Meaningful Use Theory. Rachel Ramoni, DMD, ScD Harvard Medical School

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1 Meaningful Use Theory Rachel Ramoni, DMD, ScD Harvard Medical School March, 2013

2 Through the 2009 HITECH (Health Information Technology for Economic and Clinical Health) Act, the United States government committed $27 billion to promote the spread of certified electronic health records (EHRs) to improve health care in the U.S. = AN OPPORTUNITY TO COMMIT TO BUILDING A CULTURE AND PRACTICE OF QUALITY IMPROVEMENT IN YOUR DENTAL SCHOOL

3 Meaningful use is a tool. You can do it in a 'check the box' way and get the check, and that would have been an inept use of that tool. Make it meaningful. You need to use it to get to population health management, patient engagement, and health information exchange. Farzad Moshtashari, MD, National Coordinator for Health Information Technology

4 Dentists are receiving incentive payments: Number of Dentists

5 You are here and so are the rest of us Three years to start Eight years to collect

6 To qualify for Medicaid incentive payments: $8,500 each Years 3-6 Year 1 meaningful use for 1 year meaningful use for 90 days having adopted/implemented/upgra ded to a certified EHR must attest to: An eligible professional

7 Years 3-6 Year 1 meaningful use for 90 days meaningful use for 1 year An eligible professional having adopted/implemented/upgraded (AIU) to a certified EHR Report to the state the CMS EHR Certification Identification number for the complete certified system or set of modules that form a complete certified system. must attest to: In the dental academic setting, often the school is designated to report on behalf of the dentist to the state Medicaid agency A dentist with a national provider identifier who has seen at least 30% Medicaid patients in a period of 90 consecutive days within the calendar year prior to the payment year.

8 Just like the definition of what s cool, the definition of meaningful use evolves: MU Stage 1: MU Stage 2: MU Stage 3: Year: Theme: Data capture and sharing Advance clinical processes Improve outcomes Objectives: 15 core, 5/10 menu (at least 1 public health) Clinical Quality Measures: 3 core or alternate core, 3/38 additional measures 17 core, 3/6 menu 9/64 measures

9 Examples of the evolution of objectives and clinical quality measures: More than 50% of all unique patients seen by the EP have demographics recorded as structured data. Higher Bar More than 80% of all unique patients seen by the EP have demographics recorded as structured data. New Objectives Dentistry Appears A secure message was sent using the electronic messaging function of Certified EHR Technology by more than 5% of unique patients seen during the EHR reporting period. Percentage of children, ages 0-20 years, who have had tooth decay or cavities during the measurement period.

10 # * * * * * Beginning in 2014, all providers regardless of their stage of meaningful use will report on CQMs in the same way # Even if in Stage 1, must have a Stage 2 certified EHR system Note: This progression is with respect to the eligible professional rather than with respect to the clinic.

11 A few finer points: Medicaid eligible professionals who also treat Medicare patients will have a payment adjustment to Medicare reimbursements starting in 2015 if they do not successfully demonstrate meaningful use. An EP may receive only one payment per year, even if they work at more than one clinic An EP must re-qualify every year to receive the incentive payment An EP does not re-start the cycle if he or she changes clinics EPs participating in the Medicaid EHR Incentive Program can skip years during the attestation process. Incentive payments for the Medicaid EHR Incentive Program are made to individual providers, not to practices or medical groups. Although a provider can designate a practice to receive the incentive funds on their behalf, it is up to the provider to make this decision the practice or medical group cannot claim the money or make the decision for the provider, even if the EHR belongs to the practice.

12 Meaningful Use helps to identify health IT gaps in dentistry and dental education: The absence of EHRs with diagnostic, therapeutic, or decision support applications appropriate for dentists Lack of proven interoperability between medical and dental EHRs Lack of training on oral health IT at the pre-doctoral and residency program level From:

13 Moving from theory to practice In theory there is no difference between theory and practice. In practice there is. - Yogi Bear

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