Stage 2 Meaningful Use Final Rule CPeH Advocacy Opportunities August 29, 2012
Agenda Review EHR Incentive Program and Intended Purpose Walk through Stage 2 Final Rule Changes to Stage 1 Stage 2 Criteria Discuss Consumer Perspectives and Opportunities for Advocacy
Overview of Meaningful Use Stages
MU Stage 1 Changes Stage 1 Policy Final Changes Effective Year (CY/FY) Meeting an exclusion for a menu set objective counts towards the number of menu set objectives that must be satisfied to meet MU Change: Exclusion does not count towards number of menu objectives that must be satisfied 2014 Onward (Required) 4
MU Stage 1 Changes Stage 1 Objective Final Changes Effective Year (CY/FY) Capability to exchange key clinical information Change: Eliminated this requirement from Stage 1; no replacement relative to exchange of information 2013 Onward (Required) 5
MU Stage 1 Changes Stage 1 Objective Final Changes Effective Year (CY/FY) EP and EH Objective: Provide patients with an electronic copy of their health information upon request. Hospital Objective: Provide patients with an electronic copy of their discharge instructions at time of discharge, upon request. Change: Replace these four objectives with the Stage 2 objective and one of the two Stage 2 measures. 2014 Onward (Required) EP Objective: Provide patients with timely electronic access to their health information within 4 business days of the information being available to the EP. 6
Overarching CPeH Goals for MU Support partnerships between patients, their family caregivers, and their care team; Improving the coordination of care; Increasing health equity; and Enabling new payment and delivery models 7
Priority 1: Supporting Partnerships View, Download, and Transmit Health Information EPs: Core objective for both EPs and EHs. 50% of patients have electronic access to their health info within 4 business days (subject to EP s discretion to withhold certain info) 5% of all patients view, download, or transmit their health info to a 3 rd party EHs: 50% of all patients are provided online access to their health info within 36 hours of discharge 5% of all patients view, download, or transmit their health info to a 3 rd party 8
Priority 1: Supporting Partnerships Required Elements For View, Download, and Transmit Patient name Admit and discharge date and location Reason for hospitalization Care team including the attending of record as well as other providers of care Procedures performed during admission Current and past problem list Current medication list and medication history Current medication allergy list and medication allergy history Vital signs at discharge Laboratory test results (available at time of discharge) Summary of care record for transitions of care or referrals to another provider Care plan field(s), including goals and instructions Discharge instructions for patient Demographics (sex, race, ethnicity, date of birth, preferred language) Smoking status 9
Priority 1: Supporting Partnerships Secure Messaging EPs Only 5% of all patients seen during reporting period send a secure message using electronic messaging Core Objective Advance Directives EHs Only: 50% of patients 65 years or older have advance directive status recorded as structured data Menu Objective No change from Stage 1 Additional positive advancements In: eprescribing Patient Reminders Family Health History 10
Priority 2: Improving Care Coordination Health Information Exchange Summary of Care Record Summary of Care Record provided for 50% of transitions and referrals 10% of transitions and referrals have a summary of care record that is provided electronically At least 1 electronic exchange of summary of care record is with a recipient using technology designed by a different developer than sender OR 1 or more successful tests with the CMS-designated test EHR 11
Priority 2: Improving Care Coordination Summary of Care Record and Care Plan Required: Up-to-date problem list Active medication list and active medication allergy list Patient name Referring or transitioning provider's name and office contact information (EP only) Procedures Encounter diagnosis 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 (EH Only) Reason for referral (EP only) 12
Priority 3: Increasing Health Equity Record demographics EPs and EHs: Threshold increased from 50% - 80% No additional demographic elements (although disability status referenced in SOC Record) OMB standards finalized for race and ethnicity No requirement for USE of data No requirement to stratify condition lists by demographics No requirement to use preferred language data in meeting patient education materials criterion 13
Priority 4: Enabling New Payment and Delivery Models Increasing focus on population health Report by condition Submission of data to registries Requiring collaboration among providers, across settings and with patients and their families Lab results sent to ordering provider Electronic summary of care record Electronic exchange with providers using a different vendor s technology Secure messaging Group reporting Emphasizing provider role in patient engagement V/D/T measures Moving toward longitudinal use of the medical record Family health history Summary of care record Alignment of federal payment/incentive programs PQRS option Six CQM domains 14
Prime Opportunities for CPeH Advocacy Health equity and disparities reduction Evolution of care plans/care planning and inclusion of advance directives Health Information Exchange Patient contributed data and shared decisionmaking Strengthening approach to clinical quality measures Others? 15
Get Involved! Contact us: Follow us: Eva Powell epowell@nationalpartnership.org Elina Alterman ealterman@nationalpartnership.org www.facebook.com/nationalpartnership www.twitter.com/npwf Find us: www.nationalpartnership.org 16