Meaningful Use Stage 3166.78.170.144/sites/default/files/Meaningful Use Stage 3.pdf · New Rules • Medicare Access ... (APM) Incentive Under the Physician Fee Schedule, and Criteria

Meaningful Use Stage 3

Meaningful Use Stage 3

Target audience: All- General Evident and Healthland

Session Presenters:

• Rick Reeves Director of Government Relations, Evident

Learning Objectives

Objective 1 • Understand the requirements for successful

participation in the program • Objective 2 • Understand our corporate plan for acquiring

2015 Edition certification and Site Implementation

Objective 3 • Understand Modular components essential

to successful attestation

1

2

3

EH and CAH Requirements

New Rules

• Medicare Access and CHIP Reauthorization Act of 2015-- MACRA

• April 2015

• Replaces SGR, establishes Quality Payment Program(QPP) for

physician payments

• Consolidates components of three existing programs :

• Physician Quality Reporting System (PQRS)

• Physician Value-based Payment Modifier (VM)

• Medicare EHR Incentive Program for EPs

New Rules

• Medicare Program; Merit-Based Incentive Payment System (MIPS)

and Alternative Payment Model (APM) Incentive Under the Physician

Fee Schedule, and Criteria for Physician-Focused Payment Models

• November 4, 2016

• Two primary tracks: 1) Advanced Alternative Payment Model

2) MIPS

• Quality Program based on performance across 4 categories:

Improvement Activities, Cost, use of CEHRT (Advancing Care

Information- ACI) and Quality Measures

•

New Rules

• Beginning in 2017-if eligible as an Eligible Clinician(EC), Medicare

EP’s will attest to the Advancing Care Information performance

category under MIPs instead of the EHR Incentive Program

• EPs that attest directly to a state for the Medicaid EHR Incentive

Program will continue to attest to the objectives and measures as

finalized in the 2015 EHR Incentive Program Final Rule

• To access the Quality Payment Program and requirements for

Medicare eligible clinicians visit the website www. qpp.cms.gov

New Rules

• Medicare Program: Hospital Outpatient Prospective Payment and

Ambulatory Surgical Center Payment Systems and Quality Reporting

Programs

• November 14, 2016

• Impacts participants in the Medicare EHR Incentive Programs-

changes only apply to EH, CAH and dual-eligible hospitals

attesting to CMS—does NOT affect Medicaid EHR Incentive

Program as defined in previous rule for EH/CAH

New Rules

• Revisions to the objectives and measures for EH, CAHs and dual-

eligible hospitals to lower the reporting burden:

• Removal of CPOE & CDS starting 2017

• Reduced thresholds 2017 and Stage 3

• Reduced Public Health Reporting requirements from previous

rule

• Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Program Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals

• Proposed April 28, 2017 • Public Comment closed June 13, 2017 • Anticipated final rule Summer 2017

Proposed Rule

• Proposals : • 90 day Reporting Period in 2018 for EH/CAH • Excludes clinicians who see 75-90% of their patients at

ambulatory surgery centers from EHR Incentive • Changes to electronic clinical quality measures- Hospitals can

select 6 eCQMs from 16 available for 2 self- selected quarters in 2017, and select 6 eCQMs for the first three quarters of 2018 to satisfy electronic reporting to Hospital IQR & EHR Medicare & Medicaid Incentive Program (Must use updated prior year version of eCQMs to report)

Proposed Rule

Proposed Rules

• Medicare Program; CY 2018 Updates to the Quality Payment

Program

• Proposed: June 26, 2017

• Open for Comment until August 21, 2017

• Reduced thresholds for eligibility

• Flexibility- Virtual groups, Exceptions and Bonus points for small

providers

EHR Reporting Periods 2017 and 2018 • For Modified Stage 2 in 2017, providers must attest to objectives

