Achieving Meaningful Use: Ready? Set? GO! Anna Twomey, SME Healthcare Solutions Architect
Dec 23, 2015
Achieving Meaningful Use:Ready? Set? GO!
Anna Twomey, SME
Healthcare Solutions Architect
Meaningful Use Agenda
MU BackgroundMU Phase One Criteria BreakdownMU Technology SupportMU Case Study Clinical (EPs) SettingMU Case Study Hospital (Admissions) SettingQuestions and Wrap Up
Meaningful Use Overview
The stimulus plan incorporates programs with a total spending amount of $787 billion.
Of this amount, approximately $30 billion is allocated to several healthcare programs, including: IT adoption. Health information exchange. Research and development. Standards development. Education and outreach.
Though the federal government has published funding programs and incentive amounts, it has not yet published the process for accessing those funds.
The American Recovery and Reinvestment Act of2009 (ARRA) offers funding for several healthcareprograms with a total of approximately $30 billion.
Meaningful Use - Definition and Timing
The Medicare incentives are offered to nonhospital-based physicians who are using EHRs in a meaningful way. To show that physicians are “meaningful users,” they need to:
Use an eligible EHR system. Use electronic prescription. Participate in the electronic exchange of health information to improve the
quality of care. Measure and report clinical quality measures.
The secretary’s calculation of a provider’s incentive payment amount and determination of whether a provider is a meaningful EHR user is non-reviewable.
ONC, in conjunction with the secretary of HHS, will govern the standards and policies of ARRA.
The Health Information Technology for Economic and Clinical Health(HITECH) Act contains funding through a Medicare payment incentives
and penalties program ($17.2 billion) and the Office of the NationalCoordinator for Health Information Technology (ONC) ($2 billion).
Meaningful Use Key Terms and Conditions
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By 2011, the definition implies an EHR actively used at the point of care withCPOE (which may drop to fax), alerts/reminders, medicines, vitals,
demographics, ADR, coded problem list, e-prescribing, and quality measures.
Meaningful Use – Medicare Stimulus Payments
Qualified physicians who adopt EHR technology by 2011 will receive amaximum payment of $44,000. Physicians who adopt to EHR technology in orafter 2015 will receive penalties up to 3% of their Medicare reimbursements.
Amount Physicians Receive Each Year(assuming meaningful use is demonstrated by the beginning of that year)
Year Physicians First File 2011 2012 2013 2014 2015 2016 2017 Total
2011 $18,000 $12,000 $8,000 $4,000 $2,000 $0 $0 $44,000
2012 $0 $18,000 $12,000 $8,000 $4,000 $2,000 $0 $44,000
2013 $0 $0 $15,000 $12,000 $8,000 $4,000 $0 $39,000
2014 $0 $0 $0 $12,000 $12,000 $4,000 $0 $24,000
2015 and After(penalty up to amaximum of 3%) $0 $0 $0 $0 -1% -1% -1% -3%
Additionally, the payments will be increased by 10% if the physicians are working inareas certified by the secretary of HHS as “health professional shortage areas.”
Meaningful Use – Medicaid Stimulus PaymentsMedicaid payments to physicians are limited to $65,000 over 5 years. The first-year payment is capped at $25,000, and these costs should occur no
later than 2016. States may make payments to Medicaid providers to encourage adoption
and use of certified EHR technology. Providers must demonstrate a meaningful use of EHR. A minimum of 30% (20% for pediatricians) of patients should be covered by
Medicaid.
Payments are made to physicians based on average costs determined by ONC.
The payment schedule is as follows:
First-year costs should occur no later than 2016, and no payments will be made after 2021.
No duplicative Medicare and Medicaid payments will be made.
Year Physicians First File First Year
Second Year
Third Year
Fourth Year
Fifth Year Total
2011 til 2016 $25,000 $10,000 $10,000 $10,000 $10,000 $65,000
So.. Phase One Breakdown…
Phase One Includes: CPOE used for orders for 80% of EPs and 10% for Hospitals 75% of prescriptions are transmitted electronically. 80% of patients seen or admitted have at least one structured
medication entry (or “None”). 80% of hospitals and EPs maintain an up-to-date problem list of
current and active diagnoses based on ICD9 or SNOMED CT ® Maintain active medication list for all patients (80% for EPs and 80%
for Hospital admissions) 80% of hospitals and EPs maintain active medication allergy lists for
patient clientele and admissions. Etc.
Phase OneProviders have through 2012 to meet Stage 1 criteria, after which the criteria
become more stringent.
Technology Breakdown
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Reporting
Query & Analysis
Dashboards
Information Delivery
Performance Management
Enterprise Search
Visualization & Mapping
Mobile Applications App/Dev, Portals
& Mash-ups Predictive Analytics
MS Office & e-Publishing
Front office
Extended BI
Core BI
Extensions to the WebFOCUS platform allow you to build more application types at a lower cost
Business to Business
Data Warehouse & ETL
Master Data Management
Data Quality Business Activity MonitoringBack office
Achieving Meaningful Use of Health Data means…
Data Capture
Data Sharing Across Platforms
Advanced Clinical Process
Achieving Cost Effective Treatments
Improving Outcomes
2009
2011
2013
2015
P4P
Chronic Disease Mgt.
