Meaningful Use 2015 Measures 22 October 2015 11:00 am Presented by: Sarah Leake MBA, CPEHR Co-Host: Susan Clarke HCISPP 1
Thank you for spending your valuable time with us today. A copy of today s presentation and the webinar recording will be available on our website. A link to these resources will be emailed to you following the presentation. We would greatly appreciate your providing us feedback by completing the survey at the end of the webinar today. 2
The goal of this session is to review the 2015 Meaningful Use Requirements focusing on the changes. It will identify important considerations and actions to take now. Review of MU measures, but detail in suggested resources. Answers to submitted questions. 3
Mountain-Pacific holds the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO) contract for the states of Montana, Wyoming, Alaska and Hawaii, providing quality improvement assistance. HTS, a department of MPQHF, has assisted 1480 providers and 50 Critical Access Hospitals to reach Meaningful Use. We also assist healthcare facilities with utilizing Health Information Technology (HIT) to improve health care, quality, efficiency and outcomes. 4
The presenter is not an attorney and the information provided is the presenter(s) opinion and should not be taken as legal advice. The information is presented for informational purposes only. Compliance with regulations can involve legal subject matter with serious consequences. The information contained in the webinar(s) and related materials (including, but not limited to, recordings, handouts, and presentation documents) is not intended to constitute legal advice or the rendering of legal, consulting or other professional services of any kind. Users of the webinar(s) and webinar materials should not in any manner rely upon or construe the information as legal, or other professional advice. Users should seek the services of a competent legal or other professional before acting, or failing to act, based upon the information contained in the webinar(s) in order to ascertain what is may be best for the users individual needs. 5
Sarah Leake Sarah Leake, MBA, CPEHR QR/PR Specialist, MU, PQRS, PM 6
Meaningful Use for 2015 Overview Key Considerations Actions to take now Questions and Discussion 7
Restructured Stage 1 and Stage 2 Objectives and Measures to align with Stage 3 One set of Required Objectives EHR Reporting Period Aligns with Calendar Year 2015 any 90 consecutive days reporting Modified 2 Patient Engagement objectives that require patient action Removed duplicative, redundant and topped out measures CQM reporting remains the same 8
CMS Final Rule encompasses EHR Incentive Programs in 2015 through 2017 called Modified Stage 2 and Stage 3 in 2018 No longer the Stage/Year Concept 2015-2017 is Modified Stage 2 Alternate Exclusions and Specifications are available for Providers scheduled for Stage 1 in 2015. Optional to use these Exclusions are available for the Modified Stage 2 measures under certain quotas or circumstances 9
(from EHR Incentive program 2015-2017 Tip Sheet) 10
Goal to report to the MODIFIED STAGE 2 11
Based on Calendar Year 2015 continuous 90-day period 2016 Full Year (if not first year of attestation) 2017 full year (if Modified Stage 2) or 90 day period (if you choose Stage 3) EHR Technology Used 2015 use 2014 Certified Edition 2016 & 2017 Choose 2014 or 2015 Certified Edition 12
Patient Electronic Access WAS >5% NOW at least 1 patient seen by the EP or Hospital views, downloads or transmits his or her information. This must be 1 patient for EACH PROVIDER Secure Electronic Messaging (EP Only) WAS >5% NOW capability for patients to send and receive a secure electronic message with the EP was fully enabled during the EHR reporting period Y/N 13
Criteria Provider Hospital/CAH Objectives 10 9 # Public Health Measures 2 3 CQMs (measures/domains) 9/3 16 Reporting Period continuous 90 day continuous 90 day 14
Finalized! 15
1. Protect Patient Health Information: Protect electronic health information created or maintained by the CEHRT through the implementation of appropriate technical capabilities. Security Risk Analysis each Year 2. Clinical Decision Support (CDS): Use clinical decision support rules to improve performance on high priority health conditions. Measure 1: Implement five clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period. Measure 2: Enabled the functionality of Drug/Drug, Drug/Allergy checks for entire reporting period. 16