and measures for a continuous 90 day period between January 1

and December 31, 2017 using EHR technology certified to the 2014

Edition. If it is available, providers may also attest using EHR

technology certified to the 2015 Edition, or a combination

• Reporting for Stage 3 remains Optional in 2017 for a 90 day

continuous period

• Full year reporting period for Stage 3 Required in 2018 using the

2015 Edition*

• * 90 Continuous Days Proposed

EHR Reporting Periods 2017 and 2018

• For the 2017 EHR reporting period, the attestation deadline is

February 28, 2018

• To avoid the 2018 payment adjustment, first time participants must

attest by October 1, 2017

• All hospitals must successfully attest to avoid the Medicare payment

adjustment each year


• For EHR Incentive program measures, CMS clarified that a

numerator is not constrained to an EHR reporting period when the

EHR reporting period is less than one year. The numerator action

may reasonably fall outside the EHR reporting period timeframe but

must take place no earlier than the start of the calendar year and no

later than the end of the calendar year in order for the patients to

be counted in the numerator. As such, actions occurring after the

end of the reporting period's calendar year will not count in the

numerator.


The following are Modified Stage 2 objectives, which Eligible Hospitals and CAHs Attesting to CMS must meet in order to successfully demonstrate meaningful use for an EHR reporting period in 2017: 1. Protect Patient Health Information 2. Electronic Prescribing 3. Health Information Exchange 4. Patient Specific Education 5. Medication Reconciliation 6. Patient Electronic Access 7. Public Health Reporting


The following are Stage 3 objectives, which Medicare Eligible Hospitals, CAHs and Dual-Eligible Hospitals attesting to CMS must meet in order to successfully demonstrate meaningful use for an EHR reporting period in 2017(optional) and 2018: 1. Protect Patient Health Information 2. Electronic Prescribing 3. Patient Electronic Access to Health Information 4. Coordination of Care Through Patient Engagement 5. Health Information Exchange 6. Public Health and Clinical Data Registry Reporting

Stage 3 Objectives

and Measures

• OBJECTIVE: • Protect electronic protected health information (ePHI)

created or maintained by the CEHRT through the implementation of appropriate technical, administrative, and physical safeguards

• MEASURE:

• Security Risk Analysis: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308(a)(1), including addressing the security (including encryption) of data created or maintained by CEHRT in accordance with requirements under 45 CFR 164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the provider’s risk management process

Protect Patient Health Information

• Eligible hospitals and CAHs must attest YES to conducting or reviewing a security risk analysis and implementing security updates as necessary and correcting identified security deficiencies to meet this measure

• Eligible hospitals and CAHS must conduct or review a security

risk analysis of CEHRT including addressing encryption/security of data, and implement updates as necessary at least once each calendar year and attest to conducting the analysis or review

• At minimum, providers should be able to show a plan for correcting or mitigating deficiencies and that steps are being taken to implement that plan

Protect Patient Health Information

• OBJECTIVE: • Generate and transmit permissible discharge

prescriptions electronically (eRx) • MEASURE: e-Prescribing:

• More than 25 percent of hospital discharge medication orders for permissible prescriptions (for new and changed prescriptions) are queried for a drug formulary and transmitted electronically using CEHRT

Electronic Prescribing

• Providers may choose to include CS prescriptions where feasible and allowable by state and local law. If a provider chooses to include such prescriptions, they must do so uniformly across all patients and across all allowable schedules for the duration of the EHR reporting period

• Instances where patients specifically request a paper prescription may not be excluded from the denominator of this measure. The denominator includes all prescriptions written during the EHR reporting period

Electronic Prescribing

• OBJECTIVE: • Provides patients (or patient authorized representative)

with timely electronic access to their health information and patient-specific education

• 2 Measures • Eligible Hospitals and CAHs must satisfy both measures in

order to meet the objective:

Patient Electronic Access to Health

Information

• MEASURE 1: • Provide Patient Access: For more than 50 percent of all

unique patients discharged from the eligible hospital or CAH inpatient or emergency department (POS 21 or 23):

• The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and

• The provider ensures the patient’s health information is available for the patient (or patient authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the application programming interfaces (API) in the provider’s CEHRT


Information

• API or Application Programming Interface –

• App developer builds an app to access data from API-connection to EHR

• App developer registers with Hospital or EHR • Pt becomes aware of app and decides to connect • Pt signs into hospital portal and authorizes to share some

or all data for a time period and Hospital records decision • Hospital portal sends patient back to app and app gets

access token • App accesses data


Information

• Providers may not prohibit patients from using any

application, including third-party applications, which meet the technical specifications of the API, including the security requirements of the API

