MEANINGFUL USE BASICS Medicare $44,000 Medicaid $63,000 What is Meaningful Use? Meaningful Use is an umbrella term for rules and regulations that health care providers can meet to qualify for federal incentive funding under the American Recovery and Reinvestment Act of 2009, also known as the ARRA. The Act authorizes the Centers for Medicare & Medicaid Services, known as CMS, to provide reimbursement incentives for Eligible Professionals (EP s) that make a constant effort to keep up with and meet the Meaningful Use criteria and metrics. What has to be reported? 1. EPs must report on the following: A. All 15 Core Measures (note: one of the required core measures is that EPs report Clinical Quality Measures, also known as CQMs) B. 5 out of 10 of the Menu Measures; at least 1 Public Health Measure must be selected. C. A sum total of up to 9 CQMs; 3 core, up to 3 alternate core, and 3 additional CQMs. If an EP reports a denominator of 0 for any of the 3 core measures, the EP must record for an alternate core CQM to supplement the core measure. Therefore, an EP may report a minimum of 6 and a maximum of 9 CQMs depending on the resulting values in the denominators for the core measures as reported from heir certified EHR. How do I register for and attest in Meaningful Use? To enroll, go to https://ehrincentives.cms.gov/hitech/login.action. How do I calculate my measures? Go to http://www.cms.gov/apps/ehr/meaningful-use-calculator.aspx O f f i c e A l l y 1 6 7 0 3 S E M c G i l l i v r a y B l v d V a n c o u v e r, W A 9 8 6 8 3
M e a n i n g f u l U s e B a s i c s 2 What are Office Ally s certification numbers? Office Ally s CCHIT Certification Number: CC-1112-490300-1 Office Ally s CMS Certification Number: 30000001SVL7EAK (used for attestation) What are the 15 Core Measures? 1. CPOE/CPOE for Medication Orders (Must use online e-prescription to meet the numerator of this measure) A. Where to find it in EHR: Patient Chart/SOAP Note/online e-prescription/finish/add to Current Meds or Print Rx/Add to Current Meds B. Objective: Use computerized provider order entry (CPOE) for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines C. Measure: >30% D. Numerator: The number of patients in the denominator that have at least one medication order entered using CPOE E. Denominator: Number of unique patient with at least one medication in their medication list seen by the EP during the EHR reporting 2. DDI, DAI Checks/Drug Interaction Checks (Online e-prescription must be enabled in order to meet this measure) A. Where to find it In EHR: Patient Chart/SOAP Note/online e-prescription B. Objective: Maintain active medication list 3. Diagnosis/Maintain Problem List A. Where to find it in EHR: Patient Chart/SOAP Note B. Objective: Maintain an up-to-date problem list of current and active diagnoses C. Measure: >80% D. Numerator: Number of patients in the denominator who have at least one entry or an indication that no problems are known for the patient recorded as structured data in their problem list
M e a n i n g f u l U s e B a s i c s 3 4. eprescribe/e-prescribing (erx) (Must use online e-prescription to meet this measure) A. Where to find it in EHR: Patient Chart/SOAP Note/online e-prescription/transmit Rx B. Objective: Generate and transmit permissible prescriptions electronically C. Measure: >30% D. Numerator: Number of prescriptions written for drugs requiring a prescription in order to be dispensed other than controlled substances during the EHR reporting E. Denominator: Number of prescriptions written for drugs requiring a prescription in order to be dispensed other than controlled substances during the EHR reporting 5. Active Meds/Active Medication List A. Where to find it in EHR: Patient Chart/SOAP Note B. Objective: Maintain active medication list C. Measure: >80% D. Numerator: Number of patients in the denominator who have a medication (or an indication that the patient is not currently prescribed any medication) recorded as structured data 6. Active Allergy/Medication Allergy List A. Where to find it in EHR: Patient Chart/SOAP Note B. Objective: Maintain active medication allergy list C. Measure: >80% D. Numerator: Number of unique patients in the denominator who have at least one entry )or an indication that the patient has no known medication allergies) recorded as structured data in their medication allergy list E. Denominator: Number of unique patient seen by the EP during the EHR reporting 7. Demographics/Record Demographics A. Where to find it in EHR: Patient Chart/Edit Demographics B. Objective: Record all of the following demographics: preferred language, gender, race ethnicity and date of birth D. Numerator: Number of patients in the denominator who have all of the elements of demographics (or a specific exclusion if the patient declined to provide one or more elements or if recording an element is contrary to state law) recorded as structured data