3. Computerized Provider Order Entry (CPOE): 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. Measures: More than 60% medication, 30% laboratory and 30% radiology created using CPOE 4. Electronic Prescribing: (EPs) Generate and transmit permissible prescriptions electronically (erx); (Eligible hospitals/cahs) Generate and transmit permissible discharge prescriptions electronically (erx). Measure: EPs >50%, Hospitals and CAHs >10% 17
5. Health Information Exchange: The EP, eligible hospital or CAH who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care provides a summary care record for each transition of care or referral. Measure: 1) use CEHRT to create a summary of care record; and (2) electronically transmit such summary to a receiving provider for more than 10 percent of transitions of care and referrals 18
6. Patient Specific Education: Use clinically relevant information from CEHRT to identify patient specific education resources and provide those resources to the patient. Measure: >10 percent of all unique patients with office visits seen by the EP, or admitted to the EH, IP or ER are provided education 7. Medication Reconciliation: 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 performs medication reconciliation. Measure: Medication reconciliation is performed for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP or admitted to the eligible hospital's or CAH's inpatient or emergency department (POS 21 or 23). 19
8. Patient Electronic Access: (EPs) Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP. (Eligible hospitals/cahs) Provide patients the ability to view online, download, and transmit their health information within 36 hours of hospital discharge. Measure 1: 50% of unique patients must have access to online health information. Measure 2: at least one patient seen by the provider or discharged from IP or ER during the reporting period views, downloads or transmits health information. **2017 will be >5% of unique patients seen by EP 20
9. Secure Electronic Messaging (EPs only): Use secure electronic messaging to communicate with patients on relevant health information. Measure: 2015 capability is fully enabled during the entire reporting period) 2016 a secure message was sent by provider for at least 1 patient 2017 - a secure message was sent for >5% patients seen 10. Public Health and Clinical Data Reporting: The EP, eligible hospital or CAH is in active engagement with a public health agency to submit electronic public health data from CEHRT, except where prohibited and in accordance with applicable law and practice. (more explanation on next page) 21
Providers choose 2 of 3 measures, Hospitals need 3 of 4 measures Registries to choose from: 1. Immunization registry 2. Syndromic surveillance reporting 3. Specialty registry reporting 4. Electronic reportable lab (hospital only) Active Engagement with Public Health reporting 22
2015 MU requirement is to report CQMs for 90 Days, No Threshold Reporting Options Provider Hospital/CAH Reporting Measure Requirements Continuous 90 day period when you attest 9 measures/ 3 domains 16 Measures Full year through PQRS electronically MU, PQRS NA 1Q, 2Q, 3Q Electronically QualityNet NA MU, IQR, OQR MU MU 23
For an EHR reporting period in 2015, an eligible hospital or CAH must attest by February 29, 2016. Despite the change to a 90-day EHR reporting period in 2015, providers will not be able to attest to meaningful use for an EHR reporting period in 2015 prior to January 4, 2016. 24
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Confirm Providers that are Eligible for MU Confirm Program Can no Longer switch between programs Medicare, (if first year) has no incentive but can receive penalty in 2016 and 2017 if not reporting in 2015 Confirm Practice Location(s) Must combine num/den Y/N must be met at each location Ensure Providers are Registered and Active in CMS EHR Registration Site (NLR) and State Level Registries (SLR) for Medicaid May need to activate in Pecos (this can take time!) 26
Verify your EHR technology is Certified to 2014 Edition Certified Health IT Product List (CHPL) website here Make sure these are Configured and ON CPOE Drug/Drug, Drug/Allergy Interaction checks ** FIVE Clinical Decision Support Rules ** Health Information Exchange for Summary of Care Transition Patient Portal ** Direct Messaging (EP) ** ** DOCUMENT these are Configured from Day 1 or Now. 27
