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ELECTRONIC HEALTH RECORDS
Meaningful Use Overview
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TRANSFORMING HEALTH CAREEHRs and the
HIT Regional Extension Center
2Confidential Proprietary to eQHealth Solutions
eQHEALTH Solutions, Inc.
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Selected as the Mississippi Regional Extension
Center
Offering health information technology consulting
services to Mississippi physicians in small group
practices that participate in Medicare or Medicaid.
eQHealth SolutionsFounded in 1986
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Regional Extension Centers
Offer Technical Assistance Guidance and information on best practice to support and
accelerate health care providers efforts to become meaningfulusers of Electronic Health Records
60 Regional Extension Centers, each serving a defined geographicarea.
Mississippi to work with 1000 providers to adopt, implement and useEHR systems in a meaningful way..
Regional Extension Center
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Since 2006, we have helped physician offices adoptEHR to their practices.
Knowledgeable of all components of certified health
information systems.
Knowledgeable about federal funding opportunities.
Work through all stages of the transformation from paperrecords to digital.
eQHealth Solutions and HealthInformation Technology
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ARRA has major funding allocated for HITimplementation under the following sections:
Section 4101: Medicare incentives for eligible professionals. Section 4102: Medicare incentives for hospitals. Section 4103: Implementation funding. Section 4201: Medicaid provider HIT adoption and operation
payments.
What is ARRA?American Recovery and Reinvestment Act (ARRA) 2009
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ARRA Funding
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Medicare
Up to $44,000 over thefirst five years.
MDs in a health provider
shortage area eligible for
10% more.
Medicaid
If 30%+ patients in apractice are Medicaid,practice is eligible for up
to $63,750 over the firstfive years. (20% forpediatricians)
Types of Incentives
Note: Physicians delivering care entirely in a hospital are ineligible.(anesthesiologist, pathologist & ED MDs)
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Medicare First Calendar Year in which the EP receives an IncentivePayment
CalendarYear
2011 2012 2013 2014 2015 &later
2011 $18,000
2012 $12,000 $18,000
2013 $8,000 $12,000 $15,000
2014 $4,000 $8,000 $12,000 $12,000
2015 $2,000 $4,000 $8,000 8,000 $0
2016 $2000 $4,000 $4,000 $0
Total $44,000 $44,000 $39,000 $24,000 $0
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Medicaid First Calendar Year in which the EP receives anIncentive Payment
Calendar
Year
2011 2012 2013 2014 2015 2016
2011 $21,250
2012 $8,500 $21,250
2013 $8,500 $8,500 $21,500
2014 $8,500 $8,500 $8,500 $21,500
2015 $8,500 $8,500 $8,500 $8,500 $21,500
2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,000
2017 $8,500 $8,500 $8,500 $8,500 $8,500
2018 $8,500 $8,500 $8,500 $8,500
2019 $8,500 $8,500 $8,500
2020 $8,500 $8,500
2021 $8,500
Total $63,750 $63,750 $63,750 $63,750 $63,750 $63,750
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Meet requirements in 2011 or 2012
$15,000 - $18,000 payments yr 1, $44,000 total by yr4
Declining payments through year 5
The later you meet requirements, the less you get No incentives after 2016 or for first adopters after 2014
Provider payments increase 10% in HPSA
Payment reduction if not adopted by 2015
Excludes hospital based eligible professionals Special rules for Medicare Advantage
Medicare Providers- Meaningful Use
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Medicare FFS Eligible professionals (EPs)
Eligible hospitals and critical access hospitals (CAHs)
Medicare Advantage (MA) MA EPs
MA-affiliated eligible hospital
Medicaid EPs
Eligible hospitals
Eligible Providers
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Eligible Professionals (EPs)
Doctor of Medicine or Osteopathy
Doctor of Dental Surgery or Dental Medicine
Doctor of Podiatric Medicine
Doctor of Optometry
Chiropractor
Eligible Hospitals
Acute Care Hospitals
Critical Access Hospitals (CAHs)
Medicare Eligible Providers
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Must demonstrate meaningful useby 2014.
