IMS Meaningful Use Webinar

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1 IMS Meaningful Use Webinar Presented on: May 9 11:00am 12:00pm (PDT) May 13 12:00pm 1:00pm (EST) This Webinar Will Be Recorded! Please send questions that you may have after the session to:

2 Meaningful Use: Today s Topics Meaningful Use in a Nutshell EHR Incentive Programs Meaningful Use Stage 1 Requirements Eligibility Defined Incentive Registration Overview Incentive Attestation Overview IMS Meaningful Use Report Overview MU Requirements: Core and Menu Additional Resources

3 Meaningful Use in a Nutshell Introduced as part of American Reinvestment and Recovery Act 2009 Focus to improve health care through use of health information technology Three main EHR components Use in a meaningful manner (ex: e-prescribing) Use for electronic exchange of health information to improve quality of health care Use to submit clinical quality and other measures

4 Meaningful Use in a Nutshell Managed by the Centers for Medicare & Medicaid Services (CMS) Five year program Stage 1 sets the baseline for electronic data capture and information sharing (2011 and 2012). Stage 2 (2013) and Stage 3 ( ) will continue to expand on this baseline and be developed through future rule making.

5 EHR Incentive Programs Medicare Provides incentive payments to eligible professionals (EP), eligible hospitals, and critical access hospitals (CAH) that demonstrate meaningful use (MU) of certified EHR technology. Participation can begin as early as 2011 EP can receive up to $44k over 5 years; additional incentives for Health Professional Shortage Areas Maximize benefits; begin in 2011 After 2015, adjusted reimbursements if not successfully demonstrating MU

6 EHR Incentive Programs Medicaid Provides incentive payments to EPs, eligible hospitals, and CAHs as they adopt, implement, upgrade, or demonstrate MU of certified EHR technology in their first year of participation and demonstrate MU for up to five remaining participation years. Voluntarily offered by individual states and territories and may begin as early as 2011, depending on the state. EP can receive up to $63,750 over the six years that they choose to participate in the program. There are no payment adjustments under the Medicaid EHR Incentive Program.

7 EHR Incentive Programs Terms Adopted - Acquired and installed certified EHR technology. (For example, can show evidence of installation.) Implemented: Began using certified EHR technology. (For example, provide staff training or data entry of patient demographic information into EHR.) Upgraded: Expanded existing technology to meet certification requirements. (For example, upgrade to certified EHR technology or add new functionality to meet the definition of certified EHR technology.)

8 Eligibility Defined Eligibility Requirements for Professionals Incentive payments for EPs are based on individual practitioners. If part of a practice, each EP may qualify for an incentive payment if each eligible professional successfully demonstrates meaningful use of certified EHR technology. Each EP is only eligible for one incentive payment per year, regardless of how many practices or locations at which he or she provide services. Hospital-based eligible professionals are not eligible for incentive payments. An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a hospital inpatient (Place Of Service code 21) or emergency room (Place Of Service code 23) setting.

9 Eligibility Defined - Medicare In addition to the eligibility requirements above, Medicare eligible professionals must have Medicare Part B allowed charges and must be enrolled in an approved status for Provider Enrollment, Chain and Ownership System (PECOS). EPs under the Medicare EHR Incentive Program include: Doctor of medicine or osteopathy Doctor of dental surgery or dental medicine Doctor of podiatry Doctor of optometry Chiropractor

10 Eligibility Defined - Medicaid In addition to the eligibility requirements above, to qualify for an incentive payment under the Medicaid EHR Incentive Program, an eligible professional must meet one of the following criteria: Have a minimum 30% Medicaid patient volume* Have a minimum 20% Medicaid patient volume, and is a pediatrician* Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals EPs under the Medicare EHR Incentive Program include: Doctor of medicine or osteopathy Doctor of dental surgery or dental medicine Doctor of podiatry Doctor of optometry Chiropractor * Children's Health Insurance Program (CHIP) patients do not count toward the Medicaid patient volume criteria.

11 Eligibility Defined Both??? What if an EP can qualify for Medicare and Medicaid? Professionals eligible for both the Medicare and Medicaid EHR Incentive Programs must choose which incentive program they wish to participate in when they register. Before 2015, an eligible professional may switch programs only once after the first incentive payment is initiated. Most eligible professionals will maximize their incentive payments by participating in the Medicaid EHR Incentive Program.

