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

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• 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

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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

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• 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

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• Implementation team / MU leadership

• Resources: staff and hardware

• Staff resistance

• Computer skills

• Training

• Workflow/process changes

• Data quality

General Challenges

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• 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

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• 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

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• 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

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• 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

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Workflow in BH Agencies

Psych Note Clinical Summary Electronic Document/VDT

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Clinical Summary

Clinical Summary

VDT – Electronic Document

Meaningful Use Dashboard

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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

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• 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

eCQMValue Sets

QRDA Cat I & III

Clinical Quality Measures

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Codified Data Entry

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AHRQ Value Sets

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PQRS Reporting

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• 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

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Q & A

Thank You!

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