Physician Alignment
Patient Flow
Reduce Readmits
Whole Patient
EMR/EHR/PHR/HIE
Cost Cutting & Consolidation
Comparative Effectiveness
Clinical Decision Support
Meaningful Use Data Exchange…
1) Patient Centric – One patient, One record2) Usable – Usability must be second nature
technology (3 click max)
3) Interoperable – Agnostic to any data format or message exchange methodology
4) No Borders – GRID technology that spans national and international boundaries (use what we have… internet technologies)
5) Affordable - Affordability is the key to adoption (hosted SaaS/ASP model)
Typical Healthcare Environment
AdministrativeApplications
Revenue Cycle
ApplicationsClinical
ApplicationsOR/MRI/ERApplications
HR Schedule
Applications
PhysicianPractice
Applications
Other Applications“External”
• Accounting• AP• Fixed assets• Purchasing• Inventory• HR• Benefits• Payroll• EDI
• Pre-Auth• MPI• Registration• Patient Charge• Charge Master• Billing• Collections• Claims
Scrubber• Grouper• Contract
Negotiations
• EMR• Order Entry• ED• Pharmacy• Laboratory• Radiology• Pathology• PACS• Cath Lab
• PhysicianPreferenceCards
• Requisition• Inventory• Implant Log• Scheduling
• Time and Attendance
• Absence Management
• Licensing• Credentials• Productivity• Accountable
• Scheduling• Charge
Capture• Billing• Collection• Practice Plan• Accounting• Comp Plans• Contract
Negotiations
• JACHO• CMS (MMIS) • Infectious
Disease Trak• Chronic
Disease Trak• Fraud
Detection• DHS –
Security HIPAABioHazard
Integration to Different Applications and Systems
Data capture across all systems as associated by patient encounter, (CCR/CCD)
• Lawson• Oracle
(PSFT)• Eclipsys TSI• GEAC• SAP• McKesson• D&B
• McKesson• Siemens• Kauffman Hall• Meditech• Avega
• McKesson• Cerner• Epic• GE (IDX)• Siemens• Meditech• Eclipsys
• McKesson• Cerner• Orbit• OR SOS• OR MIS
• McKesson (PerSe)
• Kronos• API• MEDITECH• Oracle HR
• McKesson (PerSe)
• Cerner• Epic• Proprietary
• Gov Owned• City• State• County
Custom applications/solutions for every reporting need within your enterprise
Typical Healthcare Environment - Foundation
AdministrativeApplications
Revenue Cycle
ApplicationsClinical
ApplicationsOR/MRI/ERApplications
HR Schedule
Applications
PhysicianPractice
Applications
Other Applications“External”
• Accounting• AP• Fixed assets• Purchasing• Inventory• HR• Benefits• Payroll• EDI
• Pre-Auth• MPI• Registration• Patient Charge• Charge Master• Billing• Collections• Claims Scrubber• Grouper• Contract
Negotiations
• EMR• Order Entry• ED• Pharmacy• Laboratory• Radiology• Pathology• PACS• Cath Lab
• PhysicianPreferenceCards
• Requisition• Inventory• Implant Log• Scheduling
• Time and Attendance
• Absence Management
• Licensing• Credentials• Productivity• Accountable
• Scheduling• Charge
Capture• Billing• Collection• Practice Plan• Accounting• Comp Plans• Contract
Negotiations
• JACHO• CMS (MMIS) • Infectious
Disease Trak• Chronic
Disease Trak• Fraud
Detection• DHS –
Security HIPAABioHazard
Integration to Different Applications and Systems• Lawson• Oracle (PSFT)• Eclipsys TSI• GEAC• SAP• McKesson• D&B
• McKesson• Siemens• Kauffman Hall• Meditech• Avega
• McKesson• Cerner• Epic• GE (IDX)• Siemens• Meditech• Eclipsys
• McKesson• Cerner• Orbit• OR SOS• OR MIS
• McKesson (PerSe)
• Kronos• API• MEDITECH• Oracle HR
• Cerner• Epic• McKesson
(PerSe)
• Gov Owned• City• State• County
350+
Information Management
Integration Assembly
Adapters
NHINHL7
SNOMEDLOINC
HIPAA
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iHIE Integration Power
Information Management
Integration Assembly
Adapters
Applications
Transactions
Databases
Messages
DocumentsServices
The ability to integrate, transform and migrate those assets for all business requirements.
More than 350 packaged adapters, providing connectivity to all enterprise information assets.
Providing support for all 7 styles of data integration required for business intelligence.
Copyright 2007, Information Builders. Slide 15
iHIE Adapters
Industry leading provider All enterprise assets
85 databases 150 real-time sources
Applications Messages Transactions Documents Services
Replaces manual programming Completely reusable
Information Management
Integration Assembly
Adapters
Applications
Transactions
Databases
Messages
DocumentsServices
Copyright 2007, Information Builders. Slide 16
iHIE SOA Middleware
iWay Software offers the widest reaching integration solutions at the lowest cost !
AdaptersService Composition Registry
Designer
Service Consumption
ProcessManager
Trading Partner
EnterpriseIndex
DataMigrator
SecurityOption
MFT
Governance
Explorer Transformer
Service Enablement
Universal Adapter Suite
Streamlines business processes Infrastructure augmentation Infrastructure standardization Multi-purpose integration
SOA, EAI, B2B, etc. Specific industry solutions
Financial services, government, supply chain, healthcare, etc.
Minimizes technology shifts, new business initiatives and mergers
SOA Governance
Adapters
Information Management
Orchestration of Services
__________
Listeners / Responses
Hospitals
Clinics
Labs
Ambulatory
Physician
Orders
ReferralNurse
Home Health
PH Investigator
Nurse Managers
ME \ Death \ Immunization
Therapy
Orc
hes
trat
ion
of
Ser
vice
s
ETL
&
DQS
DataCapture
ReportCard
Analytics
QualityTracking
DecisionSupport
Copyright 2007, Information Builders. Slide 18
Impacting the Practitioners
Questions?