12 MU Stage 1 Requirements In 2011 and/or 2012, EP must meet 20 of 25 MU objectives 15 Core Objectives EP must meet ALL of these to qualify 10 Menu Objectives EP must choose 5 from this list to qualify EP is also required to report discipline specific clinical quality measures (CQM). EP must report on 6 total clinical quality measures: 3 required core measures (substituting alternate core measures where necessary) and 3 additional measures (selected from a set of 38 clinical quality measures). For more information on CQM, visit:

13 Incentive Registration Overview Medicare registration opened January 3, 2011, so EPs may register at any time Medicaid registration varies by state and open date can be found: EP must either register personally or designate a third party to register on their behalf* If a third party will be registering for one or more EP, they must first create an account at the Identity & Access Management System (I&A) site https://nppes.cms.hhs.gov/nppes/iasecuritycheck.do * NOTE: Medicaid third-party registration availability may vary at the state level

14 Incentive Registration Overview Steps to Registration 1. Gather required information ahead of time a) NPI Number b) NPPES Number (also known as PECOS number) c) Payee Tax ID Number (if benefits to be reassigned) d) Payee NPI (if benefits to be reassigned) 2. Decide which program to register for Medicare Review the Medicare EP Registration User Guide Medicaid Review the Medicaid EP Registration User Guide 3. Follow the instructions within the appropriate guide above to complete the registration process

15 Incentive Attestation Overview Medicare attestation opened April 18, 2011 Medicaid attestation varies by state and information can be found: EP must either attest personally or designate a third party to register on their behalf* If a third party will be attesting for one or more EP, they must first create an account at the Identity & Access Management System (I&A) site https://nppes.cms.hhs.gov/nppes/iasecuritycheck.do * NOTE: Medicaid third-party attestation may vary at the state level

16 Incentive Attestation Overview Medicare Requirements for Incentive Payment EP must be registered for the Medicare EHR Incentive Program Must meet Meaningful User criteria using certified EHR technology On the CMS Registration and Attestation System, EP must successfully attest to meeting meaningful use criteria using EHR technology Medicaid Requirements for Incentive Payment EP will follow a similar process to the above, using their state s specific Attestation System

17 Incentive Attestation Overview When to Attest Medicare In the first year, must have met MU criteria for one consecutive 90-day reporting period For all subsequent years, attestation must be met for the entire calendar year IMPORTANT NOTE: If your initial attestation fails in the first year, you may select a different 90-day that may partially overlap a previously reported 90-day period and attest again. (Tip: Plan to attest initially no later than September 15, 2011 to allow 2 weeks to make EHR or clinic process adjustments if needed and still have a full 90-day period for qualification in case overlap is not possible.) Medicaid In the first year, must attest to adopting, implementing or upgrading EHR Must check at the state level to find out when participation may begin

18 Incentive Attestation Overview Steps to Attestation 1. If not yet registered, register for the EHR Incentive Program 2. Thoroughly review the CMS Attestation User Guide 3. Verify that all of the necessary measures to demonstrate MU and qualify for an EHR incentive payment have been met with the CMS MU Attestation Calculator 4. Following CMS Attestation User Guide instructions, EP or designated third-party representative shall complete attestation

19 Incentive Attestation Overview General Notes Core and Menu Requirements in the CMS Attestation User Guide might not appear in the same order as shown in the IMS Meaningful Use Report. Be mindful of this!! The attestation process may take up to several hours to complete, but does not have to be completed in one sitting. Your work will save as you go and you can return to finish later Medicare incentive payments will be made 4 to 6 weeks after an EP meets requirements and successfully attests Medicaid incentive payments are required to be issued with 45 days of provider successfully attesting to adopting, implementing or upgrading EHR technology in their first year

20 IMS MU Report Overview

21 EP must meet and attest for the objectives associated with all 15 Core Requirements EP must meet and attest for the objectives associated with 5 of the 10 Menu Requirements CMS Core and Menu Requirement information:

22 CR01: Computerized Provider Order Entry for Medication 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. Measure: More than 30 percent of all unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE. Exclusion: Any EP who writes fewer than 100 prescriptions during the EHR reporting period. (NOTE: Electronic prescription transmission IS NOT required for this.)