• Providers are expected to provide patients with detailed instructions on how to authenticate their access through the API and provide the patient with supplemental information on available applications that leverage the API


Information

• A patient who has multiple encounters during the EHR reporting period, or even in subsequent EHR reporting periods in future years, needs to be provided access for each encounter where they are discharged from the eligible hospital or CAH’s inpatient or emergency department

• A patient seen during the reporting period who does not receive access at the first encounter and does receive access at the second or subsequent encounters will not populate the numerator for the first or any subsequent visits

• A patient seen during reporting period and provided access at first visit and does not receive access at subsequent visits will populate the numerator at the first encounter and decrement the numerator for the first subsequent visit in which data is not provided in the appropriate time period

• If a patient elects to "opt out" of participation, that patient must still be included in the denominator


Information

• MEASURE 2: • Patient-Specific Education: The eligible hospital or CAH

must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide electronic access to those materials to more than 10 percent of unique patients seen by the EP or discharged from the eligible hospital or CAH inpatient or emergency department (POS 21 or 23) during the EHR reporting period

• Paper-based actions are no longer counted for the Patient

Specific Education measure calculations. Providers may still provide paper based educational materials for their patients, but no longer count in measure calculations

• Infobutton is now the only standard for patient education •


Information

• OBJECTIVE: • Use CEHRT to engage with patients or their Authorized

representatives about the patient’s care

• 3 Measures

• Must attest to all three measures • Must meet the thresholds for at least two measures to

meet the objective

Coordination of Care through Patient

Engagement

• MEASURE 1: • View, Download or Transmit (VDT) : During the EHR

reporting period, at least one unique patient (or their authorized representatives) discharged from the eligible hospital or CAH inpatient or emergency department (POS 21 or 23) actively engage with the electronic health record made accessible by the provider and one of the following:

• View, download or transmit to a third party their health information; or

• Access their health information through the use of an API that can be used by applications chosen by the patient and configured to the API in the provider's CEHRT; or

• A combination of (1) and (2)


Engagement

• MEASURE 2: • Secure Messaging: For more than 5 percent of all unique

patients discharged from the eligible hospital or CAH inpatient or emergency department (POS 21 or 23) during the EHR reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative)

• Note: Providers are not required to respond to every message received if no response is necessary


Engagement

• MEASURE 3: • Patient Generated Health Data Measure 3: Patient

generated health data or data from a nonclinical setting is incorporated into the CEHRT for more than 5 percent of all unique patients discharged from the eligible hospital or CAH inpatient or emergency department (POS 21 or 23) during the EHR reporting period


Engagement

• For the Patient Generated Health Data measure, the types of

data that would satisfy the measure are broad. • May include social service data, data generated by a patient

or a patient's authorized representative, advance directives, medical device data, home health monitoring data, and fitness monitor data.

• Sources of data vary and may include mobile applications for tracking health and nutrition, home health devices with tracking capabilities such as scales and blood pressure monitors, wearable devices such as activity trackers or heart monitors, patient-reported outcome data, and other methods of input for patient and non-clinical setting generated health data

• Note: Data related to billing, payment, or other insurance information would not satisfy this measure

• Data needs to be provided electronically in EHR


Engagement

• Certification does not specify the manner in which providers

are required to incorporate the data. • A provider may maintain an isolation between the data and

the patient record and instead include the data by other means such as attachments, links, and text references again as best meets their needs


Engagement

• OBJECTIVE: • The EP, eligible hospital, or critical access hospital (CAH)

provides a summary of care record when transitioning or referring their patient to another setting of care, receives or retrieves a summary of care record upon the receipt of a transition or referral or upon the first patient encounter with a new patient, and incorporates summary of care information from other providers into their EHR using the functions of certified EHR technology (CEHRT)

• 3 Measures

• Must attest to all three measures • Must meet the thresholds for at least two measures to

meet the objective

Health Information Exchange

• MEASURE 1: • Send a Summary of Care: For more than 10 percent of

transitions of care and referrals, the eligible hospital or CAH that transitions or refers their patient to another setting of care or provider of care:

• 1) Creates a summary of care record using CEHRT; and • 2) Electronically exchanges the summary of care record

• Transition of Care – The movement of a patient from one setting of care (hospital, ambulatory primary care practice, ambulatory specialty care practice, long-term care, home health, rehabilitation facility) to another.

