1 Lunch and Learn IFAF 09/24/11 Michael L. Brody, DPM
2 Disclaimers Sammy Sponsor of this presentation PICA Biomedix All Pro Imaging
3 The Brave New World of HIT Today s Topics: PQRS E-Rx EMR Health Information Exchanges
4 PQRS Review PQRS Need to report on three measures to qualify for the bonus which is 1% If you are in a MOC Program your bonus increases to 1.5% The only MOC Program in Podiatry is through ABPOPPM. There are only 7 specialties in this country that have approved MOC programs one of those is in Podiatry
5 Measure 126 Diabetic Foot and Ankle Care, Peripheral Neuropathy : Neurological Evaluation This measure is to reported for all patients aged 18 years and older with diabetes mellitus a minimum of once per reporting period.
7 126 Reporting G8404: Lower extremity neurological exam performed and documented G8406: Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure G8405: Lower extremity neurological exam not performed
8 Measure 127 Diabetic Foot and Ankle Care, Ulcer Prevention Evaluation of Footwear This measure is to reported for all patients aged 18 years and older with diabetes mellitus minimum of once per reporting period.
10 127 Reporting G8410: Footwear evaluation performed and documented G8416: Clinician documented that patient was not an eligible candidate for footwear evaluation measure G8415: Footwear evaluation was not performed
11 Measure 163 Foot Exam This measure is to be reported for all patients aged 18 through 75 years with diabetes mellitus a minimum of once per reporting period.
13 163 Reporting 2028F: Foot examination performed (includes examination through visual inspection, sensory exam with monofilament, and pulse exam - report when any of the three components are completed) 2028F -1P: Documentation of medical reason for not performing foot exam (i.e., patient with bilateral foot/leg amputation) P: Foot exam was not performed, reason not otherwise specified
14 Visit Sammy To view how PQRS is reported visit the Sammy table. They have tools built in that automated PQRS reporting.
15 To get the extra.5% You need to be ABPPOPPM board certified. Contact ABPOPPM for more details
16 E-Rx Must have done 10 by June 30 Must do 25 by Dec 31 New Exemptions that you can claim if you did not get 10 in by June 30
17 How do you report E-Rx G8553 Visit the Sammy Table for more details
18 How do you claim exemption You must claim exemption by Nov 1. Exemptions are available for the following reasons: You have registered to meet meaningful use and have a certified software program You have limited prescribing activity You don t have internet access There are no pharmacies in your area that accept electronic prescriptions See the links section of for access to the exemption form.
19 EMR $44,000 over 5 years 18 K year 1 12 K year 2 8 K year 3 4 K year 4 2 K year 5 This is the Medicare program Podiatry is excluded from the Medicaid Program
20 To get incentive Must have certified software Must use certified software in the environment where you see over 50% of your patients With multiple locations this can become difficule Discussion
21 15 Core Measures and 10 Menu Measures Ok fasten your seat belts because we will be going through these quickly
22 1 CPOE OBJECTIVE: Use computerized provider order entry (CPOE) for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines. EXCLUSION Any EP who writes fewer than 100 prescriptions during the EHR reporting period. THRESHOLD 30 percent of all unique patients
23 2 Drug Interaction Checks OBJECTIVE: Implement drug-drug and drug-allergy interaction checks. EXCLUSIOIN: None Threshold This is enabled in your EMR
24 3 Active Problem List OBJECTIVE: Maintain an up-to-date problem list of current and active diagnoses. EXCLUSION: None THRESHOLD 80 percent of all unique patients
25 4 Transmit Prescriptions Electronically OBJECTIVE Generate and transmit permissible prescriptions electronically (erx). EXCLUSIONS: Any EP who writes fewer than 100 prescriptions during the EHR reporting period. THRESHOLD: 40 percent of all permissible prescriptions
26 5 Active Medication List OBJECTIVE: Maintain active medication list. EXCLUSIONS: None Threshold 80 percent of all unique patients
27 6 Active Allergy List OBJECTIVE Maintain active medication allergy list. EXCLUSIONS: None THRESHOLD 80 percent of all unique patients
28 7 Record Demographics OBJECTIVE: Record all of the following demographics: Preferred language, Gender, Race, Ethnicity and Date of birth EXCLUSIONS: None THRESHOLD 50 percent of all unique patients
29 OBJECTIVE: 8 Record Vital Signs Record and chart changes in the following vital signs: Height, Weight, Blood pressure EXCLUSIONS: Your EMR Must Calculate and display body mass index (BMI) and Plot and display growth charts for children 2-20 years, including BMI EP who either see no patients 2 years or older all three vital signs of height, weight, and blood pressure of their patients have no relevance to their scope of practice. THRESHOLD 50 percent of all unique patients age 2 and over
30 9 Record Smoking Status OBJECTIVE Record smoking status for patients 13 years old or older. EXCLUSIONS: Any EP who sees no patients 13 years or older. THRESHOLD 50 percent of all unique patients 13 years old
32 11 Clinical Decision Support Rule OBJECTIVE Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule. EXCLUSIONS None THRESHOLD Implement one clinical decision support rule.