23 CR01: Computerized Provider Order Entry for Medication IMS Related Activity Current Medications within the Visit Note must include at least one medication Patient must have been prescribed a medication from within IMS during the reporting period. Chart history should show that a prescription was given to the patient on the specific date. (NOTE: Prescription does not have to be sent electronically to meet this requirement)

24 CR02: Drug Interaction Checks Objective: Implement drug-drug and drug-allergy interaction checks. Measure: The EP has enabled this functionality for the entire EHR reporting period. Exclusion: No exclusion.

25 CR02: Drug Interaction Checks IMS Related Activity User Parameters for Prescription set to Yes for: Patient Allergy Check Required Cross Sensitive Allergy Check Inactive ingredient based Allergy Check Drug Drug Interaction Check Required Medium Severity Interaction Check Low Severity Interaction Check Drug Validation (NOTE: If this is not set to yes, interactions will not be checked)

26 CR02: Drug Interaction Checks

27 CR03 Transmit Permissible Prescriptions Electronically Objective: Generate and transmit permissible prescriptions electronically. Measure: More than 40 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology Exclusion: Any EP who writes fewer than 100 prescriptions during the EHR reporting period. NOTE: Please review the Permissible Prescriptions and Additional Information sections in the following CMS Guide:

28 CR03 Transmit Permissible Prescriptions Electronically IMS Related Activity Prescriptions should be sent by the EP to pharmacy electronically when prescribed. Currently, this means a client must be registered for and submitting prescriptions through either New Crop or Surescripts. Objective is achieved when the Rx ID is assigned during the transmission process.

29 CR04 Record Demographics Objective: Record all of the following demographics: Preferred language*; Gender; Race; Ethnicity; Date of birth Measure: More than 50 percent of all unique patients seen by the EP have demographics recorded as structured data. Exclusion: No exclusion. * Preferred language is the language by which the patient prefers to communicate

30 CR04 Record Demographics IMS Related Activity Patient demographics are created for every patient in IMS. Date of Birth (DOB) and Gender are required fields. EP should verify that Race, Ethnicity, and Language have been captured or documented as Patient declined.

31 CR05 - Maintain Problem List Objective: Maintain an up-to-date problem list of current and active diagnoses. Measure: More than 80 percent of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data. Exclusion: No exclusion. NOTE: Please review the Additional Information section in the following related CMS Guide:

32 CR05 - Maintain Problem List IMS Related Activity Patient Diagnosis must either: Be entered within the Visit Note for the specific encounter and be visible within the Active Diagnosis tab in the Diagnosis Visit Note Template and also within Chart View on the Dx tab. Or Be entered within the Visit Note for the specific encounter and recorded with the Mark as No Known Problem button if the patient does not have any current problems.

33 CR06 - Active Medication List Objective: Maintain active medication list. Measure: More than 80 percent of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data. Exclusion: No exclusion

34 CR06 Active Medication List IMS Related Activity Current Medications within the Visit Note should include the following: A list of all active medications that the patient is currently taking Or It must be documented that the Patient is not taking any medication.

35 CR07 - Medication Allergy List Objective: Maintain active medication allergy list. Measure: More than 80 percent of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data. Exclusion: No exclusion.

36 CR07 - Medication Allergy List IMS Related Activity Drug Allergy within the Visit Note should include the following: A list of all known drugs that patient is allergic to Or It must be specifically documented that patient has No Known Drug Allergies

37 CR08 - Record Vital Signs Objective: Record and chart changes in the following vital signs: Height; Weight; Blood pressure; Calculate and display body mass index (BMI); Plot and display growth charts for children 2-20 years, including BMI Measure: For more than 50 percent of all unique patients age 2 and over seen by the EP, height, weight, and blood pressure are recorded as structured data. Exclusion: Any EP who either see no patients 2 years or older, or who believes that all three vital signs of height, weight, and blood pressure of their patients have no relevance to their scope of practice.

38 CR08 - Record Vital Signs IMS Related Activity Vital Signs must be completed for a minimum of Height, Weight and Blood Pressure. If any one or more of the elements are missing, the requirement will not be met.

