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1 Mara Robertson Tennessee Primary Care Assoc. November 5, Meaningful Use: What s the Big Deal! 2 1

2

3 5 Internal Pressures 6 3

4 External Motivation President Promotes Switching To Electronic Medical Records Bush Says Paperless System Would Cut Costs, Improve Care By Michael Fletcher Washington Post Staff Writer Friday, January 28, 2005; Page A07 CLEVELAND, Jan. 27 President Bush called on doctors and hospitals Thursday to move their medical records from paper to electronic files, a change that he said would improve medical care while shaving significant sums from the nation's spiraling health care bill. Speaking at the Cleveland Clinic, Bush quoted health analysts who said that the efficiencies wrought by electronic medical records could reduce medical costs as much as 20 percent. Electronic records can "help change medicine and save money and save lives," he said. 7 Obama Wants E Health Records In Five Years President elect says medical information on all Americans should be digitized by By K.C. Jones InformationWeek January 12, :53 PM President elect Barack Obama said he wants the federal government to invest in electronic health records so all medical records are digitized within five years. Obama announced the plans and the deadline during a speech at George Mason University in Fairfax, Va., on Thursday. "This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests," he said, adding that the switch also would save lives by reducing the number of errors in medicine. Since President George W. Bush called for health records to be stored electronically by 2014, Obama's announcement confirms his administration's plans to continue pushing for that deadline. 8 4

5 Stimulus Bill To computerize their medical records, physicians and their practices stand to get $44,000 to $64,000 in incentives, and hospitals up to $11 million... With the federal government spending more than $600 billion annually on 80 million Americans through Medicare, Medicaid and other programs, that could prove a powerful incentive for providers to get on board. By Anita Huslin Washington Post Staff Writer Monday, February 16, 2009; Page D01 9 From Conception to Actuality February 2009, the HITECH Act (Health Information Technology for Economic and Clinical Health Act is a provision of the American Recovery and Reinvestment Act (ARRA). designed to encourage the widespread adoption of EHRs. Within the HITECH Act are guidelines of an incentive program outline which contain two distinct sections; certification of EHR technology and using the certified technology in a meaning way Meaningful Use. June 30, 2010, the Office of the National Coordinator (ONC) released the set of standards and certification criteria that software vendors must meet to support providers in achieving the meaningful use objectives. July 13, 2010, CMS (Centers for Medicare & Medicaid Services) and ONC announced the release of the anticipated final regulated objectives that eligible providers, eligible hospitals, and critical access hospitals must achieve. August 2010, first of six ONC ATCB s announced 10 5

6 Why Health IT? Health information technology (health IT) makes it possible for health care providers to better manage patient care through secure use and sharing of health information. Health IT includes the use of electronic health records (EHRs) instead of paper medical records to maintain patient s health information. Improving Patient Care With the help of health IT, providers will have: Accurate and complete information about a patient's health. The ability to better coordinate the care they give. A way to securely share information with patients and their family caregivers. Information to help doctors diagnose health problems sooner, reduce medical errors, and provide safer care at lower costs. Improving Our Nation's Health Care Delivery System Widespread use of health IT can also: Make our health care system more efficient and reduce paperwork for patients and doctors. Expand access to affordable care. Build a healthier future for our nation. 11 Demystifying Meaningful Use 12 6

7 13 What is Meaningful Use 14 7

8 Meaningful Use Policy Vision & Goals HIT Policy Committee (HITPC) 15 Who is Eligible to Participate? 16 8

9 Who is Eligible to Participate? 17 Who is Eligible to Participate? 18 9

10 Who is Eligible to Participate? 19 Who is Eligible to Participate? 20 10

11 Who is Eligible to Participate? 21 What are the Requirements ~ Adopt/Implement/Upgrade? No EHR Reporting Period 22 11

12 Requirements to Participate 23 Requirements to Participate 24 12

13 Requirements to Participate 25 What are the Requirements of Meaningful Use? 26 13

14 What are the Requirements of Meaningful Use? Stage 1 Objectives and Measures Reporting Eligible Professionals must complete: 15 core objectives 5 objectives out of 10 from menu set 6 total Clinical Quality Measures (3 core or alternate core, and 3 out of 38 from menu set) 27 Additional Requirements of Meaningful Use! 28 14

15 Additional Information

16 MU Stage 1: Core Set Objectives 31 MU Stage 1: Core Set Objectives 32 16

17 MU Stage 1: Core Set Objectives 33 MU Stage 1: Menu Set Objectives 34 17

18 MU Stage 1: Menu Set Objectives 35 MU Stage 1: Menu Set Objectives 36 18

19 States Flexibility to Revise MU 37 Required Clinical Quality Measures 38 19

20 What are the Requirements ~ Clinical Quality Measures 39 What are the Requirements of Meaningful Use? Stage 1 Objectives and Measures Reporting Eligible Professionals must complete 15 core objectives 5 objectives out of 10 from menu set 6 total Clinical Quality Measures (3 core or alternate core, and 3 out of 38 from menu set) 40 20

21 What are the Requirements ~ Clinical Quality Measures 41 What are the Requirements ~ Clinical Quality Measures 42 21

22 What are the Requirements ~ Clinical Quality Measures 43 What are the Requirements ~ Clinical Quality Measures 44 22

23 What are the Requirements ~ Clinical Quality Measures 45 What are the Requirements ~ Clinical Quality Measures 46 23

24 What are the Requirements ~ Clinical Quality Measures 47 What are the Requirements ~ Clinical Quality Measures 48 24

25 What are the Requirements ~ Clinical Quality Measures States

26 Approach to Meaningful Use Established 3 stages of meaningful use: 2011 Data capture and sharing 2013 Advanced clinical processes 2015 Improved outcomes 51 Payment Year vs. Adoption Year Stage of Meaningful Use Criteria by Payment Year 52 26

27 Payment Incentives? 53 Payment Incentives? 54 27

28 Payment Incentives? 55 Payment Incentives? 56 28

29 Payment Incentives? 57 Payment Incentives? Note: More information on payment adjustments and the requirements to qualify for a hardship exemption will be provided in future rulemaking prior to the 2015 effective date

30 Payment Incentives? Eligible Professional Calculation Subject to an annual limit, Equal to 75 percent* of the Medicare allowed charges for covered professional services furnished by the EP during the relevant payment year Incentive maximum /.75 = Allowable Charges /.75 = $24000 * 75% based on Final Rule 59 Time Management 60 30

31 Timeline of the Program 61 Timeline of the Program November 30, 2011 Last day for hospitals to register and attest to receive an incentive payment for FY 2011 February 29, 2012 Last day for EPs to register and attest to receive an incentive payment for CY Medicare payment adjustments begin for EPs and eligible hospitals that are not meaningful users of EHR technology 2016 Last year to receive a Medicare EHR incentive payment; Last year to initiate participation in Medicaid EHR Incentive Program 2021 Last year to receive Medicaid EHR incentive payment 62 31

32

33 The Road Ahead Develop a Plan Work the Plan Plan will Work 65 Road Map To Success Workflow Review & Process Redesign & Adequate Training 66 33

34 67 Care Coordination Specialist Primary Care Public Health 68 34

35 Quality

36 Improve Outcomes

37 73 References: Centers for Medicare & Medicaid Services: Certified Health IT Product List: CMS official website for Meaningful Use (Medicare / Medicaid) : HIMSS: Institute of Medicine: Erris Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf Office of the National Coordinator s (ONC), provision of assistance for providers with EHR vendor selection, support and workflow redesign using the Regional Extension Center Program: m/

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