Meaningful Use and Behavioral Healthcare€¦ · Meaningful Use and Behavioral Healthcare Author: Alex Attinson Subject: meaningful use Keywords: meaningful use, human services, behavioral

AWARDS and Meaningful Use

Alex Attinson Rachel Miller

ConnectedCare Team

– Created by three human service agencies – Web based EHR used by more than 900

agencies in 25 states – Behavioral Healthcare functionality:

• Demographics • Notes • Plans • Outcomes, reporting, billing

Who We Are

Additional Information: http://footholdtechnology.com/awards-software/meaningful-use/

http://footholdtechnology.com/awards-software/meaningful-use/

• Behavioral Health vs. Hospitals – Smaller budgets; chronic cash flow crises – Many clinical workers, few EPs if any – Part-time / shared EPs

• MU Objectives – Alignment with behavioral health – Relevant CQMs

Behavioral Health and MU



Interested

Eligible and Able

Adopt, Implement, Upgrade

• AWARDS is a complete, ambulatory 2014 Edition

• Majority Medicaid – Some mixed

Medicare/Medicaid volume

– Choose Medicaid • AIU • More Money • More flexible

Meaningful Use Clients



• Eligibility – MU not designed for Behavioral Healthcare – Who on staff qualifies? – Can I claim them? – Medicaid/Medicare volume

• Resource allocation – EHR features, vendor support – EP access to technology – MU content expertise

• REC, internal, external consultant

• Cost/Benefit Analysis – Does MU overlap with mission of the agency? – Can we afford it?

Early Challenges



• Implementation team / MU leadership • Resources: staff and hardware • Staff resistance • Computer skills • Training • Workflow/process changes • Data quality

General Challenges



• Message to agencies: – Meaningful Use is not easy… – Attestation is not easy…

• Job well done for getting to attestation

• Meaningful Use ‘14 – Stage 1 – Non-reportable objectives: screenshots – Reportable objectives: Objectives Report – Clinical Quality Measures: Quality Measures Report

The 2014 Edition



• 2011/2014 CHERT Flexibility Rule • Mandatory 90-day 2014 reporting period • Possible 90-day 2015 reporting period • Role specific vitals recording • RECs that provide one-on-one support • Possible incentives for BH organizations

CMS Relief



• Patients and EPs – Record encounters, associate patients with EPs

• Always be ready for an audit • Know your exclusions

– Ex: is blood pressure in the scope of practice?

• Selecting your Menu Set Objectives – Public Health objectives

• View, Download, Transmit – Connected to a HISP/DIRECT

Attesting with AWARDS







• Ex: Consumer meets with psychiatrist • In AWARDS, the touch point is the Psych Note • Maintain existing functionality • Maximize functionality from that screen

– Record encounter – E-Rx (reconciliation, medications, allergy, formulary) – Update medical record (vitals, problem list, smoking) – Generate Clinical Summary – VDT: DIRECT or offline generation of electronic doc

Workflow in BH Agencies







Workflow in BH Agencies

Psych Note Clinical Summary Electronic Document/VDT



Clinical Summary

Clinical Summary

VDT – Electronic Document

Meaningful Use Dashboard



Core • Controlling High Blood Pressure - CMS165v2 (NQF 0018) • Tobacco Use: Screen and Cess. - CMS138v2 (NQF 0028) • Body Mass Index (BMI) Screen - CMS69v2 (NQF 0421) • Documentation of Current Med. - CMS68v3 (NQF 0419) • Use of High-Risk Medications - CMS156v2 (NQF 0022) • Use of Imaging Studies for Low Back Pain - CMS166v3 (NQF 0052) Behavioral Heath Specialty • Anti-depressant Medication Man. - CMS128v2 (NQF 0105) • Weight Assessment and Counseling - CMS155v2 (NQF 0024) • Major Depressive Disorder - CMS161v2 (NQF 0104)

Clinical Quality Measures



• Codify medical encounters and vocabulary

• RxNorm, SNOMED CT, ICD, CPT, LOINC

• AHRQ Value Sets – eCQM

• QRDA Physicians Quality Reporting System

• Extensible framework for new CQMs

Codified Data

eCQM Value Sets

QRDA Cat I & III

Clinical Quality Measures



Codified Data Entry







AHRQ Value Sets



PQRS Reporting



• Interoperability – Secure messaging – RHIO subscriptions – Health Homes – DSRIP and ACO

• CQMs as a part of Care Plan Reporting

• EPCS • Opt-out consent for data exchange

Stage 2 and Beyond



Q & A

Thank You!







Meaningful Use and Behavioral Healthcare€¦ · Meaningful Use and Behavioral Healthcare Author: Alex Attinson Subject: meaningful use Keywords: meaningful use, human services, behavioral

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