33 12 Electronic Copy of Health Information OBJECTIVE Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies) upon request. EXCLUSIONS Any EP that has no requests from patients or their agents THRESHOLD 50 percent of all patients who request an electronic copy of their health information are provided it within 3 business days
34 13 Clinical Summaries OBJECTIVE Provide clinical summaries for patients for each office visit. EXCLUSIONS Any EP who has no office visits during the EHR reporting period THRESHOLD Clinical summaries provided to patients for more than 50 percent of all office visits within 3 business days
35 14 Electronic Exchange of Clinical Information OBJECTIVE Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, and diagnostic test results), among providers of care and patient authorized entities electronically. EXCLUSIONS None THRESHOLD Performed at least one test of certified EHR technology s capacity to electronically exchange key clinical information.
36 15 Protect Electronic Health OBJECTIVE Information Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities EXCLUSIONS None THRESHOLD Conduct or review a security risk analysis in accordance with the requirements under 45 CFR (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.
37 10 Menu Measures Required to meet 5 of the 10 If you can claim an exemption from a menu measure it counts as 1 of your 5.
38 M1 Drug Formulary Checks OBJECTIVE Implement drug formulary checks. EXCLUSIONS Any EP who writes fewer than 100 prescriptions THRESHOLD The EP has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period.
39 M2 Clinical Lab Test Results OBJECTIVE Incorporate clinical lab test results into EHR as structured data. EXCLUSIONS An EP who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period. THRESHOLD More than 40 percent of all clinical lab test results whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data.
40 M3 Patient Lists OBJECTIVE Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach. EXCLUSIONS None THRESHOLD Generate at least one report listing patients of the EP with a specific condition
41 M4 Patient Reminders OBJECTIVE Send reminders to patients per patient preference for preventive/follow-up care. EXCLUSIONS An EP who has no patients 65 years old or older or 5 years old or younger THRESHOLD 20 percent of all patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period
42 M5 Patient Electronic Access to Health Information OBJECTIVE Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, and allergies) within 4 business days of the information being available to the EP. EXCLUSIONS Any EP that neither orders nor creates lab tests or information that would be contained in the problem list, medication list, medication allergy list THRESHOLD 10 percent of all unique patients seen (within four business days)
43 M6 Patient Specific Educational Resources OBJECTIVE Use certified EHR technology to identify patientspecific education resources and provide those resources to the patient if appropriate. EXCLUSIONS None THRESHOLD More than 10 percent of all unique patients seen by the EP are provided patient-specific education resources.
44 M7 Medication Reconcilliation OBJECTIVE The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation. EXCLUSIONS An EP who was not the recipient of any transitions of care during the EHR reporting period. THRESHOLD The EP performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP.
45 M8 Transition of Care Summary OBJECTIVE The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral. EXCLUSIONS An EP who neither transfers a patient to another setting nor refers a patient to another provider during the EHR reporting period. THRESHOLD 50 percent of transitions of care and referrals
46 M9 Immunization Registries OBJECTIVE Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice. EXCLUSIONS An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically. THRESHOLD Performed at least one test of certified EHR technology s capacity to submit electronic data to immunization registries and follow up submission if the test is successful
47 M10 Syndromic Surveillance OBJECTIVE Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice. EXCLUSIONS An EP who does not collect any reportable syndromic information or no public health agency has the capacity to receive the information electronically. THRESHOLD Performed at least one test of certified EHR technology s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful
48 What is a Health Information Exchange Stage 2 of Meainginful Use will have many changes including the requirement to use Health Information Exchanges to communicate with other providers of care.