Beginning 2015, Medicare Fee Schedules will bereduced by 1%.
Additional decreases to follow in 2016 and 2017 to 97%of the regular fee schedule.
May be further reduced to 95% if the Secretarydetermines total adoption is below 75% in 2018.
What happens if one doesnt adopt EHR?Disincentives or penalties
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Eligible Professionals (EPs)
Physicians (Peds have special eligibility & payment rules)
Nurse Practitioners (NPs)
Certified Nurse-Midwives (CNMs)
Dentists
Physician Assistants (FQHC or RHC that is directed by a PA)
Eligible Hospitals
Acute Care Hospitals
Childrens Hospitals
Medicaid Eligible Providers
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The Medicaid EHR Incentive Program starts in 2011 andends in 2021
The latest that a Medicaid provider can initiate theprogram is 2016
A Medicaid provider can initiate the program under theAdopt, Implement and Upgrade bar but in their 2nd andsubsequent years, they must meet MU at the stage thatis in place, per rule-making (Stage 3 by 2015).
Medicaid Providers- Meaningful Use
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Medicaid Only: Adopt/Implement/ Upgrade (A/I/U)
First participation year only for Medicaid providers
AdoptedAcquired and Installed
Ex: Evidence of installation prior to incentive
ImplementedCommenced Utilization of Ex: Staff training, data entry of patient demographic information into
EHR
UpgradedExpanded
Upgraded to certified EHR technology or added new functionality to
meet the definition of certified EHR technology Must use certified EHR technology
No EHR reporting period
CMS EHR Incentives Program -Medicaid
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Eligibility: Practices Predominantly & Needy
Individuals
EP practicing predominantly in FQHC/RHC providingcare to needy individuals
Practicing predominantly is when FQHC/RHC is
the clinical location for over 50% of totalencounters over a period of 6 months in the mostrecent calendar year
Needy individuals: Medicaid or CHIP enrollees;
Patients furnished uncompensated care by theprovider; or furnished services at either no cost or
on a sliding scale.
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Notable Differences Between theMedicare & Medicaid EHR Programs
Medicare MedicaidFederal Government will implement (availablenationally)
Voluntary for States to implement (may not be anoption in every State)
Fee schedule reductions begin in 2015 forproviders that do not demonstrate MeaningfulUse
No Medicaid fee schedule reductions (butMedicare penalties still apply)
Must demonstrate meaningful use in Year 1 Adopt/Implement/Upgrade option for 1st
participation year
Maximum incentive is $44,000 for EPs (bonus forEPs in HPSAs)
Maximum incentive is $63,750 for EPs
MU definition will be common for Medicare States can adopt a more rigorous definition (basedon common definition) though hospitals only haveto meet the Medicare definition if they participatein both
Last year an EP may initiate program is 2014; Last
payment in program is 2016. Paymentadjustments begin in 2015
Last year an EP may initiate program is 2016; Last
payment in program is 2021
Payment years must be consecutive Payment years neednt be consecutive for EPs butmust be for EHs after 2016
Only physicians, subsection (d) hospitals andCAHs
5 types of EPs, acute care hospitals (includingCAHs) and childrens hospitals
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Adapted from: CMS presentation July 20, 2010
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Use of a certified EHR product with e-Prescribingcapability.
EHR technology is connected for the electronicexchange of patient health information.
Complies with submission of reports on clinical quality
measures.
What does it take to receive the funding?Meaningful Use Demonstration
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Medicare
Up to $11 million using $2million as base paymentand a payment of $2,000
for each dischargebetween the 1,150 and23,000 dischargesannually.
Medicaid
For those with more than10% Medicaid patients,incentives to bedetermined by the samecalculation as Medicare,but weighted for the firstfour years, rather thanfollowing descending
payments.