• Note: At a minimum this includes all discharges from the inpatient department and after admissions to the emergency department when follow-up care is ordered by an authorized provider of the hospital


• Summary of Care Record – All summary of care documents used to meet this objective must include the following information if the provider knows it:

• Patient name • Procedures • Encounter diagnosis • Immunizations • Laboratory test results • Vital signs (height, weight, blood pressure, BMI) • Smoking status • Functional status, including activities of daily living, cognitive

and disability status • Demographic information (preferred language, sex, race,

ethnicity, date of birth) • Care plan field, including goals and instructions


• Care team including the primary care provider of record and any additional known care team members beyond the referring or transitioning provider and the receiving provider

• Discharge instructions (eligible hospital and CAH only) • Current problem list (Hospitals may also include historical

problems at their discretion)* • Current medication list* • Current medication allergy list*

• *Note: An eligible hospital or CAH must verify that the fields

for current problem list, current medication list, and current medication allergy list are not blank and include the most recent information known by the eligible hospital or CAH as of the time of generating the summary of care document or include a notation of no current problem, medication and/or medication allergies

•


• Apart from the three fields noted as required for the summary of care record (i.e., current problem list, current medication list, and current medication allergy list), in circumstances where the eligible hospital/CAH does not record such information or because there is no information to record, the eligible hospital/CAH may leave the field(s) blank and still meet the objective and its associated measure

• For the Send a Summary of Care measure, a provider must have confirmation of receipt or that a query of the summary of care record has occurred in order to count the action in the numerator


• MEASURE 2: • Request/Accept Summary of Care: For more than 10

percent of transitions or referrals received and patient encounters in which the provider has never before encountered the patient, the eligible hospital or CAH incorporates into the patient’s EHR an electronic summary of care document


• For the purposes of defining the cases in the denominator for Accept/Request Summary of Care what constitutes ‘‘unavailable’’ and, therefore, may be excluded from the denominator, will be: • Provider Requested an electronic summary of care record

to be sent and did not receive an electronic summary of care document; and

• Provider either Queried at least one external source via HIE functionality and did not locate a summary of care for the patient, or the provider does not have access to HIE functionality to support such a query, or

• Confirmed that HIE functionality supporting query for summary of care documents was not operational in the provider’s geographic region and not available within the provider’s EHR network as of the start of the EHR reporting period


• A record cannot be considered to be incorporated if it is discarded without the reconciliation of clinical information or if it is stored in a manner that is not accessible for provider use within the EHR

•

•

•


• MEASURE 3: • Clinical Information Reconciliation: For more than 50

percent of transitions or referrals received and patient encounters in which the provider has never before encountered the patient, the eligible hospital or CAH performs a clinical information reconciliation. The provider must implement clinical information reconciliation for the following three clinical information sets:

• 1) Medication. Review of the patient’s medication, including the name, dosage, frequency, and route of each medication

• 2) Medication allergy. Review of the patient’s known medication allergies

• 3) Current Problem list. Review of the patient’s current and active diagnoses


• The process may include both automated and manual reconciliation to allow the receiving provider to work with both the electronic data provided with any necessary review, and to work directly with the patient to reconcile their health information

• If no update is necessary, the process of reconciliation may consist of simply verifying that fact or reviewing a record received on referral and determining that such information is merely duplicative of existing information in the patient record

• Non-medical staff may conduct reconciliation under the direction of the provider so long as the provider or other credentialed medical staff is responsible and accountable for review of the information and for the assessment of and action on any relevant CDS


• OBJECTIVE: • The eligible hospital or CAH is in active engagement with

a public health agency or clinical data registry to submit electronic public health data in a meaningful way using certified EHR technology, except where prohibited, and in accordance with applicable law and practice

• 6 Measures • Eligible hospitals and CAHs must attest to at least three

measures from the Public Health Reporting Objective, Measures 1 through 6

• https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/CentralizedRepository-.html

Public Health and Clinical Data Registry

Reporting

https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/CentralizedRepository-.html



