Meaningful Use: Core Measures

Meaningful Use: Core Meaningful Use: Core MeasuresMeasures

Lori HinesLori Hines

Associate Vice PresidentAssociate Vice President

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EHR Incentive Programs EHR Incentive Programs HighlightsHighlights

• Medicare EHR Incentive Program– Requires demonstration of Meaningful

Use of Certified EHR Technology beginning in Year One (90 day reporting period)

– Up to $44,000 over five years

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EHR Incentive Programs EHR Incentive Programs HighlightsHighlights

• Medicare EHR Incentive Program– Payment adjustment in 2015 and after

for EPs who do not successfully demonstrate MU

– Participation can begin as early as 2011

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EHR Incentive Programs EHR Incentive Programs HighlightsHighlights

• Medicaid EHR Incentive Program– First year: Adopt, implement, upgrade or

demonstrate MU of certified EHR technology

– Requires demonstration of Meaningful Use in subsequent years

– Up to $63,750 over six years4

EHR Incentive Programs EHR Incentive Programs HighlightsHighlights

• Medicaid EHR Incentive Program– No payment adjustment

– Program is voluntarily offered by individual states and may begin as early as 2011, depending upon the state

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Requirements for Demonstration Requirements for Demonstration of Meaningful Useof Meaningful Use

• Must meet all 15 Core Measures*

*Some exclusions are allowed for specific measures, reducing the number of required measures accordingly

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Requirements for Demonstration Requirements for Demonstration of Meaningful Useof Meaningful Use• Must achieve compliance with 5 out of

10 Menu Set measures*– One of the five Menu Set measures must

be related to Public Health (either Immunization Registry or Electronic Syndromic Surveillance)

*Some exclusions are allowed for specific measures, reducing the number ofrequired measures accordingly

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Core Measures Affecting Core Measures Affecting Physician Workflow RoutinePhysician Workflow Routine

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Record Vital Signs: Record Vital Signs: Core Measure #8Core Measure #8• Record and chart changes in the following

vital signs:

– Height, Weight, Blood Pressure

– Calculate and display BMI• Plot and display growth charts for children

2-20 years• Stage One Threshold: > 50% of unique

patients >=2 years old• Exclusion: EP who sees no patients >=2

years old or who believes all three vitals have no relevance to their scope of practice

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Documentation of Vitals & Documentation of Vitals & Smoking StatusSmoking Status

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Record Smoking Status:Record Smoking Status:Core Measure #9Core Measure #9• For all patients 13 and older, assess

smoking status• Stage One Threshold: > 50% of

patients 13 and older seen during the reporting period

• Exclusion: EP who sees no patients >=13 years old

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CPOE: Core Measure #1CPOE: Core Measure #1

• Use computerized provider order entry (CPOE) for medication orders

• Stage One Threshold: > 30% of unique patients seen during the reporting period

• Exclusion: EP who writes fewer than 100 Rx’s during the reporting period

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Active Medication Allergy List:Active Medication Allergy List:Core Measure #6Core Measure #6• Maintain active medication allergy

list; document allergies or document “No Known Allergies”

• Stage One Threshold: > 80% of unique patients seen during the reporting period

• No exclusion

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Active Medication List:Active Medication List:Core Measure #5Core Measure #5• Maintain active medication list.

Document medications patient is taking using structured drug database or document “No Known Current Medications”

• Stage One Threshold: > 80% of unique patients seen during the reporting period

• No exclusion14

Documentation of Active Documentation of Active MedicationsMedications

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Drug Interaction Checks:Drug Interaction Checks:Core Measure #2Core Measure #2• Implement drug-drug and drug-

allergy checks• Stage One Threshold: By attestation

(EP has this functionality for the entire reporting period)

• No Exclusion

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Documentation of Warning Documentation of Warning Override ReasonOverride Reason

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Electronic Prescribing: Electronic Prescribing: Core Measure #4Core Measure #4• Generate & transmit permissible

prescriptions electronically (eRx)– Contact SuccessEHS Support to enroll if

you’re not already eRx’ing

• Stage One Threshold: > 40% of permissible prescriptions written during reporting period are transmitted electronically

• Exclusion: EP who writes <100 Rxduring reporting period

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e-Prescribing (eRx)e-Prescribing (eRx)

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More Reasons to e-Prescribe!More Reasons to e-Prescribe!

• 2012 Medicare Payment Adjustment–1% Medicare Payment Adjustment

for physicians reimbursed under PFS unless National Claims History database receives 10 qualifying encounters with G8553 (or single hardship code) between January 1, 2011 & June 30, 2011!

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More Reasons to e-Prescribe!More Reasons to e-Prescribe!

• 2011 eRx Incentive– Receive 1% bonus in 2012 if >=25

qualifying encounters with G8553 verified in NCH database for DOS 1/1/2011 – 12/31/2011

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Maintain Problem List:Maintain Problem List:Core Measure #3Core Measure #3• Maintain an up-to-date problem list

of current and active diagnoses. Document problems (or “No Known Problems”) as structured data

• Stage One Threshold: > 80% of unique patients seen during the reporting period

• No Exclusion

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Documentation of ProblemsDocumentation of Problems

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Clinical Decision Support:Clinical Decision Support:Core Measure #11Core Measure #11• Implement one clinical decision

support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule

• Stage One Threshold: Attestation• No Exclusion

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Clinical Decision Support Clinical Decision Support RulesRules

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Clinical Decision Support Clinical Decision Support Preferences & AlertsPreferences & Alerts

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Clinical Summaries:Clinical Summaries:Core Measure #13Core Measure #13• Provide clinical summaries for

patients for each office visit• Stage One Threshold: > 50% of all

office visits (provided within three business days)

• Exclusion: EP who has no office visits during EHR reporting period.

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Clinical Quality Measures: Clinical Quality Measures: Core Measure #10Core Measure #10• Report ambulatory clinical quality

measures (CQMs) to CMS in the manner specified by CMS to meet the measure

• Stage One Threshold: Attestation • No Exclusion

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Electronic Copy of Health Electronic Copy of Health Information: Core Measure #12Information: Core Measure #12• Provide patients with electronic copy

of HI upon request• Stage One Threshold: < 50% of all

patients requesting electronic copy receive it within 3 business days

• Exclusion: Any EP that has no requestsfor electronic copy during the entirereporting period.

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Other Core MeasuresOther Core Measures

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Record Demographics:Record Demographics:Core Measure #7Core Measure #7• Record all of the following

demographics: Preferred language, Gender, Race, Ethnicity, DOB

• Stage One Threshold: < 50% of all unique patients seen during the reporting period

• No Exclusion

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Exchange of Clinical Data:Exchange of Clinical Data:Core Measure #14Core Measure #14• Perform at least one test of certified

EHR technology’s capacity to electronically exchange key clinical information

• Stage One Threshold: by attestation• No Exclusion

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Exchange of Clinical DataExchange of Clinical Data

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Protect Electronic Health Info:Protect Electronic Health Info:Core Measure #15Core Measure #15• Conduct or review a security risk

analysis and implement security updates/correct deficiencies as necessary

• Stage One Threshold: by attestation• No Exclusion

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Interested in learning more about Meaningful Use? Visit http://www.successehs.com/item/hitech-meaningful-use-certified-systems/registering-for-meaningful-use.htm for more information.

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