1 Meaningful Use 2015 PER THE CMS REVISION TO THE FINAL RULE RELEASED OCTOBER 6, 2015 CHARTMAKER MEDICAL SUITE
WHEN WE ARE FINISHED TODAY YOU SHOULD KNOW THE FOLLOWING. 2 EHR reporting periods Amended 2015 Meaningful Use requirements Applicable exclusions Attestation dates Penalties for non-participation Brief overview of Stage 3
2015 REPORTING PERIOD IS 90 DAYS 3 Must be a continuous 90 day period within 2015 calendar year DOES NOT need to be a calendar quarter Applicable for Stage 1 and Stage 2 Meaningful Users
FACTS of 4 23 The amended rules should make it easier to obtain Meaningful Use CQM reporting requirements have not changed 2 year look back is used for the Meaningful Use Program (2015 work will be rewarded or penalized in 2017) Core set & menu set measures have been removed Single set of objectives of 10 objectives First day attestation system is available, January 4, 2016 Last day attestation system is available, February 29, 2016
10 OBJECTIVES Previously known as Core & Menu Set Measures 5 Clinical Decision Support Protect Electronic Health Information Computerized Provider Order Entry (CPOE) Electronic Prescribing (erx) Health Information Exchange Patient Specific Education Medication Reconciliation Patient Electronic Access (VDT) Secure Messaging Public Health and Clinical Data Registry Reporting
6 Clinical Decision Support STAGE 2 Implement five clinical decision support interventions related to four or more clinical quality measures The EP has enabled and implemented the functionality for drug-drug and drug allergy interaction checks for the entire EHR reporting period STAGE 1 Implement one clinical decision support rule related to clinical quality measure Exemptions - None
7 Protect Electronic Health Information STAGE 1 & STAGE 2 Conduct or review a security risk analysis (as before) Exemptions - None
Computerized Provider Order Entry 8 (CPOE) STAGE 2 >60% of medication orders >30% of laboratory orders >30% of radiology orders Exemptions Any provider who writes fewer than 100 medications, lab or radiology orders during the reporting period. STAGE 1 >30% of medication orders created Exemptions Providers scheduled to be in Stage 1 in 2015 can claim exemption from lab and radiology orders
Electronic Prescribing (ERX) 9 STAGE 2 >50% of prescriptions sent electronically & queried for drug formulary Exemptions - Writes <100 scripts during EHR reporting period OR no pharmacies that accept ERX within 10 miles of the EP's practice STAGE 1 >40% of prescriptions sent electronically Exemptions - None
10 Health Information Exchange STAGE 2 Generate and transmit transition of care electronically >10% of transitions and referrals Exemptions - Stage 2 providers that transfer patients to another provider less than 100 times during the EHR reporting period STAGE 1 Not an applicable measure for this stage Exemptions All providers in Stage 1 for 2015
Patient Specific Education 11 Stage 1 & Stage 2 >10% of all unique patients who had an office visit during the EHR reporting period Exemptions EP with no office visits during reporting period OR Stage 1 providers that did not intend to select the Stage 1 Patient Specific Education menu objective
Medication Reconciliation 12 STAGE 2 > 50% of transitions of care in which the patient is transitioned into the care of the EP have medication reconciliation Exemptions - Stage 2 providers not the recipient of transitions of care during the reporting period STAGE 1 Not an applicable measure for this stage Exemptions In 2015 they were scheduled to demonstrate Stage 1 but did not intend to select the Stage 1 Medication Reconciliation objective
Patient Electronic Access (VDT) 13 STAGE 2 Patient electronic access >1 patient seen by provider or discharged from hospital ability to view, download, and transmit their health information AND > 50% of unique patients seen during the reporting period are provided access to view, download and transmit information within 4 business days Exemptions >50% of patient encounters in a county that does not have 4Mbps broadband availability for >50% of housing units STAGE 1 >50% of unique patients seen during reporting period are provided access to view, download and transmit information within 4 business days Exemptions Stage 1 Providers may claim an exclusion for the second part of the measure if they were scheduled to demonstrate Stage 1, which does not have an equivalent measure
Secure Messaging 14 STAGE 2 Messaging functionality enabled during the reporting period (at attestation this will be a yes/no answer) Exemptions - >50% of patient encounters in a county that does not have 4Mbps broadband availability for >50% of housing units STAGE 1 Not an applicable measure for this stage Exemptions - Providers may claim an exclusion for the measure if they were scheduled to demonstrate Stage 1, which does not have an equivalent measure.