Coordinate and complete a Security Risk Analysis - within the 90 Day reporting period Must begin active engagement with a Public Health Agency no later than 60 days from the start date of the reporting period If 90 Day start is Oct 1, 2015 need to contact the State Registries by Nov 29, 2015 Registration of Intent with DPHHS Active engagement can be completing registration to start conversation, then receiving and retaining the acknowledgment of your registration http://dphhs.mt.gov/publichealth/meaningfuluse.aspx http://wyomingincentive.wyo.gov/registration-intent 28
Identify >30% Medicaid patient volume for 90-365 days in qualifying period Document Note: First year still can be AIU but, if provider is dual eligible, Medicare payment adjustment will apply 29
Run your MU and CQM reports for the Modified Stage 2 and CQMs from 2014 Certified EHR For all locations a provider practices in (they need to be combined) Monitor and Verify accuracy of MU reports/data Determine the MU Gap for each provider Identify Measures not met, investigate reason and modify workflows 30
With the new rules do you still pick either OBS, IP and swing bed or ER for your patient population? I don t see anything specific and I do see that several of the objectives state discharged from the Inpatient and ER. - We have found no change in the method for selecting your patient population. The objectives state IP or ED for every measure. How could you prove that Secure Messaging was turned on during the entire reporting period? - Gather documentation/ screenshots that you may have regarding Go-Live prior to or on Oct 1 What are requirements for successfully attesting to Public Health Measures? Please see slide 27 31
If an EP, eligible hospital or Critical Access Hospital (CAH) is unable to effectively plan for a reporting period in 2015 due to the timing of the publication of the 2015 through 2017 Modifications final rule, can they apply for a hardship exception? Yes, if a provider is unable to meet the requirements of meaningful use for an EHR reporting period in 2015 for reasons related to the timing of the publication of the final rule, a provider may apply for a hardship exception under the "extreme and uncontrollable" circumstances category. Each hardship exception application will be reviewed on a case-by-case basis, as required by law. In the past, CMS has considered these applications seriously and, in fact, has approved over 85% of hardship exemptions. Hardship applications will be available in early 2016 on https://www.cms.gov/ehrincentiveprograms 32
Determine if providers practice in more than one location Calculate and document Medicaid Eligibility Confirm EHR version is 2014 Determine Stage of MU for each provider Verify EP registration info in PECOS, NLR and SLR if Medicaid Verify EHR configurations and functionality Actively Engage for the Public Health Measures (2 for EPs or 3 for Hospital/CAH) 33
Determine MU Gap Monitor MU performance and adjust workflows Choose MU reporting period Take screenshots needed for CMS Audit Perform or Update Security Risk Assessment Meet MU Attest Finalize CMS MU Audit folder documentation 34
Register for our upcoming webinars and check out the resources used today: www.healthtechnologyservice.com HTS HOSTED PUBLIC WEBINARS: Wednesday, Nov 4 1-2pm MDT *MU 2015 Step by Step to Attestation Wednesday, Dec 16 2-3pm MDT *Patient Engagement OTHERS WEBINARS OF INTEREST: Tuesday, Nov 3, 1-2pm MDT *Unleashing the Power of Data (QualityNet euniversity)) Thursday, Nov 19, 11:30am-12:30pm MDT *2015 PQRS Reporting Requirements (QualityNet euniversity)) 35
Quality Reporting Program Assistance *PQRS & Value-Based Modifier for Providers, HIQR for Hospitals Meaningful Use *Avoiding payment adjustments *Stage 1 and Stage 2 assistance for EH or EPs *2015 Meaningful Use Requirements Security Risk Assessments *Basic or Comprehensive SRAs HIT Consulting and Project Management *Assistance with interfaces, HIE, etc. Combined Services *Year long assistance with Meaningful Use, PQRS/IQR and ICD-10 HTS services and pricing can be found on our website: www.healthtechnologyservice.com 36
2015 EHR CMS Link https://www.cms.gov/regulations-and- Guidance/Legislation/EHRIncentivePrograms/2015ProgramRequirem ents.html CMS 10/8/2015 Webinar: EHR Incentive Programs Final Rule Overview and What You Need to Know for 2015 PDF Presentation Webinar Recording EHR for Eligible Professionals: What You Need to Know for 2015 Tip sheet EHR for Eligible Hospitals and CAHs: What You Need to Know for 2015 Tipsheet EHR Incentive Programs in 2015-2017 Overview Fact Sheet FAQ Page Top Questions https://questions.cms.gov/ 37
What further Topics or Areas you would like to explore or have interactive sessions regarding MU, QRUR, PQRS, VBM? Please complete our survey after the webinar! 38