awards and meaningful use
DESCRIPTION
Foothold Technology recently had the unique opportunity to present to the Centers for Medicare & Medicaid Services’ (CMS) Community of Practice, an online community of doctors, nurses, and providers that connect to exchange innovative patient safety best practices and serves as a repository of resources, ideas, and tools. The purpose of this presentation was to discuss the environment Behavioral Healthcare providers encounter when participating in the Meaningful Use incentive program, an initiative put forth under the American Recovery and Reinvestment Act of 2009 in order to get hospitals and individual primary care providers to use electronic health records and complete objectives designed to improve patient care.TRANSCRIPT
AWARDS and Meaningful Use
Alex AttinsonRachel 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
• 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, Implemen
t, 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
Questions?
• www.footholdtechnology.com
• ConnectedCare Team: [email protected]
• Alex Attinson: [email protected]
• Rachel Miller – Senior Project Manager: [email protected]
Foothold Technology