Navigating the Trends in Health Care Today. MEDITECH Solutions for Meaningful Use and Interoperability

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1 Navigating the Trends in Health Care Today MEDITECH Solutions for Meaningful Use and Interoperability

2 Certification Update EHRs Meeting ONC 2014 Standards "There is no such thing as being 'Stage 1 Certified' or 'Stage 2 Certified' 2014 Edition EHR technology would be able to support the achievement of either meaningful use Stage." Starting in 2014, all EHR Incentive Programs participants will have to adopt certified EHR technology that meets ONC s Standards & Certification Criteria 2014 Final Rule Certification is Complete.

3 Inpatient Certification Update Complete Client/Server Complete MAGIC Complete Complete Modular certification is complete Check out meditech.com for details

4 Key Components of a Meaningful Use Audit The source document(s) used when completing the attestation: Core/Menu Reports and Clinical Quality Measure Reports Proof that certain functionality was available, enabled, and active in the system for the duration of the EHR reporting period. Proof of test submissions for public health reporting and clinical information exchange Documentation to support each exclusion to a measure claimed by the EH/EP Proof that the EH/EP possessed certified EHR technology

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6 Meaningful Use Accelerates Interoperability Stage Stage View, download and transmit - Portal Transition of Care - CCD Successful ongoing submission of Electronic data to Public Health Agencies (Cancer Cases & Specialized Registries) e-prescribing Secure electronic messaging Infobutton Capability to exchange key clinical information Capability to submit electronic data to Public Health Agencies e-prescribing - Ambulatory

7 Mobilizing Data in 2014

8 Transitions of Care Meaningful Use Requires: Stage 1 The EP, eligible hospital, or CAH that transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50 % of transitions of care and referrals. Stage 2 Provide summary of care document for more than 50% of transitions of care and referrals with 10% sent electronically and at least one sent to a recipient with a different EHR vendor or successfully testing with CMS test EHR

9 Transitions of Care: Hospital Admission Query for data in your community

10 Notification regarding Clinical Summary

11 Clinician Friendly View of Summary

12 Reconciliation of CCDA information

13 Clinical Information Reconciliation from CCDA

14 Transitions of Care: Discharge Patient Push data out to your community using IHE Transactions (ITI-41)

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16 What is Direct Messaging? Direct: A simple, affordable way to transport patients protected health information (PHI) to a known, trusted recipient via the internet

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18 HISP the Who, What, Where and How Healthcare Information Service Provider States have offered pathways to Direct Message Exchange via partnering with a HISP Some IDN s are building their own regional HISPs Regional cities may have overlap National HISP like Surescripts Certification forthcoming via DirectTrust.org Best source is your regional Health Information Exchange HISP Agnostic Approach for MEDITECH

19 How does Direct work with MEDITECH Platforms? Direct is part of MEDITECH Product Releases: o MAGIC 5.66 o Client/Server 5.66 o 6.07 o 6.13 Direct is either an add-on component to your existing CCD Interface Suite or is licensed as a new CCD Interface Suite The payload is a CCDA (Consolidated CDA which contains a CCD) Currently certified to support the SMIME/SMTP version Certified for XDR/SOAP version **NEW**

20 What is Impact of Direct on My Organization Present Day Ability to exchange transitions of care documents (such as CCDs) are part of MU Stage 2 requirements Direct messaging is one way to satisfy this requirement Sending CCDs to a Healtheway HIE Exchange member is another Direct can support your HIE initiatives no matter how big or small Offers ability to exchange info with providers outside of an existing HIE or without an EHR Most states, 40+ HIEs, 10 IDNs and 3 leading PHR providers are offering pathways to utilize Direct Future State Emerging MU 3 requirements point to increased importance for Direct

21 Implementation Considerations Addresses Inbound Users and Direct addresses need to be defined in MEDITECH Hospital Departments and General Physician Practice organizational addresses are a good place to start Recipient may be unknown Patient may not be registered New User Workflow to manage unsolicted CCD files inbound Outbound Pre-define addresses in Provider Dictionary Work with other entities on a policy for their receipt Provider Directory specifications are emerging

22 Workflows Stand Alone Routine for Medical Records and Clinicians o Bi-Directionally send and receive CCDAs Incorporated into Discharge Routines Available for patients via MEDITECH Portal

23 Send CCDA Outbound via Direct Message

24 Receive CCDA Inbound via Direct Message

25 Receive CCDA Inbound via Direct Message

26 Send CCDA Outbound via Discharge

27 Send CCDA Outbound via Portal

28 Transition of Care Measure & HIE s When using SMIME/SMTP connections to another EHR, MEDITECH receives the all important Message Delivery Notification. This is when TOC is officially met. Optional XDR/SOAP does not support.yet! When a HIE/HIO is in the middle, it is required to support EP/EH EHR systems with verification that the CCDA document made it to the recipient. 1. EP or EH utilizes CEHRT to generate a CCDA summary document and sends the document to an HIO via the CEHRT s Direct or SOAP+XDR/XDM transport capability The HIO could then repackage the message and send it to the receiving provider via any transport method. 2. HIO acts as an intermediary to which an EP or EH uses their CEHRT to send a CCDA summary document via the Direct transport standard (SMTP, SMTP+XDR/XDM) or SOAP+XDR/XDM, and the HIO then makes the CCDA available for query 3. ONC official document link

29 Medication Management and e-prescribing Stage 2 Menu item for Hospitals Integrated into MEDITECH s EDM, PCS/Nursing, and PCM Access medication histories Update patients' records Check benefits while ordering Communicate orders to retail and mail order pharmacies Standards-based NCPDP Script interfaces DrFirst as transaction clearinghouse

30 Clinician s Role in Public Health Reporting Immunizations Reporting Vaccines ordered Administered via emar Queued to registry Syndromic Surveillance Documenting Chief complaint/reason for visit May trigger reportable event to state registry Reportable Lab Results Diagnostic Lab Orders and results May trigger reportable event to state registry Cancer & Specialized Registries Documenting Cancer or other Conditions May trigger reportable event to state registry

31 Communicating with Physician Practices Orders In/Results Out Interface Suite Ambulatory Orders Inbound from Clinics Results returned to practice for better Coordinated Care Stage 2 Menu Item for Hospitals (Results Outbound)

32 Optimizing Standards in Daily Routines Introduces the Infobutton: -Providing links to patient-specific education resources -Providing context-sensitive link to reference information to support clinical decision making Providing Patient Education: Use clinically relevant information from Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient. Utilizing Clinical Decision Support Use clinical decision support to improve performance on highpriority health conditions.

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