HCCN Meaningful Use Review. October 7 th, 2015 Louisiana Public Health Institute Kelly Maggiore Jack Millaway

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1 HCCN Meaningful Use Review October 7 th, 2015 Louisiana Public Health Institute Kelly Maggiore Jack Millaway

2 What is Meaningful Use? Federal and State incentive payment program for Eligible Professionals (EP s) that either adopt, implement, upgrade or attest to usage of a Certified (ONC) EMR application Currently in its fifth year Two Programs Medicaid Medicare Last 90 day period of the year has already begun! Attestation submission for 2015 is due in Q As of this year, penalties have begun for providers who are not actively attesting 1% Medicare payment reduction per year of non compliance

3 Components of Meaningful Use Attestation Electronic Health Record Utilization Measures such as: Electronic lab, prescription, and radiology ordering Use of Clinical Decision Support rules Patient Engagement (Patient Portal) Interoperability Connections LINKS HIE Direct Messaging

4 Components of Meaningful Use Attestation Clinical Quality Measures Must report 9 measures From at least 3 Domains: Patient and Family Engagement Patient Safety Care Coordination Population/Public Health Efficient Use of Healthcare Resources Clinical Process/Effectiveness

5 Meaningful Use and Patient Centered Medical Home Original Stage 2 goals already built into NCQA PCMH 2014 accreditation standards such as: Element 1C: Electronic Access Element 2B: Clinical Data Element 3D: Use Data for Population Management (MUST PASS) Element 5A: Test Tracking and Follow up PCMH elements that include factors related to Meaningful Use account for over 40 points on the NCQA PCMH 2014 accreditation tool, including Must Pass elements

6 Meaningful Use Quick Tips Register New Providers Medicaid vs Medicare Provider Switching Identify person(s) responsible for reporting Keep detailed documentation Keep user information up to date Install EHR updates before you need them Keep up to date on regulations, changes Don t make the Clinical Quality Measures an afterthought

7 Meaningful Use Stage 2 Update In April CMS published proposed revisions to MU Stage 2 ( ) Consolidated Measures Stage 1 considerations in 2015 Removed Some Measures Reduced Patient Engagement Requirements Changed Reporting Timelines EP and EH now both report in calendar year Day reporting 2016 Only 1 st year providers attest 90 days 2017 CY reporting for all providers

8 Meaningful Use 2015 Updated Measures Stage 1 and 2 combined PROPOSED OBJECTIVE 1 Computerize d Provider Order Entry (CPOE) 2 Electronic Prescribing 3 Clinical Decision Support PROPOSED MEASURES Measure 1: 60% of medication orders Measure 2: 30% of laboratory orders Measure 3: 30% of radiology orders 50% of all permissible prescriptions, or all prescriptions written by the EP are queried for a drug formulary and transmitted electronically using CEHRT. Measure 1: Implement 5 CDS interventions related to 4 or CQM) Measure 2: The functionality for PROPOSED ALTERNATE MEASURES / EXCLUSIONS / SPECIFICATIONS (For providers demonstrating Stage 1 in 2015) Alternative Measure 1: 30% of unique patients with have at least one medication order entered using CPOE; or more than 30% of medication orders created by the EP during the EHR reporting period are recorded using CPOE. Measure 2: Claim Exclusion Measure 3: Claim Exclusion Alternate EP Measure: 40% of all permissible prescriptions written by the EP are transmitted electronically using CEHRT. Alternate Objective and Measure 1: Objective: Implement one clinical decision support rule relevant to

9 Meaningful Use 2015 Updated Measures Stage 1 and 2 combined Cont d PROPOSED OBJECTIVE 4 Patient Electronic Access 5 Protect Electronic Health Information 6 Patient Specific PROPOSED MEASURES Measure 1: 50% of all unique patients are provided timely (within 4 business days after the information is available to the EP) online access to their health information Measure 2: At least one patient views, downloads, or transmits their health information to a third party. Conduct or review a security risk and implement security updates as necessary and correct identified security deficiencies Patient specific education resources identified by CEHRT are PROPOSED ALTERNATE MEASURES / EXCLUSIONS / SPECIFICATIONS (For providers demonstrating Stage 1 in 2015) Measure 2: Claim Exclusion N/A Alternate Exclusion: Claim Exclusion if provider did not intend to select the

10 Meaningful Use 2015 Updated Measures Stage 1 and 2 combined Cont d PROPOS ED OBJECTI VE 8 Summar y of Care 9 Secure Messagi ng 1 0 Public Health PROPOSED MEASURES For transitions or refers to another setting of care or provider of care (1) CEHRT us used to create a summary of care record and (2) SoC is electronically transmitted for 10% of transitions of care and referrals. Capability for patients to send and receive a secure electronic message with the provider is fully enabled. Measure Option 1 Immunization Registry Reporting: active engagement to submit immunization data and receive immunization forecasts and histories Measure Option 2 Syndromic Surveillance Reporting: active engagement to submit syndromic surveillance data from a non urgent care PROPOSED ALTERNATE MEASURES / EXCLUSIONS / SPECIFICATIONS (For providers demonstrating Stage 1 in 2015) Claim Exclusion Claim Exclusion N/A

11 Clinical Quality Measures 64 total measures Be sure to select measures that are reportable from your EHR Select measures early in year and train providers on proper documentation When possible, align selected CQM measures with existing practice work

12 Possible CQM Measures Many Measures overlap with existing FQHC, PCMH, or HCCN priorities Controlling high blood pressure (CMS165v3) [Clinical Process] Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (CMS155v3) [Pop Health] Tobacco Use: Screening and Cessation Intervention (CMS138v3) [Pop Health] Cervical Cancer Screening (CMS124v3) [Clinical Process] Diabetes: Urine Protein Screening (CMS134v3) [Clinical Process] Diabetes: Hemoglobin A1c Poor Control (CMS122v3) [Clinical Process] Documentation of Current Medication in the Medical Record (CMS68v4) [Patient Safety] Childhood Immunization Status (CMS117v3) [Pop Health] Screening for Clinical Depression and Follow Up Plan (CMS2v4) [Pop Health]

13 Meaningful Use Stage 3 Situation Proposed Rule released in Q Previously expected to be finalized in Sept 2015 Massive Pushback has put the beginning of Stage 3 of Meaningful Use in doubt

14 HCCN Medicaid Meaningful Use Participation by Year Clinic A B C D E F G H I J K L M N O P Q R TOTAL

15 HCCN and Stage 2 Meaningful Use Approximately 20% of HCCN clinicians are to attest for Stage 2 Meaningful Use in 2015 Key areas identified by TA Survey and Quarterly Data: Patient Engagement/Access (Patient Portal) Electronic Referrals (Direct Mail) Medication Reconciliation

16 Meaningful Use Discussion Is your clinic participating in MU this year? Is Meaningful Use a priority at your clinic or conflicting with other priorities (i.e. PCMH and ICD 10)? What specific measure are you having trouble with in you clinic?

17 Questions?

0 What is Meaningful Use and where are we? 0 What is the Physician Quality Reporting System and where stage are we on?

0 What is Meaningful Use and where are we? 0 What is the Physician Quality Reporting System and where stage are we on? Outline 0 What is Meaningful Use and where are we? 0 What is the Physician Quality Reporting System and where stage are we on? 0 How can we leverage the EMR to demonstrate the quality of our care? Meaningful

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