• Example of Spreadsheet • Headings for all Public Health • Regional and State applicability • EP and EH/CAH applicability

Centralized Repository

Registry Name Website Address EMAIL PHONE

Immun-ization registry

reporting

Syndromic surveillance

reporting

Specialized registry

reporting

Electronic Reportable Laboratory

Result Reporting

Electronic Case Reporting

Public Health registry

reporting

Clinical Data Registry

Reporting northeast midwest south west State Eligible

Professionals Hospitals/CAHs

QualityAdvisor™ www.premierinc.com 13034 Ballantyne Corporate Place Charlotte, NC 28277 [email protected] 877.777.1552 X X X X X

[m]pirik www.mpirik.com 270 E. Highland Ave. Milwaukee, WI 53202 [email protected] 414-220-4384 X X X X X X X X X

AAAAI American Academy of Allergy, Asthma,and Immunology Clinical Data Registry in Collaboration with CECity

www.medconcert.com/AAAAIQIR

555 E. Wells St., Suite 1100, Milwaukee, WI 53222 [email protected] 877-509-7774 X X X X X X

AAD’s DataDerm™ https://www.aad.org/dataderm

American Academy of Dermatology 930 East Woodfield Road Schaumburg, IL 60173

[email protected] (847) 330-0230 X X X IL X

Acuere QOL http://www.acuereqol.co1n/

OCHIN 1881 SW Naito Parkway Portland, Oregon 97201

[email protected], [email protected] 503-943-2500 X X X X X X

Advanced Pain Management Services, LLC www.americanspinemd.com

PO Box 2348 Germantown MD 20875 [email protected] 240-629-3917 X X X X

Aggregate Data Program www.epic.com Aggregate Data Program - Epic 1979 Milky Way Verona, WI 53593

[email protected] 608-271-9000 X X X X X X X X

http://www.mpirik.com/

mailto:[email protected]

• Immunization Registry Reporting:

• The eligible hospital or CAH is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS) Bi-directionality, provides that certified health IT must be able to receive and display a consolidated immunization history and forecast in addition to sending the immunization record

• Syndromic Surveillance Reporting:

• The eligible hospital or CAH is in active engagement with a public health agency to submit syndromic surveillance data from an urgent care setting


Reporting

• Electronic Case Reporting: • The eligible hospital or CAH is in active engagement with a

public health agency to submit case reporting of reportable conditions Consume and maintain a table of trigger codes to determine which encounters may be reportable

• (ii) Match a patient visit or encounter to the trigger code based on the parameters of the trigger code table

• (iii) Case report creation. Create a case report for electronic transmission


Reporting

• Public Health Registry Reporting: • The eligible hospital or CAH is in active engagement with a

public health agency to submit data to public health registries

• Create antimicrobial use and resistance reporting information for electronic transmission in accordance with the standard

• Create health care survey information for electronic transmission in accordance with the standard

• For the Public Health Registry Reporting, eligible hospitals/CAHs may choose to report to more than one public health registry


Reporting

• Clinical Data Registry Reporting:

• The eligible hospital or CAH is in active engagement to submit data to a clinical data registry

• No standard chosen for 2015 Edition • EH/CAHs may choose to report to more than one clinical

data registry to meet the number of measures required to meet the objective

• The definition of jurisdiction is general, and the scope may be local, state, regional or at the national level. The definition will be dependent on the type of registry to which the provider is reporting. A registry that is ‘‘borderless’’ would be considered a registry at the national level and would be included for purposes of this measure


Reporting

• Electronic Reportable Laboratory Result Reporting:

• The eligible hospital or CAH is in active engagement with a public health agency to submit electronic reportable laboratory results

.

•

•


Reporting

• The eligible hospital or CAH must attest YES to being in active engagement with a public health agency to submit data

• Active engagement - means that the provider is in the process of moving towards sending "production data" to a public health agency or clinical data registry, or is sending production data to a public health agency or CDR

• Active Engagement Option 1 - Completed Registration to Submit Data

• Active Engagement Option 2 - Testing and Validation • Active Engagement Option 3 - Production


Reporting

• If public health agencies have not declared 6 months before the start of the EHR reporting period whether the registry they are offering will be ready on January 1 of the upcoming year for use by providers seeking to meet EHR reporting periods in that upcoming year, a provider can claim an exclusion

• An exclusion for a measure does not count toward the total of three measures. Instead, in order to meet this objective an eligible hospital or CAH would need to meet three of the total number of measures available to them. If the eligible hospital or CAH qualifies for multiple exclusions and the total number of remaining measures available to the eligible hospital or CAH is less than three, the eligible hospital or CAH can meet the objective by meeting all of the remaining measures available to them and claiming the applicable exclusions.