What about the hospitals?
C
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Conceptual Approach toMeaningful Use
DataCaptureandSharing
AdvancedClinical
Processes
Improved
Outcomes
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Stage 1
Capture data in coded format.
Stage 2
Expand exchange of information in the most structured
format possible.
Stage 3
Focus on CDS for high priority conditions, patient
self management, and access to comprehensive
data.
A Phased, Incremental Approach
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Stage 1 Meaningful Use Criteria
25 objectives and measures for eligible professionals (EP)
15 are required, up to 5 of the remaining 10 may be
differed to Stage 2 8 require attestation; 17 require data submission
In 2012, clinical quality metrics will be reported
electronically
To meet certain objectives/measures, 80% of patients seenduring the reporting period must have records in thecertified EHR technology
Key Provisions
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Patient Summary Record
Problem List - ICD9/SNOMED, ICD10/SNOMED
Medications - RxNorm mapping, RxNorm
Allergies - None, UNII
Vital Signs - None, CDA Template
Unit of Measure, None, UCUM
EHR Usage: Captured Data
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Ali i C ifi i d
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Aligning Certification andStandards
Source: Farzad Mostashari, ONC Presentation to HIT Policy Committee January 13, 2010
Meaningful UseObjectives
E-Rx
Provide PatientSummary Record
Electronically
Submit Data toImmunizationRegistries
Certification Criteria
Capability to E-Rx must
be included
Capability to
electronically transmit apatient summary record
must be included
Capability to
electronically transmitimmunization data mustbe included
Standards
NCPDP SCRIPT
8.1/10.6 must be used
Continuity of CareDocument (CCD) orContinuity of Care Record(CCR) must be used plusvocabulary standards
HL7 2.5.1 or HL7 2.3.1
andCVX Code Set
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The Stage 1 meaningful use criteria focus on Electronically capturing health information in a
structured format
Using that information to track key clinical
conditions and communicating that informationfor care coordination purposes
Implementing clinical decision support tools to
facilitate disease and medication management
Using EHRs to engage patients and families and
reporting clinical quality measures and public
health information.
Progression of Stages
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Stage 1 (2011 and 2012) To meet certain objectives/measures, 80% of patients must have
records in the certified EHR technology
EPs have to report on 20 of 25 MU objectives
Eligible hospitals have to report on 19 of 24 MU objectives
Reporting Period90 days for first year; one year subsequently
Meaningful Use: Basic Overview ofFinal Rule
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Core Criteria
Providers must complete each of the core criteriaunless unable to due to scope of practice,population served or number in the denominator.For example:
Chiropractor and ePrescribing CAH and no patients have requested electronic access
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Meaningful Use Criteria
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Organized according to the Health OutcomesPolicy Priorities:1
Improving quality, safety, efficiency, and reducing
health disparities
Engage patients and families in their health care Improve care coordination
Improve population and public health
Ensure adequate privacy and security protections
for personal health information Divided into Core Criteria and Menu Criteria
Meaningful Use CriteriaHow were the core objectives selected?
