Meaningful Use Stage 2 For Eligible and Critical Access Hospitals

Transcription

1 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 with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 10SOW-NV-2013-PO-35 This material was prepared by HealthInsight as part of our work as the Regional Extension Center for Nevada and Utah, under Cooperative Agreement #90RC0033/01 from the Office of the National Coordinator, Department of Health and Human Services.

2 HealthInsight Meaningful Use Education Sessions 2014

3 Slides and recording on HealthInsight.org Posted under Events Section

4 Agenda Overview Core Measures Menu Measures Clinical Quality Measures Brief Q&A

5 Meaningful use is Using certified EHR technology 1 to: Improve quality, safety, efficiency, and reduce health disparities Engage patients and families Improve care coordination, and population and public health Maintain privacy and security 1 Certification as defined by ONC-Authorized Testing and Certification Body (ONC-ATCB). For more information on certified EHRs and the process of certification, visit

6 Meaningful use: Path to better outcomes and quality Stage 2 Advanced clinical processes Stage 3 Improved outcomes Stage 1 Data capture and sharing Better clinical outcomes Improved population health outcomes Increased transparency and efficiency Empowered individuals More robust research data on health system

7 Meaningful Use as a Building Block Use information to transform Improved population health Enhanced access and continuity Utilize technology to gather information Basic EHR functionality, structured data Improve access to information Care coordination Patient informed Structured data utilized Data utilized to improve delivery and outcomes Patient self management Care coordination Evidenced based medicine Registries for disease management Data utilized to improve delivery and outcomes Patient engaged, community resources Patient centered care coordination Team based care, case management Registries to manage patient populations Privacy & security protections Privacy & security protections Privacy & security protections Privacy & security protections Stage 1 MU Stage 2 MU PCMHs 3-Part Aim ACOs Stage 3 MU

8 Stage 2 Overview Published final Stage 2 rule in August 2012 Stage 2 retains the core and menu structure for meaningful use objectives Combine some measures Addition of new measures 2014 Certification for EHR

9 Total Objectives Stage 1 Stage 2 Eligible Hospitals Eligible Hospitals 14 core objectives 16 core objectives 5 of 10 menu objectives 3 of 6 menu objectives 19 total objectives 19 total objectives

10 Core Objectives Must meet all 16 measures

11 Core Objectives - CPOE Use CPOE for more than: 60% medication orders 30% laboratory orders 30% radiology orders

12 Core Objectives - Demographics Record demographics as structured data for more than 80% of all unique patients admitted to the inpatient or emergency department

13 Core Objectives Vital Signs Record and chart changes in vitals for more than 80% of all unique patients Height/ Length Weight Blood Pressure BMI Growth Charts

14 Core Objectives Smoking Status Record smoking status for more than 80% of all unique patients 13 or older admitted to the inpatient or emergency departments (POS 21 or 23)

15 Core Objectives Clinical Decision Support Use Clinical Decision Support Implement 5 clinical decision support interventions Enable Drug-Drug and Drugallergy interaction Checks

16 Core Objectives Patient Electronic Access Electronic Copy and Electronic Access of Health Information EH: Patient access to view, download, and transmit information EH: >50% have information within 36 hours

17 Core Objectives Protect Electronic Health Information A top reason for audit failure in Stage 1 Measure: Conduct or review a security risk analysis, including addressing the encryption/security of data stored in CEHRT, and implement security updates as necessary and correct identified security deficiencies as part of the risk management process

18 Core Objectives Clinical Lab-Test Results Incorporate clinical lab test results As structured data

19 Core Objectives Patient Lists Generate at least one report listing patients with a specific condition to use for quality improvement, reduction of disparities, research, or outreach.

20 Core Objectives Patient Education Use clinically relevant information to identify patient specific education resources for more than 10% of all unique patients

21 Core Objectives Medication Reconciliation Perform medication reconciliation for more than 50% of transitions of care in which the patient is admitted into the inpatient or emergency department

22 Core Objectives Summary of Care Measure 1 Provide summary of care for more than 50% of transitions and referrals Measure 2 Provide summary of care electronically for more than 10% of transitions and referrals Measure 3 Conduct one or more successful exchanges of summary of care document

23 Core Objectives Immunization Registries Successful ongoing submission of electronic immunization data from certified EHR technology to an immunization registry or immunization information system

24 Core Objectives Electronic Reportable Lab Results Successful ongoing submission of electronic reportable laboratory results from certified EHR Technology to a public health agency Nevada: Utah:

25 Core Objectives - Syndromic Surveillance This measure will be a Yes/No question in the attestation. Proof for audit Keep for six years Store in multiple places/forms Know where documentation is stored

26 Syndromic Surveillance Nevada info: Utah info: Anne Burke (801)

27 Core Objectives - emar Automatically track medications for more than 10% of medication orders created by authorized providers from order to administration using assistive technologies in conjunction with an emar

28 Menu Objectives Must meet 3 of 6 available measures Menu Objective Exclusions: Measure Exclusions will not count toward minimum if other menu measures can be selected and met

29 Menu Measures Advanced Directives

30 Menu Objectives Electronic Notes Enter at least one electronic progress note created, edited and signed by an authorized provider for more than 30% of unique patients admitted to the inpatient or emergency department

31 Menu Objectives Imaging Results

32 Menu Objectives Family History Record patient family health history as structured data for more than 20% of all unique patients admitted to the inpatient or emergency department

33 Menu Objectives - erx Generate and transmit permissible discharge prescriptions electronically for more than 10% of hospital discharge medication orders

34 Menu Objectives Lab Results Provide structured electronic lab results to ambulatory providers Send structured lab results to the ordering provider for more than 20% of electronic lab orders Alternate: Send structured electronic lab results to the ordering provider for more than 20% of lab orders

35 Menu Measure Conclusions You only have to do 3 of the 6 Talk to your vendor about choices Contact registries and health department early (60 days) Be careful with exclusions Must exclude from all not done Document exclusions

36 Clinical Quality Measures (CQM) Report 16 of 29 CQMs Cover 3 of 6 National Quality Strategy Domains Patient and Family Engagement Patient Safety Care Coordination Population and Public Health Efficient Use of Healthcare Resources Clinical Processes/Effectiveness

37 Reporting Options Guidance/Legislation/EHRIncentivePrograms/2014_ClinicalQualityMeasures.html

38 Payment Adjustments Begin in 2015 FY 2015: October 1, 2014 for Hospitals CY 2015: January 1, 2015 for Eligible Professionals Must continue to meet Meaningful Use each year to avoid payment adjustments

39 Payment Adjustments EH: Applied to IPPS increase cumulative for every consecutive year not meeting MU CAH: Applied to Medicare reimbursement for Inpatient services for the year meaningful use was not met

40 Avoiding Payment Adjustments Eligible Hospitals First year 2011 or 2012: must demonstrate MU for full fiscal year in 2013 First year 2013: must demonstrate MU for 90 day reporting period in fiscal year 2013 First year 2014: must demonstrate MU for 90 day reporting period in first nine months of Fiscal year 2014

41 Avoiding Payment Adjustments Critical Access Hospitals Meet Meaningful Use for full FY that is the same as the payment year

42 Reference/Source Links Stage 2 Tool kit: Guidance/Legislation/EHRIncentivePrograms/Downloads/Stag e2_toolkit_ehr_0313.pdf CMS: Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html Payment Adjustments Hospitals: Guidance/Legislation/EHRIncentivePrograms/Downloads/Pay mentadj_hardshipexceptipsheetforhospitals.pdf 42

43 Questions Eileen Colen