Reporting

Corporate Plan

• Thrive 2015 Edition V20 Roadmap • Phase I- Completed February 3, 2017

170.315 (a)(1): Computerized Provider Order Entry (CPOE) - Medications 170.315 (a)(2): CPOE - Laboratory 170.315 (a)(3): CPOE - Diagnostic Imaging 170.315 (a)(4): Drug-Drug, Drug-Allergy Interaction Checks for CPOE 170.315 (a)(5): Demographics 170.315 (a)(6): Problem List 170.315 (a)(7): Medication List 170.315 (a)(8): Medication Allergy List


170.315 (a)(10): Drug-Formulary and Preferred Drug List Checks 170.315 (a)(11): Smoking Status 170.315 (a)(12): Family Health History 170.315 (a)(13): Patient-Specific Education Resources 170.315 (a)(14): Implantable Device List 170.315 (b)(3): Electronic Prescribing


170.315 (d)(1): Authentication, Access Control, Authorization 170.315 (d)(2): Auditable Events and Tamper-Resistance 170.315 (d)(3): Audit Report(s) 170.315 (d)(4): Amendments 170.315 (d)(5): Automatic Access Time-out 170.315 (d)(6): Emergency Access 170.315 (d)(7): End-User Device Encryption 170.315 (d)(8): Integrity 170.315 (d)(9): Trusted Connection 170.315 (e)(2): Secure Messaging


170.315 (e)(3): Patient Health Information Capture 170.315 (f)(1): Transmission to Immunization Registries 170.315 (f)(2): Transmission to Public Health Agencies - Syndromic Surveillance 170.315 (f)(3): Transmission to Public Health Agencies - Reportable Laboratory Tests and Values/Results 170.315 (g)(3): Safety-Enhanced Design 170.315 (g)(4): Quality Management System 170.315 (g)(5): Accessibility-Centered Design

• Thrive 2015 Edition V20 Roadmap • Phase II- Tentative- mid July

170.315 (a)(9): Clinical Decision Support 170.315 (b)(1): Transitions of Care 170.315 (b)(2): Clinical Information Reconciliation and Incorporation 170.315 (b)(4): Common Clinical Data Set Summary Record - Create 170.315 (b)(5): Common Clinical Data Set Summary Record - Receive 170.315 (b)(6): Data Export 170.315 (g)(6): Consolidated CDA Creation

• Thrive 2015 Edition V20 Roadmap • Phase II- Tentative- mid July

170.315 (e)(1): View, Download, and Transmit to 3rd Party 170.315 (g)(7): Application Access - Patient Selection 170.315 (g)(8): Application Access - Data Category Request 170.315 (g)(9): Application Access - All Data Request 170.315 (g)(2): Automated Measure Calculation

• Thrive 2015 Edition V20 Roadmap • Phase II- Tentative- August

170.315 (c)(1): Clinical Quality Measures - Record and Export 170.315 (c)(2): Clinical Quality Measures - Import and Calculate 170.315 (c)(3): Clinical Quality Measures – Report

• Thrive 2015 Edition V20 Roadmap • Phase III- Tentative August/September 2017

170.315 (f)(4): Transmission to Cancer Registries 170.315 (f)(5): Transmission to Public Health Agencies - Electronic Case Reporting 170.315 (f)(6): Transmission to Public Health Agencies - Antimicrobial Use and Resistance Reporting 170.315 (f)(7): Transmission to Public Health Agencies - Health Care Surveys

• Implementation Plan • Pilot sites 2015 Edition V20

• 1-2 sites • Implement V20 late July/Aug for completed criteria • 90 continuous days for Stage 3 in 2017 when all

essential CEHRT criteria certified • GA distribution 2015 Edition Complete V20- tentative

