Road to Meaningful Use Webinars

Transcription

1 Road to Meaningful Use Webinars Meaningful Use Criteria in Centricity 9.5 Presented by Tom Forsberg & Mirian Smith HealthSystems October 15 th

2 Meaningful Use Webinars Oct 15 th - Road to Meaningful Use MU Criteria in Centricity V9.5 Nov 19 th - Road to Meaningful Use MQIC / PQRI Dec 2 nd - Road to Meaningful Use Centricity Physician Discusses MU Objectives and Measures Slide 2

3 Agenda 1. Meaningful Use Description 2. Terms 3. Preparing for Meaningful Use 4. Meaningful Use Incentives 5. Stage 1 Meaningful Use Measures 6. Meaningful Use Objectives certified with CPS and EMR Version 9.5 Slide 3

4 Meaningful Use Description HITECH Act Part of American Recovery and Reinvestment Act of 2009 (ARRA) $30B+ for HIT infrastructure and EMR adoption/use Meaningful Use Eligible Professionals (EP s) must demonstrate Meaningful Use of a Certified EMR to receive Medicare or Medicaid EMR incentives. EP s can only participate in one of these incentive programs, but not both. Medicare Incentives EP s can receive up to $44,000 over a five year period. Medicaid Incentives EP s with 30% of their volume attributable to Medicaid (20% for pediatricians) can receive up to $63,750 over a six year period. Slide 4

5 Terms MU Objectives: EMR Certification Criteria to meet Meaningful Use MU Measures: The reporting requirements for the defined EMR Criteria CCR: Continuity of Care Record - A patient health summary standard that creates flexible documents containing the most relevant and timely core health information about a patient, that can be sent electronically from one care giver to another. It contains various sections such as patient demographics, insurance information, diagnosis and problem list, medications, allergies and care plan. CCD: Continuity of Care Document - A patient summary standard containing a core data set of the most relevant administrative, demographic, and clinical information facts about a patient's healthcare, covering one or more healthcare encounters. It provides a means for one healthcare practitioner, system, or setting to aggregate all of the pertinent data about a patient and forward it to another practitioner, system, or setting to support the continuity of care. ONC: The abbreviation for the Office of the National Coordinator for Health Information Technology MQIC: The Medical Quality Improvement Consortium A GE Solution for practices to report Meaning Use and get feedback on quality improvement. NIST: National Institute of Standards and Technology FIPS - Federal Information Processing Standards ATNA - is a database auditing method called Audit Trail and Node Authentication (ATNA) SHA-1 - is a secure data transmission method called cryptographic hash function designed by the National Security Agency (NSA) Slide 5

6 Preparing for Meaningful Use Meeting Meaningful Use requirements, will mean: Having an EMR solution Having an e-prescribing solution Having a Patient Portal solution (with Secure Login) Having a plan to report the use of these solutions to CMS CPS Version 9.5 and EMR 9.5 will support the Stage 1 Meaningful Use requirements by CMS. Stage I focuses on capturing data in structured formats, implementing clinical decision support, and reporting clinical quality measures. Stage 2 expands Stage I criteria to encourage continuous quality improvement at the point of care and the exchange of information including orders and diagnostic test results. Stage 2 will be released in the coming years Stage 3 promotes improved quality outcomes related to safety and efficiency by emphasizing decision support for high priority decisions and will be released in the coming years. CMS incentives are distributed based on the practice s annual reporting of the appropriate measures related to Meaningful Use. Slide 6

7 Medicare Incentive Impact: Physicians Stimulus Physician Medicare Incentives Pay-Out Year Start Date Totals 2011 $ 18 $ 12 $ 8 $ 4 $ 2 $ - $ $ 18 $ 12 $ 8 $ 4 $ 2 $ $ 15 $ 12 $ 8 $ 4 $ $ 12 $ 8 $ 4 $ Per Physician In Thousands $ - $ - $ - Medicare Penalties: % of allowed charges: 2015 (1%), 2016 (2%), (3%) Note: 2011 will only require reporting for a 90 Day window Slide 7

