 Attesting for MU Objective #3
19 19 Attesting for MU Objective #3
20 20 Attesting for MU Objective #3
21 21 Attesting for MU Objective #3
22 Common Issues
23 23 Common Issues: Objective #3
24 Common Issues: Objective #3 Juxtapositional errors Faulty assumptions about other providers awareness of the orders Clinical Decision Support rules not well integrated Loss of physician control Nature of practice does not incorporate an ordering process 24
25 Questions Questions? 25
26 Helpful Links CMS 2015 Program Requirements page MeHI Medicaid EHR Incentive Program page MeHI 2015 Supporting Documentation Requirements Guide 26
27 Contact Us Thomas Bennett Client Services Relationship Manager (508) , ext. 403 Brendan Gallagher Client Services Relationship Manager (508) , ext Al Wroblewski, PCMH CCE Client Services Relationship Manager (508) , ext. 603
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Transforming Data to Knowledge Guide to Preparing for Meaningful Use Stage 1 Bill Presley September 27, 2013 Hospital Attestation Process A successful and active Registration in the CMS website. https://ehrincentives.cms.gov
Troubleshooting Audio
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Medicaid EHR Provider Incentive Payment Program. September 26, 2011
Medicaid EHR Provider Incentive Payment Program September 26, 2011 Definitions Electronic Health Record (EHR)*-An electronic record of health-related information on an individual that conforms to nationally
Note: Every encounter type must have at least one value designated under the MU Details frame.
Meaningful Use Eligible Professionals Eligible Providers (EPs) who are participating in the EHR Incentive Program either under Medicare or Medicaid must complete at least 2 years under Stage 1 before they
MEANINGFUL USE FOR THE OB/GYN. Steven L. Zielke, MD 6/13/2014
MEANINGFUL USE FOR THE OB/GYN Steven L. Zielke, MD 6/13/2014 Disclosures: I have no conflicts of interest I am not being paid by CMS to present this talk I am not endorsing any EHR I cannot guarantee attestation
Meaningful Use Stage 2 For Eligible and Critical Access Hospitals
Meaningful Use Stage 2 For Eligible and Critical Access Hospitals Eileen Colen This material was prepared by HealthInsight, the Medicare Quality Improvement Organization for Nevada and Utah, under contract