Understanding Meaningful Use

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Understanding Meaningful Use. Review of Stage 1 and Stage 2. Purdue Research Foundation 2012. Presented by: Allison Bryan MS, CHES December 7, 2012. Meaningful Use. Purdue Research Foundation 2012. - PowerPoint PPT Presentation

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Understanding Meaningful UsePresented by: Allison Bryan MS, CHESDecember 7, 2012Purdue Research Foundation 2012Review of Stage 1 and Stage 2Meaningful UseFinancial incentives for the meaningful use of certified EHR technology to improve patient care

Providers have to meet thresholds for certain objectivesRequired core objectivesChoice of menu objectives

Meaningful use must be demonstrated for all patients, not just Medicare or Medicaid subscribersPurdue Research Foundation 2012Meaningful Use StagesPurdue Research Foundation 2012

Purdue Research Foundation 2012

Purdue Research Foundation 2012Improving quality, safety, efficiency and reducing health disparities(cont.)Maintain active medication allergy list

80%+ of patientsRecord and chart changes in selected vital signs (height, weight, BP, BMI, growth charts (2-20 yrs.)50%+ of patients Record smoking status for patients 13 years old or older

50%+ of patientsImplement one clinical decision support rule along with the ability to track compliance that rule

1 rule

Report ambulatory quality measures to CMS or the StatesAggregate numerator/ denominatorPolicy Priority Stage 1 Objectives MeasurePurdue Research Foundation 2012666Engage patients and families in their healthcare

Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and medication allergies) upon request, within 3 days of request50%+ of all patients who requestProvide clinical summaries to patients for each office visit within 3 days of visit50%+ of all office visitsImprove Care Coordination

Capability to exchange key clinical information (for example problem list, medication lists, medication allergies, diagnostic test results) among providers of care and patient authorized entities electronically1 test of capabilityEnsure adequate security and privacy provisions for personal health informationProtect electronic health information created or maintained by certified EHR technology through the implementation of appropriate technical capabilities.Conduct or review a security risk analysisPolicy Priority Stage 1 Objectives MeasurePurdue Research Foundation 20127SecurityProviders fined $100,00 for Internet privacy violations

2 physician cardiology practice

The physician practice was posting clinical and surgical appointments for its patients on an Internet-based calendar that was publicly accessibleOCR findings:Few policies and procedures to comply with the HIPAA Privacy and Security RulesLimited safeguards in place to protect ePHIOutcome:$100,000 penaltyRequired to adopt a Corrective Action Plan

Purdue Research Foundation 2012http://hipaahealthlaw.foxrothschild.com/2012/04/articles/hipaa-enforcement/first-small-physician-practice-joins-the-parade-of-hipaa-phi-security-breaches/

SecurityMassachusetts provider settles HIPAA case for $1.5 million

300 Physician Eye and Ear Institute

Result of a theft of an unencrypted personal laptop containing ePHI of patients and research subjectsOCR findings: No thorough analysis of the risk to the confidentiality of ePHI maintained on portable devices Did not Implement security measures sufficient to ensure the confidentiality of ePHI Did not implement policies and procedures to restrict access to ePHI to authorized users of portable devicesOutcome:$1.5 million penaltyRequired to adopt a Corrective Action PlanPurdue Research Foundation 2012http://www.phiprivacy.net/?p=10212

Menu SetPolicy Priority Stage 1 Objectives MeasureImproving quality, safety, efficiency and reducing health disparities

Implement drug formularychecksFunctionality enabledIncorporate clinical lab test results into certifiedEHR technology as structured data40%+ of all clinical lab tests orderedGenerate lists of patients by specific conditions touse for quality improvement, reduction of disparities, research or outreachAt least 1 report of patients with conditionSend reminders to patients 65 years or older of 5 years or younger per patient preference for preventive/ follow up care20%+ of patientsPurdue Research Foundation 2012Policy Priority Stage 1 Objectives MeasureEngage patients and families in their healthcare Improve Care Coordination