39 CR09 Record Smoking Status Objective: Record smoking status for patients 13 years old or older. Measure: More than 50 percent of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data. Exclusion: Any EP who sees no patients 13 years or older.

40 CR09 Record Smoking Status IMS Related Activity Within the Meaningful Use Report window, ensure that the EP has defined the appropriate Social History value to be recorded as capturing this data. For all patients over 13 years of age, Social History within the Visit Note should include the following: Smoking Status recorded as positive within the Question selected in Parameter Or Smoking Status recorded as negative within the Question selected in Parameter

41 CR10 - 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. Measure: Implement one clinical decision support rule. Exclusion: No exclusion. NOTE: Please review the Additional Information section in the following related CMS Guide:

42 CR10 Clinical Decision Support Rule IMS Related Activity Within IMS, there are a number of features available that qualify as clinical decision support rules. Essentially, this means that based on findings during a patient visit, IMS will offer diagnostic or treatment options to the provider. The link with functionality within IMS can be configured to assist EP s by providing reference information and other tools to support decisions within clinical workflow. Proper use of alerts and reminders qualify as CDS rules. Incorporating clinical guidelines or protocols into IMS workflow would also qualify. Defining appropriate Health Maintenance rules for specific patient populations is another option. EP s may use order sets to improve CPOE. The use of reports and dashboards to aid in clinical decision support would also qualify.

43 CR11 - Clinical Quality Measures (CQMs) Objective: Report ambulatory clinical quality measures to CMS. Measure: Successfully report to CMS ambulatory clinical quality measures selected by CMS in the manner specified by CMS. Exclusion: No exclusion. NOTE: Please review the Additional Information section in the following related CMS Guide:

44 CR11 - Clinical Quality Measures (CQMs) IMS Related Activity IMS provides a PQRI/NQF reporting tool for tracking of quality measures. This tool allows each EP to define clinical quality measures relevant to their specialty for reporting. PQRI was presented during our March Webinar series. If you were not able to attend, you may view the recorded session by clicking the link below. You will be prompted for contact information and then access to the recording will appear: Lunch & Learn Webinar: IMS v14 - PQRI - Physician Quality Reporting Initiative

45 CR12 - 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. Measure: More than 50 percent of all patients who request an electronic copy of their health information are provided it within 3 business days. Exclusion: Any EP that has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period. NOTE: Please review the Additional Information section in the following related CMS Guide:

46 CR12 - Electronic Copy of Health Information IMS Related Activity EP shall create a Reminder Category specific to this purpose. Reminder Category shall contain all Reminder Tasks that inform staff that patient requires a copy of their health information in electronic format (CD, USB drive, portal, etc). (NOTE: only one category will be reported on, so it is important that ONLY health information request related reminders are stored within this category.) EP shall create and configure one or more health information request Reminder Tasks assigned to the above category for use specific to these tasks EP will associate the Reminder Category created to the Reminder Category for CR12 field within the MU Report Set Parameter window As Patient Reminders are Set Done

47 CR13 - Clinical Summaries Objective: Provide clinical summaries for patients for each office visit. Measure: Clinical summaries provided to patients for more than 50 percent of all office visits within 3 business days. Exclusion: Any EP who has no office visits during the EHR reporting period. NOTE: Please review the Definition of Terms and Additional Information sections in the following related CMS Guide:

48 CR13 - Clinical Summaries IMS Related Activity EP shall create a Document Sub-Category that will contain all clinical summary letter options. Document Sub-Category can be named CR13 Clinical Summaries within IMS for ease of identification. (NOTE: For Meaningful Use, only one subcategory will be reported on, so it is important that ONLY clinical summary letters are stored within this sub-category. It is equally important that ALL are stored within this sub-category. Letters not assigned to this sub-category will not be factored into the objective requirements.) Within the Meaningful Use Report window, EP will associate the Document Sub- Category as the Letter Category for CR13 As EP or clinic staff create and Save the Clinical Summary Letter, the Objective will be achieved

49 CR14 - 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. Measure: Performed at least one test of certified EHR technology s capacity to electronically exchange key clinical information. Exclusion: No exclusion. NOTE: Please review the Definition of Terms and Additional Information sections in the following related CMS Guide:

50 CR14 - Electronic Exchange of Clinical Information IMS Related Activity IMS provides functionality for the Import and Export of Continuity of Care Documents (CCD). The Export (CCD) utility provides options for exporting Payer, Diagnosis, Allergy, Vitals, Medication/Rx, Lab Results, Immunization, Procedures, Family History, and Social History information. The file is created in XML format to share with other authorized entities. The Import (CCR) utility allows the EP to import patient information from XML files and then assign to the appropriate patient for view as a Document.

