Meaningful Use Update

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1 Meaningful Use Update

2 AGENDA Quick Refresher on Meaningful Use Overview of Stage 2 Meaningful Use Audits 2

3 MEANINGFUL USE STAGES Stage 1 focus on data capture, getting the foundation in place Stage 2 focus on sharing information across care settings and between provider and patient Stage 3 focus on Improved outcomes 3

4 PROPOSED TIMELINE Start Year * The proposed timeline does not delay Stage 2, rather it extends Stage 2 for earlier adopters and provides more time for Stage 3 preparation 4

5 ELIGIBLE PROFESSIONALS (EP) Stage 1 13 Core Objectives 5 of 9 Menu Objectives 18 Total Objectives Stage 2 17 Core Objectives 3 of 6 Menu Objectives 20 Total Objectives Stage 3 TBD 5

6 ELIGIBLE HOSPITALS (EH) Stage 1 11 Core Objectives 5 of 10 Menu Objectives 16 Total Objectives Stage 2 16 Core Objectives 3 of 6 Menu Objectives 19 Total Objectives Stage 3 TBD 6

7 NEW REQUIREMENTS IN STAGE 2 New Requirements for EPs Online Patient Information Secure Messaging Family Health History Imaging Results Registry Reporting Progress Notes New Requirements for EHs Online Patient Information Family Health History Imaging Results Registry Reporting Progress Notes eprescribing emar Electronic Lab Results 7

8 UPDATED REQUIREMENTS IN STAGE 2 Updated Requirements for EPs Lab Results Patient Lists Patient Education Summary of Care Records Medication Reconciliation Immunizations Patient Reminders Online Patient Information Updated Requirements for EHs Lab Results Patient Lists Patient Education Summary of Care Records Medication Reconciliation Immunizations Public health lab results Syndromic surveillance 8

9 EXAMPLE OF AN INCREASED AND EXPANDED MEASURE Stage 1 Objective Stage 1 Measure Stage 2 Objective Stage 2 Measure Use 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. More than 30% of unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE. Use CPOE for medication, laboratory, and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local, and professional guidelines. More than 60% of medication, 30% of laboratory, and 30% of radiology orders created by the EP during the reporting period are CPOE. 9

10 STAGE 2 FOCUS ON PATIENTS An Example from Stage 2 for EPs - Use Secure Electronic Messaging Objective Use secure electronic messaging to communicate with patients on relevant health information Measure A secure message was sent using electronic messaging function of CEHRT by more than 5 percent of unique patients (or their authorized representatives) seen by the EP during the EHR reporting period. Exclusions: No office visits, Infrastructure 10

11 STAGE 2 FOCUS ON PATIENTS (CONT.) An Example from Stage 2 for EHs - Patient Electronic Access Objective Provide patients the ability to view online, download, and transmit information about a hospital admission. Measure 1. More than 50 percent of all unique patients discharged from the inpatient or ED of the EH or CAH during the reporting period have their information online within 36 hours of discharge 2. More than 5 percent of all unique patients who are discharged from the inpatient or ED of an EH or CAH view, download, or transmit to a third party their information during the reporting period. Exclusions: Infrastructure 11

12 HARDSHIP EXEMPTIONS 1. Infrastructure 2. New Providers 3. Unforeseen Circumstances 4. EPs that meet the following criteria: Lack of face-to-face or telemedicine interaction with patients Lack of follow-up need with patients 5. EPs who practice at multiple locations EHR Vendor Issues 12

13 MEANINGFUL USE AUDITS For Medicare, you will get notified by either: Figliozzi & Company; or CMS The notification will come to the person who submitted the attestation The notification comes via Tip: make sure you know who submitted for MU and keep track of that if there are vacations, leaves of absence, or staff turnover For Medicaid, the State or its contractor will perform the audits 13

14 MEANINGFUL USE AUDITS (CONT.) Medicare Audits Medicare EPs and dual-eligible hospitals are subject to pre and post payment audits 5 10% of providers are subject to audit Audits are random and risk driven Potential for successive audits 14

15 MEANINGFUL USE AUDITS (CONT.) CMS Example Actual Letter 15

16 MEANINGFUL USE AUDITS (CONT.) 16

17 MEANINGFUL USE AUDITS (CONT.) 17

18 MEANINGFUL USE AUDITS (CONT.) 18

19 MEANINGFUL USE AUDITS (CONT.) Examples for Measure 1 (CPOE) from Franklin Community Health Network Screen Shot of MU Report Generation Screen Shot of Reporting Period 19

20 MEANINGFUL USE AUDITS (CONT.) Examples for Measure 1 (CPOE) and Measure 5 (Allergy List) from Franklin Community Health Network No Findings from Auditor Findings from Auditor 20

21 MEANINGFUL USE AUDITS (CONT.) Examples of Auditor Findings from Franklin Community Health Network 21

22 MEANINGFUL USE AUDITS (CONT.) Examples for Measure 1 (CPOE) and Measure 5 (Allergy List) from Franklin Community Health Network 22

23 MEANINGFUL USE AUDITS (CONT.) Recommendations for being prepared for a Meaningful Use Audit Have your documentation in order and saved to multiple places Know if your reports are date specific (snapshot) or variable (rolling) If variable (rolling), save them to paper or PDF at the time of attestation Document your indirect but related decisions, such as: the ED calculation method Rationale for acceptable risks and risk mitigation 23

24 MEANINGFUL USE AUDITS (CONT.) Example Audit Determination Letter from Franklin Community Health Network 24

25 INTERESTED IN MORE? Contact Dan Vogt, a Manager in BerryDunn s Management and Information Technology Group, for more information. Phone Website berrydunn.com Blog berrydunn.com/author/danvogt 25

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