Provide patients with timely electronic access to their health information (including lab results, problem list,medication lists, medication allergies) within four business days of the information being available to the EP10%+ of patientsUse certified EHR technology to identify patient-specificeducation resources and provide those resources to the patient if appropriate10%+ of patientsPurdue Research Foundation 2012Improve carecoordinationPerform Medication Reconciliation when the EP or eligible hospital receives a patient from another setting of care or provider of care50%+ of care transitions to EPProvide summary of care record for each transition of a patient to another setting of care or provider of care or referral to another provider of care50%+ of care transitions from EPImprove population healthCapability to submit electronic data to immunization registriesor Immunization Information Systems and actual submission in accordance with applicable law and practiceAt least 1 testCapability to submit electronic syndromic surveillance data topublic health agencies and actual submission in accordance with applicable law and practiceAt least 1 testPolicy Priority Stage 1 Objectives MeasurePurdue Research Foundation 201212Progress to DateIncentives according to CMS:More than 110,000 Eligible Professionals have received incentive payments from the Medicare and Medicaid EHR Incentive ProgramsFrom May 2011 to July 31, 2012, more than $3.6 billion in Medicare paymentsFrom January 2011 to August 31, 2012, more than $3.3 billion in Medicaid paymentsRelease of Stage 2 Meaningful UseBegins 2014Purdue Research Foundation 2012Meaningful Use: Stage 2Secure Messaging (Core)Use secure electronic messaging to communicate with patients on relevant health informationThreshold: greater than 5%2 exclusions apply

Timely Online Access: View, Transmit or Download (Core)2 portions, must achieve both for Meaningful UseTimely Online AccessMeasure: Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP or 36 hours after discharge from an inpatient or emergency department of an EH or CAHThreshold: greater than 50%View Transmit or DownloadMeasure: Number of unique patients seen by the EP during the reporting period (or authorized representative), who view, download, or transmit health information.Threshold: greater than 5%1 exclusion applies to each portionPurdue Research Foundation 2012Secure Messaging Exclusions:Any EP who has no office visits during the EHR reporting periodAny EP who conducts 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 3Mbps broadband availability according to the latest information available from the FCC on the first day of the EHR reporting period.

Timely Online Access Exclusion:Any EP who neither orders nor creates any of the information listed for inclusion as part of both measures (except for patient name, providers name and office contact information).

View, Transmit or Download Exclusion:Any EP who conducts 50% or more of patient encounters in a county that does not have 50% or more of its housing units with 3Mbps broadband availability according to the latest information available from the FCC on the first day of the reporting period.Meaningful Use: Stage 2Imaging Results (Menu)Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through CEHRT.Threshold: The resulting percentage must be more than 10 percent in order to meet this measure.2 exclusions apply

Family History (Menu)More than 20% of all unique patients seen by the EP during the EHR reporting periods have a structured data entry for one or more first-degree relatives1 exclusion appliesPurdue Research Foundation 2012Imaging Exclusions:Any EP who orders less than 100 tests whose result is an image during the EHR reporting periodAny EP who has no access to electronic imaging results at the start of the EHR reporting period. (No access means that none of the imaging providers used by the EP provide electronic images and any explanation or other accompanying information that are accessible through their CEHRT at the start of the EHR reporting period.)

Family History Exclusion:Any EP who has no office visits during the reporting period.

Meaningful Use: Stage 2Cancer Registry (Menu)Successful ongoing submission of cancer case information from CEHRT to a public health central cancer registry for the entire EHR reporting period. No threshold, pass/fail4 exclusions apply

Specialized Registry (Menu)Successful ongoing submission of specific case information from CEHRT to a specialized registry for the entire EHR reporting periodNo threshold, pass/fail4 exclusions apply

Purdue Research Foundation 2012Cancer Registry exclusions:The EP does not diagnose or directly treat cancerThe EP operates in a jurisdiction for which no public health agency is capable of receiving electronic cancer case information in the specific standards required for CEHRT at the beginning of their EHR reporting periodThe EP operates in a jurisdiction where no PHA provides information timely on capability to receive electronic cancer case informationThe EP operates in a jurisdiction for which no public health agency that is capable of receiving electronic cancer case information in the specific standards required