Meaningful Use: 10 Tips for Stage 2
1. Start preparing even if you are not there yet. "For those in their first or second year of Stage 1, we suggest they boost current performance to exceed minimum thresholds for all core and menu objectives and measures," said Noami Levinthal, senior consultant and healthcare IT adviser for The Advisory Board. "This strategy will allow them to prepare for Stage 2 when menu items become core and thresholds increase." Levinthal added that it's important to conduct a work flow analysis in advance of any meaningful use decisions and to designate a staff person to manage frequent updates.
2. Get organized early. Rafi Tabib, managing consultant with Navigant's healthcare practice, recommended getting an early start on the calendar year by selecting the measures that you hope to attest to. Test those measures in your system to ensure you are capturing the data that will be submitted at the end of the reporting period.
3. Focus on increasing patient engagement. "Once you implement an EHR, you should be giving patients information and follow-up instructions and, if they haven't signed up for your portal, get them signed up," said Mary Griskewicz, senior director of health information systems for the Healthcare Information and Management Systems Society. "That's the change in thinking and culture that's needed." Levinthal agreed that focusing on patient engagement is key. "Practices with a robust patient engagement initiative that includes clinician involvement may be able to meet the secure messaging and view, download, and transmit measures with greater ease," she said.
4. Focus on the transition of care requirement. The transitions of care measures are incredibly complex, and it behooves practices to make certain they know how they'll go about sending summary of care records within and outside of their four walls," said Levinthal. Shaun Conrad, manager in the Americas Health Care Practice at Ernst & Young, agreed that practices should pay close attention to the transition of care requirement, and proactively reach out to other practices, hospitals, nursing homes, and other places to which they would refer patients. "... Do that early to get partners involved so you can transmit electronically and meet that threshold for the measure."
5. Meet often. Have regularly scheduled (weekly, biweekly, or monthly) status updates to track progress during the reporting period, said Tabib. If a physician is not meeting a measure, it is better to know upfront so that you can troubleshoot the problem review with the provider or staff and correct it (this is especially critical in a shorter reporting period).
6. Consider exceptions, if necessary. "If you are a provider that will not be able to demonstrate meaningful use in 2015, we suggest they determine when they can do so in future years," said Levinthal. "Each year these providers will experience a reduction in their Medicare Part B claims unless they can demonstrate a hardship or attest to meaningful use. Be well-prepared for audits with a comprehensive book of evidence and an internal policy on how the practice would respond to an audit notice."
7. Communicate with peers. There are lessons to be learned from peers and sometimes even basic communication can simplify the process, said Tabib. This especially applies to single-specialty group practices.
8. Form a solid physician-administrative team. "Physician practices should look at having dedicated administrative staff help physicians manage meaningful use, Physician Quality Reporting System (PQRS), and other... quality-related incentive programs," said Tabib. "If possible, a wellrounded team with knowledge of the EHR functionality, reporting/data analytics, and program requirements, should be put together."
9. Don't forget the basics. Drew Boston, strategy manager for Accenture's health business, recommended the following preparation steps: 1. Make sure all of the required criteria are completed during the reporting period. 2. Confirm more than 80 percent of patient records are charted with certified EHR technology. 3. Validate whether the practice or physician is eligible for an exclusion and/or hardship exception. 4. Ensure there is a signed and dated copy of the security risk analysis. 5. Plan to safeguard relevant documentation for at least six years.
10. Document thoroughly. Keep a "book" of evidence, said Tabib. CMS is performing more and more audits and physicians should be prepared with all necessary reports, documentation, and screenshots as they attest.