30Confidential Proprietary to eQHealth Solutions
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EPs15 Core Objectives
1. Computerized physician order entry (CPOE)2. E-Prescribing (eRx)3. Report ambulatory clinical quality measures to CMS/States4. Implement one clinical decision support rule
5. Provide patients with an electronic copy of their health information, upon request6. Provide clinical summaries for patients for each office visit7. Drug-drug and drug-allergy interaction checks8. Record demographics9. Maintain an up-to-date problem list of current and active diagnoses10. Maintain active medication list11. Maintain active medication allergy list12. Record and chart changes in vital signs13. Record smoking status for patients 13 years or older14. Capability to exchange key clinical information among providers of care and patient-
authorized entities electronically15. Protect electronic health information
Meaningful Use: Core Set ObjectivesEligible Professionals
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C
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Core: Improve quality, safety, efficiency andreduce health disparities
Objective Ambulatory Measure Hospital Measure (ED or IP)
CPOE3
(Lic HC Prof)>30% of patients with oneCPOE med order (n/d EHR)1
>30% of patients with oneCPOE med order (n/d EHR) 1
Drug (D-A, D-D) Interactions
Turned on (y/n) Turned on (y/n)
ePrescribe3 >40% of permissible scripts(n/d EHR)1
-
Demographics >80% of patients seen:language, gender, race,ethnicity, DOB (n/d all)2
>80% of patients seen:language, gender, race,ethnicity, DOB, date andcause of death (n/d all)2
Problem List >80% of patients seen atleast one or none as
structured data(n/d all)2
>80% of patients seen atleast one or none as
structured data(n/d all)2
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Core: Improve quality, safety,efficiency and reduce health
disparities cont.Objective Ambulatory Measure Hospital Measure (ED or IP)
Med List >80% of patients seen atleast one or none as
structured data(n/d all)2
>80% of patients seen atleast one or none as
structured data(n/d all)2
Med Allergies >80% of patients seen atleast one or none as
structured data(n/d all)2
>80% of patients seen atleast one or none as
structured data(n/d all)2
Vitals >50% of patients 2yo
seen: height, weight, BP,BMI, & for age 2-20: growthcharts w/BMI (n/d EHR)1
>50% of patients 2yo seen:
height, weight, BP, BMI, & forage 2-20: growth chartsw/BMI (n/d EHR)1
Core Impro e q alit safet
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Core: Improve quality, safety,efficiency and reduce health
disparities cont.Objective Ambulatory Measure Hospital Measure (ED or IP)
Smoking >50% of patients 13yo seen,record status as structured data(n/d EHR)1
>50% of patients 13yoseen, record status asstructured data(n/d EHR)1
DecisionSupport
1 CDS rule relevant to thespecialty specific quality metricwith the ability to track
compliance(y/n)
1 CDS rule relevant to a highpriority hospital condition withthe ability to track compliance
(y/n)
Quality
Reporting
Report ambulatory quality
measures to CMS or states2011: Attestnumerator/denominator2012: Electronic submission
Report hospital clinical quality
measures to CMS or states2011: Attestnumerator/denominator2012: Electronic submission
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Clinical Decision Support System
CDSS are interactive computer programs, which are designedto assist physicians and other health professionals withdecision making tasks. (example - CPOE, Diagnosis)
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Core: Engage Patients and Familiesin Their Health Care
Provide patients and families with timely access to data,knowledge, and tools to make informed decisions and tomanage their health
Objective Ambulatory Measure Hospital Measure (ED or IP)
eHealthsummary
>50% of patients whorequest it (incl: test results,prob list, med list, medallergies) w/i 3 businessdays (n/d EHR)1
>50% of patients who requestit (incl: test results, prob list,med list, med allergies, d/csummary, procedures) w/i 3business days (n/d EHR)1
eDischarge
Instructions
- >50% of patients who request
it at discharge (n/d EHR)1
Visit summaries >50% of patients seen getvisit summary within 3business days (n/d EHR)1
-
36
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Core: Improve Care Coordination
Exchange meaningful clinical information among professionalhealth care teams
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Objective Ambulatory Measure Hospital Measure (ED & IP)
Exchange withproviders1 Capability of electronicexchange of keyinformation (Ex: prob list,med list, allergies, testresults2). One test permeasurement period (y/n)
Capability of electronicexchange of key information(Ex: d/c summary,procedures prob list, med list,allergies, test results). Onetest per measurement period
(y/n)
Core: Privacy and security for
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Core: Privacy and security forpersonal health information
Ensure privacy and security protections for confidentialinformation through operating policies, procedures, andtechnologies and compliance with applicable law.
