Protecting Your Peace of Mind Protecting Your Peace of Mind A Roadmap to Meaningful Use Session One: Unraveling What it Takes to be a Meaningful User August 24, 2010
Feb 12, 2016
Protecting Your Peace of MindProtecting Your Peace of Mind
A Roadmap to Meaningful Use
Session One:Unraveling What it Takes to be a
Meaningful User
August 24, 2010
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Objectives
Basics
Core Criteria
Menu criteria
Report/AttestMeaningful User
Navigating Stage One
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Meaningful Facts
ARRA HITECH EHR Incentive Program
Program to Provide Monetary Incentives for the “Meaningful Use” of Healthcare Technology
Final Rule Published July 28, 2010(http://edocket.access.gpo.gov/2010/pdf/2010-17207.pdf)
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Meaningful Facts
Healthcare Transformation
Quality
Efficiency
Information Exchange
Safety Improved Health of
Americans
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Implementation Approach
Stage One
Stage TwoStage ThreeStage One
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Stage One at a GlanceMenu Criteria Core Criteria
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Core Set Criteria Patient Demographics Vital Signs Problem List Medication List Medication Allergy List Smoking Status Clinical Summaries or
Discharge Summary Electronic Copies of
Patient Health Information Electronic Prescriptions
(eRx)
CPOE (Medications) Drug-Drug, Drug-Allergy
Interactions Electronically Exchange
Key Clinical Info Among Providers and Patient-Authorized Entities
Clinical Decision Support
Privacy & Security Clinical Quality
Reporting
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Patient Demographics
Record patient demographics (sex, race, ethnicity, date of birth,
preferred language, and in the case of hospitals, date and preliminary
cause of death in the event of mortality)
•Measure: •More than 50% of patient’s demographic data recorded as
structured data•Denominator:•The number of unique patients seen by the EP or admitted
as IP or through ER during the EHR reporting period•Numerator: •The number of patients in the denominator who have all the
elements of demographics (or a specific exclusion if the patient declines to provide one or more elements) recorded as structured data
Begins on pg 44340 of Federal RegisterHelpful Link: http://www.whitehouse.gov/omb/inforeg_statpolicy/#dr
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Vital Signs
Record vital signs and chart changes (height, weight, blood
pressure, body-mass-index, growth charts for children)
•Measure: •More than 50% of patients 2 years of age or older have
height, weight, and blood pressure recorded as structured data
•Denominator:•The number of unique patients age 2 or older seen by the EP
or admitted as IP or through ER during the EHR reporting period
•Numerator: •The number of patients in the denominator who have at
least one entry of their height, weight and blood pressure recorded as structured data
Begins on pg 44342 of Federal Register
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Problem List
Maintain up-to-date problem list of current
and active diagnosis
•Measure: •More than 80% of patients have at least one entry recorded
as structured data•Denominator:•The number of unique patients seen by the EP or admitted
as IP or through ER during the EHR reporting period•Numerator: •The 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
Begins on pg 44336 of Federal Register
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Medication List
Maintain active medication list
•Measure: •More than 80% of patients have at least one entry recorded
as structured data•Denominator:•The number of unique patients seen by the EP or admitted
as IP or through ER during the EHR reporting period•Numerator: •The 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
Begins on pg 44338 of Federal Register
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Medication Allergy List
Maintain active medication allergy
list
•Measure: •More than 80% of patients have at least one entry recorded
as structured data•Denominator:•The number of unique patients seen by the EP or admitted
as IP or through ER during the EHR reporting period•Numerator: •The number of 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
Begins on pg 44339 of Federal Register
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Smoking Status
Record smoking status for patients 13 years of age or older
•Measure: •More than 50% of patients 13 years of age or older
have smoking status recorded as structured data•Denominator:•The number of unique patients seen by the EP or
admitted as IP or through ER during the EHR reporting period
•Numerator: •The number of patients in the denominator with
smoking status recorded as structured data.
Begins on pg 44344 of Federal RegisterHelpful Link: http://www.cdc.gov/nchs/nhis/tobacco/tobacco_recodes.htm.