September 2017 • Activation of new 2015 Edition development in V20

requires MU3Bundle purchase • Education for V20 completed criteria( updated and

new) requires purchase of MU3 bundle

Thrive 2015 Edition V20 Roadmap

• Centriq 2015 Edition V14 Roadmap • Phase I- Completed December 2016 (EH)

170.315 (c)(1) Clinical Quality Measures – record and export 170.315 (c)(2) Clinical Quality Measures – import and calculate 170.315 (c)(3) Clinical Quality Measures - record

• Centriq 2015 Edition V14 Roadmap • Phase II- Tentative mid July 2017

170.315(a)(1) CPOE – medications 170.315(a)(2) CPOE – laboratory 170.315(a)(3) CPOE – diagnostic imaging 170.315(a)(4) Drug-drug, drug-allergy interaction checks for CPOE 170.315(a)(5) Demographics 170.315(a)(6) Problem List 170.315(a)(7) Medication list 170.315(a)(8) Medication allergy list


170.315(a)(10) Drug-formulary and preferred drug list checks 170.315(a)(11) Smoking status 170.315(a)(12) Family health history 170.315(a)(14) Implantable device list 170.315(a)(15) Social, psychological, and behavioral data 170.315(b)(4) Common clinical data set summary record – create 170.315(b)(6) Data export 170.315(f)(7) Transmission to public health agencies – health care surveys


170.315(d)(1) Authentication, access control, and authorization 170.315(d)(2) Auditable events and tamper-resistance 170.315(d)(3) Audit report(s) 170.315(d)(4) Amendments 170.315(d)(5) Automatic access time-out 170.315(d)(6) Emergency access 170.315(d)(7) End-user device encryption 170.315(d)(8) Integrity


170.315(g)(3) Safety-enhanced design 170.315(g)(4) Quality management system 170.315(g)(5) Accessibility-centered design 170.315(g)(6) CCDA creation performance

• Centriq 2015 Edition V14 Roadmap • Phase III- Tentative August 2017

170.315 (a)(9) Clinical Decision Support 170.315 (a)(13) Patient-specific Education Resources 170.315 (b)(1) Transitions of Care 170.315 (b)(2) Clinical Information Reconciliation and Incorporation 170.315 (b)(3) Electronic Prescribing 170.315 (b)(5) Common Clinical Data Set Summary Record - receive

• Centriq 2015 Edition V14 Roadmap • Phase III- Tentative August 2017

170.315 (c)(1) Clinical Quality Measures – record and export* 170.315 (c)(2) Clinical Quality Measures – import and calculate* 170.315 (c)(3) Clinical Quality Measures – record* 170.315 (d)(9) Trusted Connection 170.315 (d)(10) Auditing Actions on Health Information 170.315 (e)(1) View, Download, and Transmit to 3rdParty 170.315 (e)(2) Secure Messaging 170.315 (e)(3) Patient Health Information Capture *Updated measures,Additional EH measures, and MIPS EC measures through Quality Analysis and Reporting for Centriq and Thrive

• Centriq 2015 Edition V14 Roadmap • Phase III- Tentative late July/August 2017

170.315 (f)(1) Transmission to Immunization Registries 170.315 (f)(2) Transmission to Public Health Agencies – syndromic surveillance 170.315 (f)(3) Transmission to Public Health Agencies – reportable laboratory tests and values/results 170.315 (f)(4) Transmission to Cancer Registries

• Centriq 2015 Edition V14 Roadmap • Phase III- Tentative late July/August 2017

170.315 (g)(2) Automated Measure Calculation 170.315 (g)(7) Application Access-patient selection 170.315 (g)(8) Application Access-data category request 170.315 (g)(9) Application Access-all data request 170.315 (h)(1) Direct Project

• Centriq 2015 Edition V14 Roadmap • Phase IV- TBD 2017

170.315 (f)(5) Transmission to Public Health Agencies – case reporting 170.315 (f)(6) Transmission to Public Health Agencies – antimicrobial use and resistance reporting

• Implementation Plan • Pilot sites 2015 Edition V14

• 5 pilot sites • Deployment to dedicated validation environment

completed March 6, 2017 • Go-live planned May 2017 • 90 continuous days in 3rd or 4th Quarter 2017