Provide transparency of data sharing to patient.Signed Business Agreement
Objective Ambulatory Measure Hospital Measure
Protect Patient
Personal HealthInformation
Conduct or review a
security risk analysis per45 CFR 164.308 (a)(1)and correct deficiencies(y/n)
Conduct or review a
security risk analysis per45 CFR 164.308 (a)(1)and correct deficiencies(y/n)
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Eligible Professionals
Drug-formulary checks Incorporate clinical lab test results as structured data Generate lists of patients by specific conditions
Send reminders to patients per patient preference for preventive/follow up care Provide patients with timely electronic access to their health information Use certified EHR technology to identify patient-specific education resources
and provide to patient, if appropriate Medication reconciliation Summary of care record for each transition of care/referrals Capability to submit electronic data to immunization registries/systems* Capability to provide electronic syndromic surveillance data to public health
agencies*
*At least 1 public health objective must be selected
Meaningful Use: Menu Set ObjectivesEligible Professionals
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Menu: Engage Patients and Familiesin Their Health Care
Provide patients and families with timely access to data,knowledge, and tools to make informed decisions and tomanage their health
Objective Ambulatory Measure Hospital Measure (ED or IP)
eResults >10% patients seen withelectronic access to lab results,prob lists, med list, medallergies w/i 4 business days ofit being updated in the EHR(n/d all)
-
Patient Ed >10% patients seen provided with ed resources identified
with the EHR(n/d all)
>10% patients seen provided withed resources identified with the
EHR(n/d all)
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Menu: Improve quality safety
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Menu: Improve quality, safety,efficiency and reduce health
disparitiesObjective Ambulatory Measure Hospital Measure (ED or IP)
Formularies Implement drug formulary checks
with at least one internal or
external formulary (y/n)
Implement drug formulary checks
with at least one internal or
external formulary (y/n)
Advanced
Directives
- >50% of 65yo admitted indicate
advanced directive recorded(n/dEHR non ED)
Lab Results >40% of labs with numeric or +/-result in chart as structured data(n/d EHR)
>40% of labs with numeric or +/-result in chart as structured data(n/d EHR)
Patient Lists3 Generate at least one pt lists basedon a specific condition (y/n)
Generate at least one pt lists basedon a specific condition (y/n)
Reminders >20% of pts 65 or 5yo sentreminders for follow up care (n/dEHR)
-
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Menu: Improve Care Coordination
Exchange meaningful clinical information among professionalhealth care teams
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Objective Ambulatory Measure Hospital Measure (ED & IP)
Medicationreconciliation >50% of transitions of care1
ora relevant encounter2 (n/dEHR)3
>50% of transitions of care1
ora relevant encounter2 (n/dEHR)3
Summarycare record
>50% of referrals andtransitions of care1 (n/d EHR)3
>50% of referrals andtransitions of care1 (n/d EHR)3
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Menu: Improve Population and PublicHealth1
Communicate with public health agencies
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Objective Ambulatory Measure Hospital Measure (ED & IP)
ImmunizationRecords2
1 test of submission to stateimmunization registry (unless no
registries are capable) withcontinued submission ifsuccessful (y/n)
1 test of submission to stateimmunization registry (unless no
registries are capable) withcontinued submission ifsuccessful (y/n)
ReportableLabs2
- 1 test of submission to publichealth (unless no ph agency iscapable) with continuedsubmission if successful (y/n)
SyndromicSurveillance2
1 test of submission to publichealth (unless no ph agency iscapable) with continuedsubmission if successful (y/n)
1 test of submission to publichealth (unless no ph agency iscapable) with continuedsubmission if successful (y/n)
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Providers and hospitals may defer up to 5 of the menucriteria until stage 2
- At least one of the criteria from population and publichealth must be included in order to qualify as ameaningful user
- States can seek CMS prior approval to require 4 MUcriteria be core for their Medicaid providers:- Generate lists of patients by specific conditions for qualityimprovement, reduction of disparities, research, oroutreach (can specify particular conditions)
- Reporting to immunization registries, reportable lab results,and syndromic surveillance (can specify for their providershow to test the data submission and to which specificdestination)
Menu Criteria
44Confidential Proprietary to eQHealth Solutions
C Q
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Core, Alternate Core, and Additional CQM setsfor Eps EPs must report on 3 required core CQM, and if the denominator
of 1 or more of the required core measures is 0, then EPs are
required to report results for up to 3 alternate core measures
EPs also must select 3 additional CQM from a set of 38 CQM(other than the core/alternate core measures)
In sum, EPs must report on 6 total measures: 3 required core
measures (substituting alternate core measures wherenecessary) and 3 additional measures
Clinical Quality Measures- EPs
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Cli i l Q li M (CQM)
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2011EPs, eligible hospitals, and CAHs seeking todemonstrate Meaningful Use are required to submitaggregate CQM numerator, denominator, and exclusiondata to CMS or the States by attestation.