51 CR15 - Protect Electronic Health Information Objective: Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities. Measure: 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. Exclusion: No exclusion. NOTE: Please review the Definition of Terms and Additional Information sections in the following related CMS Guide:

52 CR15 - Protect Electronic Health Information IMS Related Activity Security - Manages access to patient data at a User and Group level. Provides user level access via Username/Password with additional parameters to enforce: 1) minimum characters for password, 2) case sensitivity, 3) enforced alpha-numeric passwords, 4) lockouts after number of failed login attempts, 5) password resets every set number of days and 6) historically unique passwords. Grouping and Grants, can further limited access. Lock Session protects data when a user must step away from the workstation Audit Log - allows the EP to determine when specific patient related data elements were accessed or modified within the database and by which specific user. Other Requirements The security within the EHR depends a great deal on the security practices within the clinic setting. Please review for other EP requirements outside of the EHR such as defining security management processes, assigning a security official, limiting personnel and information access, providing security awareness training, handling security incidents, establishing contingency plans, and periodically evaluating security policies and procedures.

53 MN01 - Drug Formulary Checks Objective: Implement drug formulary checks. Measure: The EP has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period. Exclusion: Any EP who writes fewer than 100 prescriptions during the EHR reporting period. Additional Information At a minimum an EP must have at least one formulary that can be queried. This may be an internally developed formulary or an external formulary. The formularies should be relevant for patient care during the prescribing process.

54 MN01 - Drug Formulary Checks IMS Related Activity Formularies should be setup at the Carrier and/or Plan level in IMS When prescribing, EP should take action based on formulary specific action specified

55 MN02 - Clinical Lab Test Results Objective: Incorporate clinical lab test results into EHR as structured data. Measure: More than 40 percent of all clinical lab test results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data. Exclusion: An EP who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period. NOTE: Please review the Additional Information section in the following related CMS Guide:

56 MN02 - Clinical Lab Test Results IMS Related Activity Although incorporation of an HL7 interface with compatible lab companies will help to ensure the successful input of the required Lab Result data, it is not required. Essentially, the EP should ensure that any Labs defined within IMS have results entered as structured data. Linking a faxed results page to a Lab Order will not qualify for this requirement. The EP or a staff member must associate the returned results to the order by entering the values manually.

57 MN03 - Patient Lists Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach. Measure: Generate at least one report listing patients of the EP with a specific condition. Exclusion: No exclusion.

58 MN03 - Patient Lists IMS Related Activity Patient Special Search - Within IMS, the Patient Special Search feature allows real-time generation of patient lists by specific conditions. The Patient Special Search is found within the Utilities menu. EMR Reports - IMS also provides specific EMR reports that will also generate the conditions requested

59 MN04 -Patient Reminders Objective: Send reminders to patients per patient preference for preventive/follow-up care. Measure: More than 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. Exclusion: An EP who has no patients 65 years old or older or 5 years old or younger with records maintained using certified EHR technology. NOTE: Please review the Additional Information section in the following related CMS Guide:

60 MN04 -Patient Reminders IMS Related Activity EP shall create a Document Sub-Category specific to this purpose that will contain all Patient Reminder letters that apply to the preventative/follow-up needs associated with patients 5 and under or 65 and older. Document Sub-Category can be aptly named MN04 Patient Preventative Reminder Letters within IMS for ease of identification. (NOTE: For Meaningful Use, only one sub-category will be reported on, so it is important that ONLY letters meeting requirements for this measure are stored within this sub-category. It is equally important that ALL relevant letters are stored within this sub-category. If the letters are not assigned to this sub-category, they will not be factored into the objective requirements.) Within the Meaningful Use Report window, EP will associate the Document Sub- Category as the Letter Category for MN04 As EP or clinic staff create and Save the Patient Reminder Letter, the Objective will be achieved

