Webinar #1 Meaningful Use: Stage 1 & 2 Comparison CPS 12 & UDS 2013

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1 New York State-Health Centered Controlled Network (NYS HCCN) Webinar #1 Meaningful Use: Stage 1 & 2 Comparison CPS 12 & UDS 2013 January 31, 2014 Ekem Merchant-Bleiberg, Director of Implementation Services

2 Welcome & Introductions Participants Presenters How to Participate Learning Objectives

3 How to Participate Today Open and close your Panel View, Select, and Test your audio Submit text questions Raise your hand Q&A addressed throughout the session

4 Learning Objectives Review Meaningful Use timelines Compare & Contrast Meaningful Use Stage 1 & Stage 2 Provide Centricity Practice Solution 12 Update Review UDS 2013

5 Definition of Meaningful Use Use of ONC-HIT Certified Electronic Health Records (EHR) Electronic Exchange of Health Information Quality Reporting

6

7 Stages of Meaningful Use

8 How to Get to S2MU 17 Core Objectives 3 of 6 Menu Objectives 9 Clinical Quality Measures Meaningful Use 8

9 2014 Changes Reporting Period Reduced to Three Months to allow providers time to adopt 2014 certified EHR technology and prepare for Stage 2, all participants will have a three-month reporting period in All providers regardless of their stage of meaningful use are only required to demonstrate meaningful use for a threemonth EHR reporting period. 9

10 Stage 2: Batch Reporting Stage 2 MU rules allows for batch reporting: Starting in 2014, groups will be allowed to submit attestation information for all of their individual EPs in one file for upload to the Attestation System, rather than having each EP individually enter data.

11 COMPARISON FOR EP S

12 Menu to Core 8 items transitioned from Menu to Core: 1. Incorporate Lab data 2. Generate Patient Lists 3. Patient Reminders 4. Timely Access 5. Patient Education Resources 6. Medication Reconciliation 7. Transition of Care Summary 8. Immunization Registry Still Menu: Syndromic Surveillance

13 Percentage Increase CPOE -30%-60% for meds Demographics-50-80% Vitals % Smoking Status % Incorporate Lab % erx-40-50%

14 Eliminated as Separate Objectives Problem List Medication Allergy List Active Med List Clinical Quality Measures Drug-drug, Drug-Allergy ecopy of Health Information Drug Formulary

15 Enhancements CDS to 5 Interventions plus DD/DA Clinical Summary to patient from 3 days to 24 hours

16 New Imaging Results (40 to 10% of tests ordered from NPRM) CPOE for lab & imaging Family Health History View, Download, Transmit ( 10-50%) Cancer Registry Specialized Registry Secure Electronic Messaging ( 10-5%) Progress Notes

17 CORE & MENU REVIEW

18 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Use of computerized provider order entry 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. More than 60% of medication, 30% of laboratory and 30% of radiology orders created by the EP during the reporting period are recorded using CPOE. Revised Threshold Revised Requirement 18

19 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Generate and transmit permissible prescriptions electronically (erx) More than 40% of all prescriptions written are transmitted electronically using certified EHR technology (CEHRT). More than 50% of all permissible prescriptions or all prescriptions written by the EP and queried for a drug formulary and transmitted electronically using CEHRT. Increased Threshold Revised Requirement 19

20 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Record the following demographics : Preferred language Gender Race Ethnicity Date of birth More than 50% of all unique patients seen by the EP have demographics recorded as structured data. More than 80% of all unique patients seen by the EP during the EHR reporting period have demographics recorded as structured data. Increased Threshold 20

21 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Record and chart changes in the following vital signs: Height/length and weight Blood pressure Calculate and display BMI Plot and display growth charts for patients 0-20 years (incl. BMI) More than 50% of all unique patients age 2 and over seen by the EP height, weight and blood pressure are recorded as structured data. More than 80% of all unique patients seen by the EP during the EHR reporting period have blood pressure (for patients age 3 and over only) and height/length and weight (for all ages) recorded as structured data. Increased Threshold Revised Requirement 21

22 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Use clinically relevant information to identify patients who should receive reminders for preventive/followup care and send these patients the reminder, per patient preference More than 20% of all unique patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period. More than 10% of all unique patients who have had two or more office visits with the EP within the 24 months before the beginning of the EHR reporting period were sent a reminder, per patient preference when available. Menu to Core Decreased Threshold 22