2012EPs, eligible hospitals, and CAHs seeking todemonstrate Meaningful Use are required toelectronically submit aggregate CQM numerator,
denominator, and exclusion data to CMS or the States.
Clinical Quality Measures (CQM)Overview
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M i f l U D i
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Two types of percentage-based measures are includedto address the burden of demonstrating MU
1. Denominator is all patients seen or admitted during the EHR
reporting period The denominator is all patients regardless of whether their records
are kept using certified EHR technology
2. Denominator is actions or subsets of patients seen or admittedduring the EHR reporting period
The denominator only includes patients, or actions taken on behalfof those patients, whose records are kept using certified EHRtechnology
Meaningful Use: Denominators
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CQM C S f EP
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CQM: Core Set for EPs
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NQF Measure Number & PQRI
Implementation NumberClinical Quality Measure Title
NQF 0013 Hypertension: Blood Pressure MeasurementNQF 0028 Preventive Careand Screening Measure Pair:
a) Tobacco Use Assessment, b) Tobacco
Cessation Intervention
NQF 0421
PQRI 128
Adult Weight Screening and Follow-up
CQM Alt t C S t f EP
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CQM: Alternate Core Set for EPs
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NQF Measure Number & PQRI
Implementation NumberClinical Quality Measure Title
NQF 0024 Weight Assessment and Counseling for
Children and AdolescentsNQF0041
PQRI 110
Preventive Care and Screening:
InfluenzaImmunization for Patients 50 Years
Old or Older
NQF 0038 Childhood Immunization Status
CQM Additi l S t f EP
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CQM: Additional Set for EPs
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1. Diabetes: Hemoglobin A1c Poor Control
2. Diabetes: Low Density Lipoprotein (LDL) Management and Control3. Diabetes: Blood Pressure Management4. Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker
(ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)5. Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction
(MI)6. Pneumonia Vaccination Status for Older Adults7. Breast Cancer Screening8. Colorectal Cancer Screening9. Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for Patients with CAD10. Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)11. Anti-depressant medication management: (a) Effective Acute Phase Treatment, (b)Effective
Continuation Phase Treatment12. Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation13. Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity
of Retinopathy14. Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
15. Asthma Pharmacologic Therapy16. Asthma Assessment.17. Appropriate Testing for Children with Pharyngitis18. Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone
Receptor (ER/PR) Positive Breast Cancer19. Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients
CQM Additi l S t f EP td
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CQM: Additional Set for EPs, contd
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20. Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients21. Smoking and Tobacco Use Cessation, Medical Assistance: a) Advising Smokers and Tobacco Users toQuit, b) Discussing Smoking and Tobacco Use Cessation Medications, c) Discussing Smoking andTobacco Use Cessation Strategies
22. Diabetes: Eye Exam23. Diabetes: Urine Screening24. Diabetes: Foot Exam25. Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL-Cholesterol26. Heart Failure (HF): Warfarin Therapy Patients with Atrial Fibrillation
27. Ischemic Vascular Disease (IVD): Blood Pressure Management28. Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic29. Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a) Initiation, b)
Engagement30. Prenatal Care: Screening for Human Immunodeficiency Virus (HIV)31. Prenatal Care: Anti-D Immune Globulin32. Controlling High Blood Pressure33. Cervical Cancer Screening