M e a n i n g f u l U s e B a s i c s 4 8. Vitals/Record Vital Signs A. Where to find it in EHR: Patient Chart/SOAP Note B. Objective: Record and chart changes in the following vital signs: height, weight, blood pressure D. Numerator: Number of patients in the denominator who have at least one entry of their height, weight, and blood pressure recorded as structured data E. Denominator: Number of unique patients age 2 or over seen by the EP during the EHR reporting 9. Smoking Stat/Record Smoking Status A. Where to find it in EHR: Patient Chart/ SOAP Note B. Objective: Record smoking status for patients 13 yours old or older D. Numerator: Number of patients in the denominator with smoking status recorded as structured data E. Denominator: Number of unique patient age 13 or older seen by the EP during the EHR reporting 10. CQMs/Clinical Quality Measures A. Where to find it in EHR: Manage Office/SOAP Note Layout/NQF Recommendations; Patient Chart/SOAP Note/NQF Recommendation B. Objective: Report ambulatory clinical quality measure to CMS 11. CDSR/Clinical Decision Support Rule A. Where to find it in EHR: Manage Office/Clinical Alerts; Patient Chart/SOAP Note/Check Clinical Decisions B. Objective: Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule 12. Access Info 2/Electronic Copy of Health Information A. Where to find it in EHR: Document Center/Patient Requests B. Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies) upon request D. Numerator: Number of patients in the denominator who receive an electronic copy of their electronic health information within 3 business days E. Denominator: Number of patients of the EP who request an electronic copy of their electronic health information 4 business days prior to the end of the EHR reporting
M e a n i n g f u l U s e B a s i c s 5 13. Clin Sum/Clinical Summaries A. Where to find it in EHR: References/Patient Visist Summary; Patient Chart/SOAP Note/MU Checklist B. Objective: Provide clinical summaries for patients for each office visit D. Numerator: Number of office visits in the denominator for which the patient is provided a clinical summary within 3 business days and have the MU Checklist box checked for I have provided the Patient Clinical Summaries within 3 business days since their office visit. E. Denominator: Number of office visits by the EP during the EHR reporting 14. Exch Clin Info/Electronic Exchange of Clinical Information A. Where to find it in EHR: Patient Chart/Others/Export Clinical Exchange Info. B. Objective: Capability to exchange key clinical information (for example, problem list, medication list, medication allergies and diagnostic test results), among providers of care and patient authorized entities electronically 15. Protect Elec Health Info/Protect Electronic Health Information A. Where to find it in EHR: Manage Office/Security Alerts/Audit Log Report, Security Audit Log B. Objective: Protect electronic health information created or maintained by the certified HER technology through the implementation of appropriate technical capabilities What are the 10 Menu Measures? 1. DF Checks/Drug Formulary Checks (Online e-prescription must be enabled in order to meet this measure) A. Where to find it in EHR: Patient Chart/SOAP note/online e-prescription B. Objective: Implement drug formulary checks
M e a n i n g f u l U s e B a s i c s 6 2. Lab Results/Clinical Lab Test Results A. Where to find it in EHR: Document Center/Orders/Add New; Document Center/Orders/Lab Radiology Order List/ Add/Edit Manual Result B. Objective: Incorporate clinical lab test results into HER as structured data C. Measure: >40% D. Numerator: Number of lab test results whose results are expressed in a positive or negative affirmation or as a number which are incorporated as structured data E. Denominator: Number of lab tests ordered during the HER reporting by the EP whose results are expressed in a positive or negative affirmation or as a number 3. Pat Lists/Patient Lists A. Where to find it in EHR: References/Meaningful Use Reports/Patient List B. Objective: Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities 4. Pat Remind/Patient Reminders A. Where to find it in EHR: References/Meaningful Use Reports/Patient Reminders B. Objective: Send reminders to patients per patient preference for preventative/follow-up care C. Measure: >20% D. Numerator: Number of patients in the denominator who where sent the appropriate reminder E. Denominator: Number of unique patients 65 years old or older or 5 years old or younger 5. Access Info 1/Patient Electronic Access (Patient Ally) A. Where to find it in EHR: Patient Chart/Edit Demographics; Manage Office/Patient Ally Activation B. Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists and allergies) within 4 business days of information being available to the EP C. Measure: >10% D. Numerator: Number of patients in the denominator who have timely (available to the patient within 4 business days of being updated in the certified EHR technology) electronic access to their health information online
M e a n i n g f u l U s e B a s i c s 7 6. Edu Res 1/Patient-specific Education Resources A. Where to find it in EHR: Document Center/Education Resources; Patient Chart/SOAP Note/MU Checklist B. Objective: Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate C. Measure: >10% D. Numerator: Number of patients in the denominator who are provided patient-specific education resources and have the MU Checklist box checked for I have provided patient specific education resources to the Patient for this encounter. 7. Med Recon/Medication Reconciliation A. Where to find it in EHR: Patient Char/SOAP Note/MU Checklist B. Objective: The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation D. Numerator: Number of transitions of care in the denominator where medication reconciliation was performed and the MU Checklist box checked for I performed medication reconciliation for this patient. E. Denominator: Number of transitions of care during the EHR reporting for which the EP was the receiving party of the transition and the MU Checklist box checked for This Patient was referred to me or needed medication reconciliation (transfer of care). 8. Referrals/Transition of Care Summary A. Where to find it in EHR: Patient Chart/SOAP Note/ MU Checklist B. Objective: The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide a summary of care record for each transition of care or referral D. Numerator: Number of transitions of care and referrals in the denominator where a summary of care record was provided and the MU Checklist box checked for A Patient Visit Summary was issued for referral/transfer of care. E. Denominator: Number of transitions of care and referrals during the EHR reporting for which the EP was the transferring or referring provider and the MU Checklist box checked for I am referring this Patient to another setting of care or provider of care. 9. Immunization Submission/Immunization Registries Data Submission A. Where to find it in EHR: References/Meaningful Use Reports/Immunizations B. Objective: Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice
M e a n i n g f u l U s e B a s i c s 8 10. Syndromic Surveillance Submission/Syndromic Surveillance Data Submission A. Where to find it in EHR: References/Meaningful Use Reports/Syndromes B. Objective: Capability to submit electronic Syndromic surveillance data to public health agencies and actual submission according to applicable law and practice What is the Reporting Period? The reporting must be at least 90 consecutive days within the calendar year. After the first 90 day, each consecutive reporting thereafter becomes 1 year long. What reports does Office Ally offer? 1. Automate Measure The report that shows the numerator and denominator for each Measure, and whether or not you re meeting them. 2. CMS Quality Reporting The report that shows the numerator and denominator for each NQF. 3. Immunizations A report that allows the provider to track the immunizations that they ve administered. 4. Patient List A search engine that allows the provider to search through his or her patients using very specific search parameters if needed. 5. Patient Reminders Allows the provider to record reminder s for all patients. Print and export options are available for this report. 6. MU Attestation List For those Core and Menu Measures that are met by a simple yes, this is where those measures can be acknowledged, and therefore met.