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Office Visit Summaries / Discharge Instructions
For individual professionals, provide patients with clinical summaries for
each office visit; for hospitals, provide an electronic copy of hospital
discharge instructions on request
•Measure: •Summaries provided to patients for more than 50% of all office
visits within 3 business days; more than 50% of all patients who are discharged from the IP department or ER department of hospitals and who request an electronic copy of their discharge instructions are provided with it
•Denominator:•The number of unique patients seen by the EP or admitted as IP
or through ER during the EHR reporting period•Numerator: •The number of patients in the denominator who are provided a
clinical summary of their visit within three business days
Begins on pg 44358 of Federal Register
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Electronic Copies of Patient Health Information
On request, provide patients with an electronic copy of their health
information (including diagnostic test results, problem list, medication lists,
medication allergies, and for hospitals, discharge summary and procedures)
•Measure: •More than 50% of requesting patients receive an electronic
copy within 3 business days•Denominator:•The number of patients of the EP or hospital who request an
electronic copy of their electronic health information within 3 business days prior to the end of the EHR reporting period
•Numerator: •The number of patients in the denominator who receive an
electronic copy of their electronic health information within 3 business days
Begins on pg 44353 of Federal Register
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CPOE (Medications)
Computer provided order entry (CPOE)
for medication orders
•Measure: •More than 30% of patients with at least one medication in
their list have at least one medication ordered through CPOE•Denominator:•The number of unique patients with at least one medication
in their medication list seen by the EP or admitted as IP or through ER during the EHR reporting period
•Numerator: •The number of patients in the denominator that have at
least one mediation order entered using CPOE
Begins on pg 44332 of Federal Register
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Electronic Prescriptions (eRx)
Generate and transmit permissible prescriptions electronically (does not
apply to hospitals)
•Measure: •More than 40% are transmitted electronically using certified
EHR technology•Denominator:•The number of prescriptions written (for those patients
whose records are maintained using certified EHR technology) for drugs requiring a prescription in order to be dispensed other than controlled substances during the reporting period
•Numerator: •The number of prescriptions in the denominator generated
and transmitted electronically
Begins on pg 44337 of Federal RegisterHelpful Link: http://www.deadiversion.usdoj.gov/schedules/orangebook/e_cs_sched.pdfObjective applies to EPs only.
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Electronic Prescriptions (eRx)
200 Prescriptions
80% (or percentage
allowable by law)
160 prescriptions allowable by
law
160 Prescriptions
40% sent electronically
64 prescriptions
sent electronically
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Drug-Drug, Drug-Allergy Interactions
Implement drug-drug and drug-allergy
interaction checks
•Measure: •Functionality is enabled for these
checks for the entire reporting period•Denominator:•N/A (Attestation)•Numerator: •N/A (Attestation)
Begins on pg 44334 of Federal Register
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Electronically Exchange Key Clinical Info Among Providers and Patient-Authorized Entities
Implement capability to electronically exchange key clinical information among
providers and patient-authorized entities
•Measure: •Perform at least one test of EHR's
capacity to electronically exchange information
•Denominator:•N/A (Attestation)•Numerator: •N/A (Attestation)
Begins on pg 44360 of Federal Register
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Clinical Decision Support (CDS)
EPs: Implement one CDS rule relevant to specialty or high clinical priority along with
the ability to track compliance.EHs/CAHs: Implement one CDS rule
related o a high priority hospital condition along with the ability to track compliance
•Measure: •One clinical decision support rule
implemented•Denominator:•N/A (Attestation)•Numerator: •N/A (Attestation)
Begins on pg 44350 of Federal Register
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Privacy & Security
Implement systems to protect privacy and
security of patient data in the EHR
•Measure: •Conduct or review a security risk analysis,
implement security updates as necessary, and correct identified security deficiencies
•Denominator:•N/A (Attestation)•Numerator: •N/A (Attestation)
Begins on pg 44368 of Federal RegisterHelpful Link: http://edocket.access.gpo.gov/cfr_2003/octqtr/pdf/45cfr164.308.pdf
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Clinical Quality Measures
Report clinical quality measures to CMS or states
•Measure: •EPs report on a minimum of three
Core Clinical Quality Measures and three optional Clinical Quality Measures (from 44 available options). EHs, CAHs, MA Hospitals report on 15 hospital specific measures
Begins on pg 44380 of Federal RegisterHelpful Link: http://www.ama-assn.org/ama1/pub/upload/mm/399/ehr-clinical-quality-measures.pdf
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Menu Set Criteria Drug Formulary Checks Clinical Laboratory Test Results as Structured Data Report Patients By Condition Patient-Specific Education Medication Reconciliation Summary of Care Records for Transitions of Care Submit Immunization Data Syndromic Surveillance Reporting Advanced Directives Indicator (EH or CAH ONLY) Lab Results Reports (EH or CAH ONLY) Patient Reminders for Preventative Care (EP OPTION ONLY) Provide Patients Timely Electronic Access to Health
Information (EP OPTION ONLY)
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Drug Formulary Checks
Implement drug formulary checks
•Measure: •Drug formulary check system is
implemented and has access to at least one internal or external drug formulary for the entire reporting period
•Denominator:•N/A (Attestation)•Numerator: •N/A (Attestation)
Begins on pg 44334 of Federal Register
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Clinical Laboratory Test Results as Structured Data
Incorporate clinical laboratory test results
into EHRs as structured data
•Measure: •More than 40% of clinical laboratory test results whose results are in
positive/negative or numerical format are incorporated into EHRs as structured data
•Denominator:•The number of lab tests ordered during the EHR reporting period by