34. Chlamydia Screening for Women35. Use of Appropriate Medications for Asthma36. Low Back Pain: Use of Imaging Studies37. Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control38. Diabetes: Hemoglobin A1c Control (
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10 Menu SetObjectives
15 CoreObjectives
44ClinicalQuality
Measures
PQRI/NQFMeasures
Stage 1: Reporting Requirements
8/5/2010 VITL 52
CMS/State
3 core
3 additional
or 3
alternate
1 must bepublic health
measure
State can
move 4 frommenu to
core
Hypertension
Tobacco useAdult weight
Alternate: ChildrenWeight
Flu Immunization > 50yrs
Children Immunization
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Progression of the Stages:
The Stage 2 meaningful use criteria will focus on More rigorous expectations for health information exchange
More demanding requirements for e-prescribing andincorporating structured laboratory results
The expectation that providers will electronically transmit patientcare summaries to support transitions in care across unaffiliatedproviders, settings and EHR systems
Increasingly robust expectations for health information exchangeto support and make real the goal that information follows the
patient.
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P j t d St 2 M
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Projected Stage 2 Measures
Inclusion of the proposed measures in the NPRM thathave electronic specifications specified
Additional pediatrics measures such as completed growth charts, electronic prescriptions with
weight-based dosing support and documentation of newborn
screening
Long-term care measures.
Additional obstetrics measures.
Dental care/oral health measures.
Additional behavioral/mental health and substanceabuse measures
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Progression of the Stages:
The Stage 3 meaningful use criteria will focus on Promoting improvements in quality, safety and efficiency leading
to improved health outcomes
Focusing on decision support for national high priority conditions
Patient access to self management tools Access to comprehensive patient data through robust, patient-
centered health information exchange
Improving population health.
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In Review
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In Review
Incentives are available for both eligible hospitals andproviders who meaningfully use an EHRThe final rules are more readily achievable than were the
rules in the NPRM (proposed rules)Eligibility for incentives use will require demonstration of
meaningful use of certified technologyCriteria for meaningful use will become more demanding
over timeFirst measures of quality and then demonstration of quality
will be required to be considered for incentives orpayment increases
Begin identifying the criteria and measures you will reporton now
Begin evaluating your workflow now
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Resources:
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Resources:
Regional Extension Assistance Center for HealthInformation Technology (eQHealth solutions)
http://www.eqhs.org
Meaningful Use information on the Health and
Human Services web site: http://healthit.hhs.gov/meaningfuluse
Meaningful Use on the CMS web site:
https://www.cms.gov/EHRIncentivePrograms/35_Meaningful_Us
e.asp
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Contact Information
http://www.khareach.org/http://healthit.hhs.gov/meaningfulusehttps://www.cms.gov/EHRIncentivePrograms/35_Meaningful_Use.asphttps://www.cms.gov/EHRIncentivePrograms/35_Meaningful_Use.asphttps://www.cms.gov/EHRIncentivePrograms/35_Meaningful_Use.asphttps://www.cms.gov/EHRIncentivePrograms/35_Meaningful_Use.asphttp://healthit.hhs.gov/meaningfulusehttp://www.khareach.org/8/7/2019 Jeanie Berg eQHealth MNA Nov 3 2010
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Chris Williams, MPH, CPEHR/CPHITHIT/EHR Southern Regional LeadeQHealth [email protected](225) 938-8905
Jeanie Berg, BSN, RN, CPEHR, CPHITHIT/EHR Central Regional Team LeadereQHealth [email protected](318) 347-6454
Contact Information
Thank You
mailto:[email protected]:[email protected]:[email protected]:[email protected]