61 MN05 - Patient Electronic Access 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. Measure: At least 10 percent of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP s discretion to withhold certain information. Exclusion: Any EP that neither orders nor creates lab tests or information that would be contained in the problem list, medication list, medication allergy list (or other information as listed at 45 CFR (g)) during the EHR reporting period. NOTE: Please review the Additional Information section in the following related CMS Guide:

62 MN05 - Patient Electronic Access IMS Related Activity IMS Patient Portal is designed to meet these requirements. If the EP is not using Patient Portal, this Menu Requirement is not an available option.

63 MN06 - Patient-specific Education Resources Objective: Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate. Measure: More than 10 percent of all unique patients seen by the EP are provided patient-specific education resources. Exclusion: No exclusion.

64 MN06 - Patient-specific Education Resources IMS Related Activity EP s who are using the Micromedix companion in conjunction with IMS Link with functionality will meet this requirement. With Link with technology, care plan information is presented when relevant diagnosis, lab, prescription, examination findings or procedures are encountered during a patient visit. EP may also use Educational Handouts direct to achieve same goal from within Visit Note.

65 MN07 - Medication Reconciliation 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. Measure: 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. Exclusion: An EP who was not the recipient of any transitions of care during the EHR reporting period.

66 MN07 - Medication Reconciliation IMS Related Activity To comply with the Medication Reconciliation requirements, EP must ensure that the referring provider is recorded within the Case associated with the transitioning patient. EP must also ensure that the status of the patient s current medication is recorded within IMS. Although not specifically stated that current medications must be recorded on the first visit, it is highly recommended that the EP do this to ensure the information is in the chart and so that compliance is achieved.

67 MN08 - 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. Measure: The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals. Exclusion: An EP who neither transfers a patient to another setting nor refers a patient to another provider during the EHR reporting period.

68 MN08 - Transition of Care Summary IMS Related Activity IMS provides a Referral Tracking utility for this purpose. Within the Referral Tracking utility, the printing or faxing of a letter or form signifies that a Transition of Care Record has been provided for that patient.

69 MN09 - Immunization Registries Data Submission Objective: Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice. Measure: 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 (unless none of the immunization registries to which the EP submits such information has the capacity to receive the information electronically). Exclusion: An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically NOTE: Please review the Additional Information section in the following related CMS Guide:

70 MN09 - Immunization Registries Data Submission IMS Related Activity This menu option is currently not available in all areas. A status of Registries associated with IMS follows: Currently available registries include: GRITS (Georgia), FL Shots (Florida), NYSIIS (New York), and CAIR (California). Registries under development: NCIR Import (North Carolina), PA-SIIS (Pennsylvania), AZ-SIIS (Arizona) and Texas. If a Registry is required that is not on the list, a request can be made.

71 MN10 - Syndromic Surveillance Data Submission Objective: Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice. Measure: 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 (unless none of the public health agencies to which an EP submits such information can receive information electronically). Exclusion: An EP who does not collect any reportable syndromic information on their patients during the EHR reporting period or does not submit such information to any public health agency that has the capacity to receive the information electronically. NOTE: Please review the Additional Information section in the following related CMS Guide:

72 MN10 - Syndromic Surveillance Data Submission IMS Related Activity Syndromic Surveillance Data Submission is not currently an IMS option available to EP s.

73 References and Resources CMS References and Source of Non-IMS Webinar Material EHR Incentive Programs Eligibility Registration Meaningful Use Attestation Medicare and Medicaid EHR Incentive Programs Overview Medicaid State Information (including registration dates) EHR Incentive Programs Educational Materials (Highly Recommended) Latest Information about Medicare and Medicaid EHR Incentive Programs

74 References and Resources CMS Meaningful Use Documentation EHR Medicare Registration User Guide pdf EHR Medicaid Registration User Guide pdf Attestation User Guide for Medicare Eligible Professionals Medicaid State Level Launch Information Guide for Reading the EHR Incentive Program EP CQM Measures

75 IMS Meaningful Use Webinar Thank you very much!

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