the EP or authorized providers of the eligible hospital or CAH for patients admitted to and EH or CAH's IP or ER dept whose results are expressed in a positive or negative affirmation or as numbers
•Numerator: •The 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
Begins on pg 44346 of Federal Register
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Report Patients By Condition
Generate lists of patients by specific conditions to use for
quality improvement, reduction of disparities,
research or outreach
•Measure: •Generate at least one listing of
patients with a specific condition•Denominator:•N/A (Attestation)•Numerator: •N/A (Attestation)
Begins on pg 44325 of Federal Register
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Patient-Specific Education
Use EHR technology to identify patient-specific education
resources and provide those to the patient as appropriate
•Measure: •More than 10% of patients are provided with
patient-specific education resources•Denominator:•The number of unique patients seen by the EP or
admitted as IP or through ER during the EHR reporting period
•Numerator: •The number of patients in the denominator who are
provided patient education specific resources
Begins on pg 44359 of Federal Register
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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
should perform medication reconciliation
•Measure: •Medication reconciliation is performed for more
than 50% of transitions of care•Denominator:•The number of transitions of care during the EHR
reporting period for which the EP or hospital's IP or ER dept was the receiving party of the transition
•Numerator: •The number of transitions of care in the
denominator where medication reconciliation was performed
Begins on pg 44362 of Federal Register
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Summary of Care Records for Transitions of Care
Provide summary of care record for patients referred or transitioned to another
provider or setting
•Measure: •Summary of care record is provided for more than
50% of patient transitions or referrals•Denominator:•The number of transitions of care during the EHR
reporting period for which the EP or hospital's IP or ER dept was the transferring or referring provider
•Numerator: •The number of transitions of care and referrals in
the denominator where a summary of care record was provided
Begins on pg 44363 of Federal Register
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Submit Immunization Data
Submit electronic immunization data to
registries or immunization information systems (IIS)
•Measure: •Perform at least one test of data submission
and follow-up submission (where registries can accept electronic submission)
•Denominator:•N/A (Attestation)•Numerator: •N/A (Attestation)
Begins on pg 44325 of Federal RegisterHelpful Link: : http://www.cdc.gov/vaccines/programs/iis/stds/cvx.htm Helpful Link: http://www.cdc.gov/vaccines/programs/iis/contacts-state-iis.htm#a
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Syndromic Surveillance Reporting
Submit electronic syndromic surveillance data to public health
agencies
•Measure: •Perform at least one test of data submission
and follow-up submission (where public health agencies can accept electronic data)
•Denominator:•N/A (Attestation)•Numerator: •N/A (Attestation)
Begins on pg 44367 of Federal Register
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Advanced Directive Indicator
Record advanced directives for patients
65 years of age or older
•Measure: •More than 50% of patients 65 years of age or older
have an indication of an advanced directive status recorded
•Denominator:•The number of unique patients admitted as IP or
through ER during the EHR reporting period•Numerator: •The number of patients in the denominator who
have an indication of an advanced directive status record
Begins on pg 44345 of Federal RegisterApplies to EHs, CAH, and MA Hospitals Only
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Lab Results Reports
Submit of electronic data on reportable
laboratory results to public health agencies
•Measure: •Perform at least one test of data submission
and follow-up submission (where public health agencies can accept electronic data)
•Denominator:•N/A (Attestation)•Numerator: •N/A (Attestation)
Begins on pg 44366 of Federal RegisterApplies to EHs, CAH, and MA Hospitals Only
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Preventative Care Reminders
Send Reminders to patients (per patient preference) for preventative and follow up
care
•Measure: •More than 20% of patients 65 years of age or older of 5
years of age or younger are sent appropriate reminders•Denominator:•The number of unique patients (for those patients
whose records are maintained using certified EHR technology) ages 65 and older or 5 years and younger
•Numerator: •The number of patients in the denominator who were
sent the appropriate reminder
Begins on pg 44357 of Federal RegisterApplies to EPs Only
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Provide Patients Timely Access to Health Information
Provide patients with timely electronic access to their health
information (including laboratory results, problem list, medication
list, medication allergies)
•Measure: •More than 10% of patients are provided electronic access to
information within 4 days of its being updated in the EHR (subject to the EP's discretion to withhold certain information)
•Denominator:•The number of unique patients seen by the EP during the EHR
reporting period•Numerator: •The 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
Begins on pg 170 of Federal RegisterApplies to EPs Only
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Next Steps
Complete Assessments
Certi
fied
Tech
nolo
gyPurchase?Review Vendor Plan?
Chan
ge M
anag
emen
tGauge EHR Readiness
Elig
ibili
tySelect ProgramEnroll
Core
Set
Obj
ectiv
esIdentify GapsCreate Implementation Plan
Men
u Se
t Obj
ectiv
esSelect five criteriaIdentify GapsCreate Implementation Plan
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MMIC Meaningful Use Resources
Visit us at: www.mmicgroup.com
Join us for future MU webinars– Meaningful Evaluation: Assessments for MU Success • Tuesday, September 21, 2010
– Building and Implementing your MU Strategy • Tuesday, October 12, 2010
Review MU reference material– MU Program Overview and FAQs– MU Core Criteria FAQs– MU Menu Criteria FAQs
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MMIC Meaningful Use Services
Contact MMIC Health IT for:– EHR Incentive Program Eligibility Assessment– EHR Gap Analysis and Summary Report Services– Meaningful Use Roadmap and Project Planning
Contact Information:– Beth Schultz, Implementation Manager – [email protected]– 952-838-6854
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Helpful Websites
http://www.cms.gov/EHRIncentivePrograms/
http://healthit.hhs.gov
Additional Questions/Support? Contact: [email protected]
Thank you