23 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Provide patients the ability to view online, download and transmit their health information within 4 business days of the information being available to the EP More than 10% of all unique patients seen by the EP are provided timely electronic access to their health information. More than 50% of all unique patients seen by the EP are provided timely electronic access to their health information. More than 5% of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download or transmit to a third party their health information. Menu to Core Revised Requirement 23

24 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Provide clinical summaries for patients for each office visit Clinical summaries provided to patients for more than 50% of all office visits within 3 business days. Clinical summaries provided to patients within 1 business day for more than 50% of office visits. Revised Requirement 24

25 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Use CEHRT to identify patientspecific education resources and provide those resources to the patient More than 10% of all unique patients seen by the EP during the EHR reporting period are provided patient-specific education resources. Patient-specific education resources identified by CEHRT are provided to patients for more than 10% of all office visits by the EP. Menu to Core Revised Requirement 25

26 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Use secure electronic messaging to communicate with patients on relevant health information N/A A secure message was sent using the electronic messaging function of CEHRT by more than 5% of unique patients seen by the EP during the EHR reporting period. New Requirement 26

27 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change 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 The EP performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP. The EP performs medication reconciliation for more than 65% of transitions of care in which the patient is transitioned into the care of the EP. Increased Threshold Menu to Core 27

28 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care provides a summary care record for each transition of care or referral The EP who transitions 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. The EP who transitions 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. 10% of such transitions or referrals are electronically transmitted. One or more successful exchanges of a summary of care document with a recipient on a different EHR technology. Menu to Core Revised Requirement 28

29 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Capability to submit electronic data to immunization registries or immunization information systems except where prohibited, and in accordance with applicable law and practice 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 the immunization registries do not have the capacity to receive the information electronically). Successful ongoing submission of electronic immunization data from CEHRT to an immunization registry or immunization information system for the entire EHR reporting period. Revised Requirement Menu to Core 29

30 EP Core Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Protect electronic health information created or maintained by the CEHRT through the implementati on of appropriate technical capabilities Conduct or review a security risk analysis per 45 CFR (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management. Conduct or review a security risk analysis in accordance with the requirements under 45 CFR (a)(1), including addressing the encryption/security of data stored in CEHRT in accordance with requirements under 45 CFR (a)(2)(iv) and 45 CFR (d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the provider s risk management process. Revised Requirement 30

31 MENU SET REQUIREMENTS

32 EP Menu Set Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through CEHRT N/A More than 10% of all tests whose result is one or more images ordered by an EP during the EHR reporting period are accessible through CEHRT. New Requirement 32

33 EP Menu Set Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Record patient family health history as structured data N/A More than 20% of all unique patients seen by the EP during the EHR reporting period have a structured data entry for one or more first-degree relatives. New Requirement 33

34 EP Menu Set Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Record electronic notes in patient records N/A Enter at least one electronic progress note created, edited and signed by an EP for more than 30% of unique patients with at least one visit during the EHR reporting period. Electronic progress notes must be textsearchable. New Requirement 34

35 EP Menu Set Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Capability to submit electronic syndromic surveillance data to public health agencies, except where prohibited, and in accordance with applicable law and practice N/A Successful ongoing submission of electronic syndromic surveillance data from CEHRT to a public health agency for the entire EHR reporting period. New Requirement 35

36 EP Menu Set Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Capability to identify and report cancer cases to a State cancer registry, except where prohibited, and in accordance with applicable law and practice N/A Successful ongoing submission of cancer case information from CEHRT to a public health central cancer registry for the entire EHR reporting period. New Requirement 36

37 EP Menu Set Requirements Objective Stage 1 MU Stage 2 MU Summary of Change Capability to identify and report specific cases to a specialized registry (other than a cancer registry), except where prohibited, and in accordance with applicable law and practice N/A Successful ongoing submission of specific case information from CEHRT to a specialized registry for the entire EHR reporting period. New Requirement 37

38 CLINICAL QUALITY MEASURES

39 How do CQMs relate to the CMS Incentive Programs? Although reporting CQMs is no longer a core objective of the EHR Incentive Programs, all providers are required to report on CQMs in order to demonstrate Meaningful Use. In 2014 and beyond, reporting programs (i.e., PQRS, erx reporting) will be streamlined in order to reduce provider burden.