49 Thanks to Sammy Thanks to Sammy E H R who sponsored today's presentation. Sammy has tools built in to support your participation in PQRQ, E-Rx and Meaningful Use. Sammy Customers have already received hundreds of thousands of dollars in incentive money for these programs. Visit the Sammy Website
50 Questions? You can also use the forum section at to send me questions that you may have on any of this presentation.
Meaningful Use Objectives The purpose of the electronic health records (EHR) incentive program is not so much the adoption of health information technology (HIT), but rather how HIT can further the goals
Meaningful Use Criteria for Eligible and Eligible Professionals (EPs) Under the Electronic Health Record (EHR) meaningful use final rules established by the Centers for Medicare and Medicaid Services (CMS),
Meaningful Use Stage 1 Core Objectives Must Meet all 13 Objectives 1. CPOE for Medication Orders 2. Drug Interaction Checks 3. Up-To-Date Problem List 4. E-Prescribing (erx) 5. Active Medication List 6.
Presented by Terri Gonzalez Director of Practice Improvement North Carolina Medical Society Meaningful Use is using certified EHR technology to: Improve quality, safety, efficiency, and reduce errors Engage
Stage 1 vs. Comparison for Eligible Professionals CORE OBJECTIVES (17 Total) Stage 1 Objective Stage 1 Measure Objective Measure Use CPOE for Medication orders directly entered by any licensed healthcare
Product Mappings to the ARRA/HITECH Stage 1 Requirements for Eligible Providers Number CORE SET (These objectives are to be achieved by all eligible professionals in order to qualify for incentive payments.)
E Z BIS ELECTRONIC HEALTH RECORDS CERTIFICATION AND THE HITECH INCENTIVE PROGRAM The Incentives On July 13, 2010, the U.S. Department of Health and Human Services finalized the Electronic Health Record
Core Set of Objectives and Measures Must Meet All 15 Measures Stage 1 Objectives Stage 1 Measures Reporting Method Use Computerized Provider Order Entry (CPOE) for medication orders directly entered by
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Core Set of Objectives and Measures Must Meet All 15 Measures Stage 1 Objectives Stage 1 Measures Reporting Method Use Computerized Provider Order Entry (CPOE) for medication orders directly entered by
MEANINGFUL USE STAGE 2 2015 FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY STAGE 2 REQUIREMENTS EPs must meet or qualify for an exclusion to 17 core objectives EPs must meet 3 of the 6 menu measures.
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EMR Name/ Model EMR Vendor Cerner PowerChart Ambulatory (PowerWorks ASP) Cerner Corporation Core Set of Measures 1 Use CPOE for medication orders directly entered by any licensed healthcare professional
Insight Software, LLC 3050 Universal Blvd Ste 120 Weston FL 33331-3528 Tel. 877-882-7456 www.myvisionexpress.com Meaningful Use of Certified EHR Technology with My Vision Express* Eligible Professional
Contact Information: West Texas Health Information Technology Regional Extension Center 3601 4 th Street MS 6232 Lubbock, Texas 79424 806-743-1338 http://www.wtxhitrec.org/ Grant award - $6.6m Total number
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EMR Name/Model Amazing Charts Version 5 EMR Vendor Amazing Charts Please note: All of our answers refer to use for an Eligible Professional. Amazing Charts is not Stage 1 objectives Use CPOE Use of CPOE
CMS-0044-P 156 TABLE 4: STAGE 2 MEANINGFUL USE OBJECTIVES AND ASSOCIATED MEASURES SORTED BY CORE AND MENU SET Improving quality, safety, efficiency, and reducing health disparities Use computerized provider
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294 TABLE B5: STAGE 2 OBJECTIVES AND MEASURES CORE SET Improving quality, safety, efficiency, and reducing health disparities Use computerized provider order entry (CPOE) for medication, laboratory and
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