Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series “Ten Minutes at a Time” Module 2: The Role of the Certified Complete.

Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series Ten Minutes at a Time Module 2: The Role of the Certified Complete Electronic Health Record in Meaningful Use 9/2013

Module 2 Outline Four key terms and one requirement Required functionality in the Certified Complete EHR Getting help - resources for technical assistance and training

Four Key Terms Certified for Ambulatory (Outpatient) Practice- EHR is certified for use in outpatient settings (as opposed to inpatient or hospital setting) Complete EHR includes all of the components necessary for meeting ALL of the standards for Stage 1 Meaningful Use Certified Passed tests by an Office of the National Coordinator Authorized Testing and Certification Body (ONC- ATCB) verifying that the EHR meets the certification criteria to use the EHR to meet the standards for Stage 1 Meaningful Use 1/2014 Changes Certification and Testing entities are separated into ONC-ACB for certificaiton and ONC-ATL for testing http://www.gpo.gov/fdsys/pkg/FR-2010-07-28/pdf/2010-17210.pdf http://healthit.gov/policy-researchers-implementers/onc-hit-certification-program

Meaningful Use (MU) rolled out in stages* Stage 1 MU requires EHRs certified for Stage 1 (2011) Edition) until the end of 2013 Beginning 1/2014, the Stage 1 EHR must be certified as the Stage 1 2014 edition and used for 90 consecutive days (AIU for Year 1, full implementation for 90 days for Year 2) Stage 2 MU requires EHRs certified for Stage 2 (2014 Edition) Stages apply to qualifying for the Eligible Professional Incentive Program payments Can start participating in Stage 1 anytime until 2016 and collect full 6 years of Meaningful Use Incentive Payments https://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage1vsStage2CompTablesforEP.pdfhttps://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage1vsStage2CompTablesforEP.pdf http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage1ChangesTipsheet.pdf and One Important Requirement

Core Objectives* 1. Computerized provider order entry (CPOE) 2. E-Prescribing (eRx) 3. Report ambulatory clinical quality measures to CMS/States 4. Implement one clinical decision support rule 5. Provide patients with an electronic copy of their health information, upon request 6. Provide clinical summaries for patients for each office visit 7. Drug-drug and drug-allergy interaction checks 8. Record demographics 9. Maintain an up-to-date problem list of current and active diagnoses 10.Maintain active medication list 11.Maintain active medication allergy list 12.Record and chart changes in vital signs 13.Record smoking status for patients 13 years or older 14.Capability to exchange key clinical information among providers of care and patient-authorized entities electronically 15.Protect electronic health information * https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/EP-MU-TOC.pdf https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/EP-MU-TOC.pdf

Menu Objectives (may defer 5 of 10 to Stage 2) 1. Drug-formulary checks 2. Incorporate clinical lab test results as structured data 3. Generate lists of patients by specific conditions 4. Send reminders to patients per patient preference for preventive/follow up care 5. Provide patients with timely electronic access to their health information 6. Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate 7. Medication reconciliation 8. Summary of care record for each transition of care/referrals 9. Capability to submit electronic data to immunization registries/systems* 10. Capability to provide electronic syndromic surveillance data to public health agencies* * At least 1 public health objective must be selected.

Example Certified EHR Functionality and MU Objectives/Measures Core Objective #5 ( what the Eligible Professional needs to do) Maintain Active Medication List Measure: More than 80% of all unique patents seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data Certified EHR Technology (CEHRT) Functionality Certification Criterion Final Rule Text: 170.302(d). Maintain active medication list. Enable a user to electronically record, modify, and retrieve a patients active medication list as well as medication history for longitudinal care.

What Certified and Complete Do NOT Mean! Certified does NOT guarantee a degree of quality Certified only assures the buyer that the software meets the minimum standards, specifications and criteria for Stage 1 Meaningful Use, either for 2011-2013, or 2014, or both. Complete does not mean that the software will meet all of your organizations requirements Complete means that the EHR will allow the eligible professional to implement the workflows and collect, access and utilize the patient data necessary to meet all 15 Core and all 10 Menu Objectives and Measures for Meaningful Use

Key Differences Among Certified EHRs Complete as an EHR Business Product Scenario 1 - All of the required functionality is built into the single software product. No additional certified software modules (for example, for ePrescribing) are required. Scenario 2 - Individual software modules are certified but they have to be purchased separately and used together to make the EHR complete.

Key Differences, continued Robust vs Anemic Meaningful Use Functionality Anemic meets minimum requirement this is the floor for certification Robust meets minimum requirement and includes optional Meaningful Use applicable additional functionality. This is the ceiling. Example: Continuity of Care Record Patient data set may include data in up to 17 areas of information To meet certification criteria, the EHR only has to populate the minimum data set for 7 areas

Summary Two basic types of certified EHRS Ambulatory and Inpatient practice types Complete refers to EHR functionality needed for meeting ALL if the Meaningful Use Measures/Objectives Certified refers to the successful completion of the ONC-ATCB testing process EHR Two Stages that the EHR can be certified in Edition 1 (2011) for Stage 1, Edition 2 (2014) for Stage 2 Complete, Certified for Editions 2011 and 2014 does not indicate a level of quality, just a minimum standard for functionality

We Have Solutions for Integrating Primary and Behavioral Healthcare Contact CIHS for all types of primary and behavioral health care integration technical assistance and training needs 1701 K Street NW, Ste 400 Washington DC 20006 Web: www.integration.samhsa.govwww.integration.samhsa.gov Email:[email protected]@thenationalcouncil.org Phone:202-684-7457 Prepared and presented by Colleen ODonnell, MSW, PMP, CHTS-IM for the Center for Integrated Health Solutions

Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series “Ten Minutes at a Time” Module 2: The Role of the Certified Complete.

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