40 Domains of Quality Measures Patient and Family Engagement. Greater involvement of patients and families in decision making, self care, activation, and understanding of their health condition and its effective management Patient Safety. Processes that would reduce harm to patients and reduce burden of illness. enable longitudinal assessment of condition-specific, patientfocused episodes of care. Care Coordination. Measures that demonstrate appropriate and timely sharing of information and coordination of clinical and preventive services among health professionals in the care team and with patients, caregivers Population and Public Health. Measures that reflect the use of clinical and preventive services and achieve improvements in the health of the population served especially focused on the leading causes of mortality. Efficient Use of Healthcare Resources. Emphasize the use of evidence to best manage high priority conditions and determine appropriate use of healthcare resources. Clinical Processes/Effectiveness. Reflect clinical care processes closely linked to outcomes based on evidence and practice guidelines.

41 Clinical Quality Measures Provider Prior to and Beyond* EPs Complete 6 out of 44: 3 core or 3 alt. core + 3 menu Complete 9 out of 64 Choose at least 1 measure in 3 NQS domains Recommended core CQMs include: 9 CQMs for the adult population 9 CQMs for the pediatric population Prioritize NQS domains

42 CPS 12

43 Centricity Practice Solution v12 Capture Patient Data Use Advanced Clinical Functions Capture Data Report for Meaningful Use Engage Patients Coordinate Patient Care Manage Patient Populations Manage patient populations Patient Care Use clinical functions Report for Meaningful Use Coordinate patient care Engage patients

44 GE CPS 12 Timeline Early Adopter Release January 2014 General Release March 2014

45 CPS 12 NEW FUNCTIONALITY

46 Capture Patient Data Record Patient Demographics Patient Race ( up to 2) Record Patient Smoking Record Patient Vital Signs Record Patient Family History

47 Use Advanced Clinical Functions Computerized Provider Order Entry Classify orders as Laboratory, Radiology, or Other Support Credentialed Medical Assistants Record Administered Medications Record requests for medications administered to the patient during the visit Track medications administered to a patient during the visit in a new structured format

48 Clinical Visit Summary Engage Patients Provide Patient Specific Education Provide patient-specific education using the HL7 v3 standard Context Aware Knowledge Retrieval Application (Infobutton) Retrieve context-sensitive information for patients as well as referential information for the clinician Supports supplier-agnostic educational content Communicate with Patients Online Secure Messaging Vendor Agnostic Portal

49 Coordinate Patient Care Reconcile Clinical Information Reconcile problems, medications, and allergies from external sources Identify encounters as a Transition of Care Transition of Care documentation Create a summary document to send to another provider when transitioning care Transition of care documentation integrated with the orders workflow Customize patient content in the transition of care summary Send transition of care summaries through Centricity Clinical Messenger Immunization Management Preload Submit to Registries Create Patient Care Plans

50 Manage Patient Populations Send Patient Reminders for Follow Up or Preventative Care

51 CLINICAL QUALITY MEASURES

52 Clinical Quality Reporting ( simplified)

53 Clinical Quality Measures Track physician progress towards Clinical Quality Measures and Functional Measures for Meaningful Use 2014 Stage 1 and Stage 2 Access to the reporting dashboard is set up online, outside of the application. Users can configure the application to display the reporting dashboard. Review unmet measures to find patient data that can be updated to meet thresholds Meaningful Use Functional Measure checklist encounter form to help physicians update all of the data required for Meaningful Use while their patient is still with the physician Customize Value Sets for Reporting

54

55 UDS 2013 Dates Reporting Period: January 1-December 31, 2013 Report Due: February 15, 2014

56 UDS 2013

57 UDS 2013 Changes Zip code table will ADD patients by primary third party payor or uninsured Table 4: CHANGE age breaks for insurance Table 6B: Immunizations & Cervical Cancer measures have CHANGED Look-alike health centers: ADD managed care to Table 4 and race/ethnicity to Table 7

58 UDS 2014 Changes Looking ahead: Table 4-Other demographic data A line will be added to identify residents of public housing Table 6-Diagnosis, Services & Care Provided Table 6A: Addition for first time ever HIV diagnosis Table 6B: Multiple additions to the table Table 7-Quality of Care Indicators Table 7: Multiple additions to the table

59 UPCOMING EVENTS

60 Upcoming Events Webinar #2 Apr 9, 2014; 1-2:30: CPS12 Upgrade and reporting training, new workflows Office Hours. Wednesday February 12. 1:30-2:30pm EST

61 Questions & Thoughts

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