• General Availability 2015 Edition V14 • Remaining sites • GA distribution targeted for 3rd Quarter 2017

Centriq 2015 Edition V14 Roadmap

Essential CEHRT for Attestation

• In order for eligible providers (EPs), eligible hospitals (EHs), and eligible critical access hospitals (CAHs) to qualify for reimbursements under the Medicare and Medicaid EHR Incentive Programs, certified Health IT Modules must meet the Certified EHR Technology (CEHRT) definition

• The Modified Stage 2 Measures are applicable for calendar years 2015-2017, and the Stage 3 Measures are applicable beginning calendar year 2017. All systems certified in the 2015 Edition program are required to generate all Modified Stage 2 and Stage 3 measure reports defined in the test script for each measure selected to be tested regardless of the calendar year

CEHRT

• 170.315 (a)(1): Computerized Provider Order Entry (CPOE) - Medications

• 170.315 (a)(2): CPOE - Laboratory • 170.315 (a)(3): CPOE - Diagnostic Imaging • 170.315 (a)(5): Demographics • 170.315 (a)(6): Problem List • 170.315 (a)(7): Medication List • 170.315 (a)(8): Medication Allergy List • 170.315 (a)(9): Clinical Decision Support • 170.315 (a)(11): Smoking Status * • 170.315 (a)(14): Implantable Device List # • 170.315 (b)(1): Transitions of Care

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BASE EHR

• 170.315 (b)(6): Data Export • 170.315 (c)(1): Clinical Quality Measures - Record and Export • 170.315 (g)(7): Application Access - Patient Selection • 170.315 (g)(8): Application Access - Data Category Request • 170.315 (g)(9): Application Access - All Data Request • 170.315 (h)(1): Direct Project OR (h)(2) • 170.315 (h)(2): Direct Project, Edge Protocol, and XDR/XDM

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BASE EHR

• 170.315 (a)(4): Drug-Drug, Drug-Allergy Interaction Checks for CPOE

• 170.315 (a)(10): Drug-Formulary and Preferred Drug List Checks • 170.315 (a)(13): Patient-Specific Education Resources • 170.315 (b)(2): Clinical Information Reconciliation and Incorporation • 170.315 (b)(3): Electronic Prescribing • 170.315 (c)(3): Clinical Quality Measures – Report • 170.315 (e)(1): View, Download, and Transmit to 3rd Party • 170.315 (e)(2): Secure Messaging @ • 170.315 (e)(3): Patient Health Information Capture

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CEHRT Requirements

• 170.315 (f)(1): Transmission to Immunization Registries* • 170.315 (f)(2): Transmission to Public Health Agencies - Syndromic

Surveillance * • 170.315 (f)(3): Transmission to Public Health Agencies - Reportable

Laboratory Tests and Values/Results * • 170.315 (f)(5): Transmission to Public Health Agencies - Electronic

Case Reporting* • 170.315 (f)(6): Transmission to Public Health Agencies -

Antimicrobial Use and Resistance Reporting* • 170.315 (f)(7): Transmission to Public Health Agencies - Health Care

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CEHRT Requirements

• 170.315 (d)(1): Authentication, Access Control, Authorization • 170.315 (d)(2): Auditable Events and Tamper-Resistance • 170.315 (d)(3): Audit Report(s) • 170.315 (d)(4): Amendments • 170.315 (d)(5): Automatic Access Time-out • 170.315 (d)(6): Emergency Access • 170.315 (d)(7): End-User Device Encryption • 170.315 (d)(8): Integrity • 170.315 (d)(9): Trusted Connection • 170.315 (a)(12): Family Health History

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CEHRT Dependencies

• 170.315 (g)(2): Automated Measure Calculation • 170.315 (g)(3): Safety-Enhanced Design • 170.315 (g)(4): Quality Management System • 170.315 (g)(5): Accessibility-Centered Design • 170.315 (g)(6): Consolidated CDA Creation

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CEHRT Dependencies

Thank you!

Meaningful Use Stage 3166.78.170.144/sites/default/files/Meaningful Use Stage 3.pdf · New Rules • Medicare Access ... (APM) Incentive Under the Physician Fee Schedule, and Criteria

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