Meaningful Use Stage 2 Physician Office October, 2012
Why are we here? Meaningful Use overview NOT Stage 1 requirements NOT Interesting facts Stage 1 - The Moving Target Stage 2 Final Rule Penalties Audits Preliminary Stage 3
Meaningful Use Interesting Numbers 1,333 out of 5,754 hospitals have met MU requirements 74,000 out of 954,000 physicians have attested (not all those physicians qualify)
The Moving Target
Timing
Timing
Timing AIU (Medicaid) Example
Timing Medicare Example
Medicaid Expands Eligibility
Batch Reporting
Hardship
Changes in Stage 1
AHA Take Away on Stage 2
Stage 2
Stage of Meaningful Use
Stage of Meaningful Use, The Advisory Group
Interoperability The Advisory Group
Change from Stage 1 to Stage 2
Summary - Core
Summary - Core
CPOE FAQ Watch: licensed healthcare professional Different denominator
CPOE
erx
Vitals
Vitals
Interventions - Clinical Decision Support FAQ /Certification Watch: Definition of CDR
Labs If you are not interfacing your labs, get on the list with Munson or Mercy 55% of your labs must be structured
Patient List (Registry)
Exchange of Data verses Patient Access 2013 and beyond
View, Download and Transmit
Patient Education FAQ Watch: identified by CEHRT
Med Reconciliation The resulting percentage must be more than 50 percent in order for an EP, eligible hospital or CAH to meet this measure. The EP, eligible hospital or CAH who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation. Medication reconciliation allows providers to confirm that the information they have on the patient s medication is accurate. This not only assists the provider in their direct patient care, it also improves the accuracy of information they provide to others through health information exchange.
Secure Messaging Providers have seen reduction in time responding to inquires and less time spend on the phone Secure messaging has also been shown to increase patient satisfaction with their care. Research demonstrates that secure messaging has been shown to improve patient adherence to treatment plans, While we recognize that EPs cannot directly control whether patients use electronic messaging, we continue to believe that EPs are in a unique position to strongly influence the technologies patients use to improve their own care, including secure electronic messaging. We believe that EPs ability to influence patients coupled with the low threshold make this measure achievable for all EPs
Summary of Care
Summary Of Care Referral or Transition to Another Setting Include the following information if the provider knows it: Patient name. Referring or transitioning provider's name & office contact information (EP only). Procedures. Immunizations Laboratory test results. Vital signs (height, weight, blood pressure, BMI). Smoking status. Functional status, including activities of daily living, cognitive and disability status Demographic information (preferred language, sex, race, ethnicity, date of birth). Care plan field, including goals and instructions. Care team including the primary care provider of record and any additional known care team members beyond the referring or transitioning provider and the receiving provider. Discharge instructions (Hospital Only) Reason for referral (EP only)
Summary - Menu
Image Results Probably
Family History More than 20 percent of all unique patients seen by the EP, or admitted to the eligible hospital or CAH s inpatient or emergency department (POS 21 or 23) during the EHR reporting period have a structured data entry for one or more first-degree relatives. This does need to be structured (one entry)
Electronic Progress Notes The text of the electronic note must be text-searchable and may contain drawings and other content.
Quality Measures
Quality Measures Stage 1 Stage 2 6 measures 44 available 3 core/alternative core 3 additional 9 measures ~64 available Recommended core 3 Domains Patient and Family Engagement Patient Safety Care Coordination Population and Public Health Efficient use of Resources Clinical processes/effectiveness
Quality Measures
Mismatch on CQM s Requirement on Providers and Vendors - AHA
EP CQM Reporting Beginning in 2014
CQM Reporting PFR not PFP Group reporting option PQRS CMS website Future information: www.cms.gov/ehrincentiveprograms
Penalty Hardship Exemption
EP EHR Reporting Period 2011/2012
EP EHR Reporting Period 2013
EP EHR Reporting Period - 2014
Penalty Hardship Expectation
Meaningful Use Audits
MHC Stage 3
Stage 3 HITPC Meetings CPOE referral and transition CDS use external CDS s Demographics: occupation, sexual orientation/gender identity, disability status Code medication allergy 15 Clinical Decision Support, track compliance Real time dashboards in place of patient lists Summary of care sent electronically to 50% Patients submit information on family health history, blood pressure, weight, glucose levels, etc. Create pre-visit prep tools Patients correct their own records Information provided in top 5 languages 15% of patients securely communicate with providers Receive immunization records Send records electronically to jurisdictional registries