Public Health Reporting 15 STAGE 2 (Providers must meet 2 of 3 measures) Measure 1 - Immunization Registry Reporting : EP is in active engagement with a public health agency to submit immunization data. Measure 2 Syndromic Surveillance Reporting : EP is in active engagement with a public health agency to submit syndromic surveillance data. Measure 3 Specialized Registry Reporting - EP is in active engagement to submit data to a specialized registry (transition of care information) STAGE 1 (Providers must meet 1 of 3 measures listed above) Exemptions Stage 1 & Stage 2 -Immunizations; none administered during reporting period, registry or immunization information system is not capable of the CEHRT standards, no immunization registry or immunization information system has declared readiness at the start of the reporting period
Public Health Reporting 16 (exemptions continued) Exemptions Syndromic surveillance; not a provider that collects syndromic surveillance by their jurisdiction's syndromic surveillance system, no public health agency is capable of receiving electronic syndromic surveillance data in the specific standards required by CEHRT at the start of the EHR reporting, no public health agency ready to receive syndromic surveillance data from EPs at the start of the EHR reporting period Specialized registry reporting; not a provider that diagnoses or treats conditions associated with a specialized registry, no specialized registry is capable of receiving electronic transactions in the specific standards required by CEHRT at the start of the EHR reporting, no specialized registry is ready to receive data from EPs at the start of the EHR reporting period Providers must be enrolled within the first 60 days of the 90 day attestation period they choose
Stage 2 Requirement s - Not Applicable 17 Record demographics Vitals Smoking status Provide clinical summary Incorporate clinical lab test results Patient list Send patient recall/reminder Conduct one or more successful electronic exchange Conduct one or more successful test of exchange with CMS test tool Secure messaging from patient Record electronic notes in patient records Imaging results and information are accessible Record family history
Required Objectives Stage 1 MU 2015 18 Protect Electronic Health Information Complete risk analysis Clinical Decision Support 1 DSS rule & enable drug interaction Computerized Provider Order Entry (CPOE) - >30% of meds entered Electronic Prescribing (erx) - >40% of prescriptions sent electronically Patient Specific Education - >10% of patients given educational materials Patient Electronic Access (VDT) - >50% of patients ability to VDT information within 4 business days Public Health and Clinical Data Registry Reporting - 1 public health measure 7 OF THE 10 OBJECTIVES ARE REQUIRED (3 REMAINING OBJECTIVES WILL BE EXEMPTIONS AT ATTESTATION)
EHR REPORTING PERIODS 19 2015 All providers attest to EHR reporting period of any continuous 90- day period within calendar year 2016 2017 First-time participants may use EHR reporting period of any continuous 90-day period. All returning participants must use EHR reporting period of 1 calendar year First-time participants may use EHR reporting period of any continuous 90-day period; providers attesting to Stage 3 also use 90-day reporting period All returning participants must use EHR reporting period of 1 calendar year 2018 First-time Medicaid participants may use 90-day EHR period All other providers must use EHR reporting period of 1 calendar year
Payment Adjustments for Medicare Providers 20 Successful participation can eliminate an existing penalty Incentives are dwindling, penalties are increasing
TIPS TO PREPARE FOR 2015 ATTESTATION NOW Check Meaningful Use registration information NPPES login Make sure e-mail address is correct Make sure payment information is correct Identity and Access Management (I&A) make sure all users are up-to-date 21 EHR Information Center Help Desk (888)734-6433 / TTY: (888)734-6563 NPPES Help Desk https://nppes.cms.hhs.gov/nppes/welcome.do (800)465-3203 PECOS Help Desk https://pecos.cms.hhs.gov/ (866)484-8049 Identification & Access Management System (I&A) Help Desk PECOS External User Services (EUS) (866)484 8049 E-mail: EUSSupport@cgi.com
MEDICAID 22 Basic Information for Eligible Professionals Participating in the Medicaid EHR Incentive Program: The program is administered voluntarily by states and territories, and will pay incentives through 2021. Eligible professionals can participate for 6 years, and participation years do not have to be consecutive. The last year that an eligible professional can begin participation is 2016. Incentive payments for eligible professionals are higher under the Medicaid EHR Incentive Payments up to $63,750 over 6 years. Eligible professionals can receive an incentive payment for adopting, implementing, or upgrading, certified EHR technology in their first year of participation.
STAGE 3 23 90 day reporting for all first time participants in 2017 Stage 3 is optional in 2017 and will have a 90 reporting period to entice early stage 3 participants All providers must comply with Stage 3 in 2018 Will have 8 objectives Protect Electronic Health Information Electronic Prescribing (erx) Clinical Decision Support Computerized Provider Order Entry (CPOE) Patient Electronic Access to Health Information Coordination of Care through Patient Engagement Health Information Exchange Public Health Reporting
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