8 Meaningful Use Measures Core Set: Stage 1 measures for Eligible Professionals Measures Requirement Description Of Criteria 1 30% CPOE used for medication orders 2 Yes/No Drug to drug, drug to allergy interaction checks 3 40% Prescriptions transmitted electronically when permissible with certified EMR 4 80% Problems entered as structured data or none noted 5 80% Medications entered as structured data or none noted 6 80% Allergies entered as structured data or none noted 7 50% Demographics entered as structured data 8 50% Vital Signs are recorded in pt over 2 y/o with ht, wt, BP 9 50% Smoking status is recorded in pt's over 13 y/o 10 Yes/No Implement 1 CDS rule relevant to specialty or high clinical priority 11 Yes/No Report quality measures to CMS - 3 core and 3 other 12 50% Upon request provide pt electronic copy of health information within 3 days (dx results, prob/med/allergy) 13 50% Clinical summaries provided for each office visit within 3 days 14 Yes/No Test certified EMR to electronically exchange key clinical data 15 Yes/No Conduct or review security risk analysis and implement security updates Note: Practices will be required to report on all of the 15 core Set Measures Slide 8

9 Meaningful Use Measures Reporting (continued) Menu Set: Stage 1 measures for Eligible Professionals Measures Requirement Description Of Criteria 1 Yes/No Provide drug formulary check 2 50% Clinical lab tests (neg/pos or numeric) are entered as structured data 3 Yes/No Generate lists of pt with specific conditions to use for QI, standardized management or outreach 4 10% Provide pt electronic access to health information (lab results, prob/med/allergy lists) 5 20% Send reminders to pt (per pt preference) for preventive/ follow-up care 6 10% Provide patient Education materials 7 50% Perform medication reconciliation of relevant encounters and each transition of care 8 50% Provide care summary for each transition of care and referral *9 Yes/No Test certified EMR capacity to submit electronic data to immunization registry *10 Yes/No Test certified EMR capacity to submit electronic data to public health agencies Note: Practices will be required to report 5 of the 10 of the Menu Set measures. * Must select one public health reporting requirement Slide 9

10 Report quality measures to CMS - 3 Core Quality Measures and 3 Alternate set of Quality Measures Core Set Measure 11, means reporting 6 total quality measures from the selections below: Select 3 Core Quality Measures Child/Adolescent weight Childhood immunization status Adult over 50 Influenza status * Alternate Core Measures if the above do not apply Blood pressure measurement Tobacco use Adult weight screening and follow-up Select 3 Alternate Quality Measures 38 additional clinical quality measures to choose from Slide 10

11 Alternate Set of Clinical Quality Measures Select 3 from these 38 quality measures. 1. Diabetes: Hemoglobin A1c Poor Control 2. Diabetes: Low Density Lipoprotein (LDL) Management and Control 3. Diabetes: Blood Pressure Management 4. Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) 5. Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) 6. Pneumonia Vaccination Status for Older Adults 7. Breast Cancer Screening 8. Colorectal Cancer Screening 9. Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for Patients with CAD 10.Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) 11.Anti-depressant medication management: (a) Effective Acute Phase Treatment, (b)effective Continuation Phase Treatment 12.Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation 13.Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy 14.Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care 15.Asthma Pharmacologic Therapy 16.Asthma Assessment 17.Appropriate Testing for Children with Pharyngitis 18.Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer 19.Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients Slide 11

12 Alternate Set of Clinical Quality Measures Select 3 from these 38 other quality measures. 20.Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients 21.Smoking and Tobacco Use Cessation, Medical Assistance: a) Advising Smokers and Tobacco Users to Quit, b) Discussing Smoking and Tobacco Use Cessation Medications, c) Discussing Smoking and Tobacco Use Cessation Strategies 22.Diabetes: Eye Exam 23.Diabetes: Urine Screening 24.Diabetes: Foot Exam 25.Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL-Cholesterol 26.Heart Failure (HF): Warfarin Therapy Patients with Atrial Fibrillation 27.Ischemic Vascular Disease (IVD): Blood Pressure Management 28.Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic 29.Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a) Initiation, b) Engagement 30.Prenatal Care: Screening for Human Immunodeficiency Virus (HIV) 31.Prenatal Care: Anti-D Immune Globulin 32.Controlling High Blood Pressure 33.Cervical Cancer Screening 34.Chlamydia Screening for Women 35.Use of Appropriate Medications for Asthma 36.Low Back Pain: Use of Imaging Studies 37.Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control 38.Diabetes: Hemoglobin A1c Control (<8.0%) Slide 12

13 Meaningful Use with CPS and Centricity EMR The following slides are associated with CPS and Centricity EMR, detailing the Meaning Use Objectives that the following versions support: Centricity Practice Solution Version CPS 9.5 Centricity EMR Version EMR 9.5 Slide 13

14 Objective 2 Implement Drug to Drug, Drug to Allergy, Drug Formulary Checks Objective 2 1 st Section Automatically and electronically generate and indicate in real-time, alerts at the point of care for drug to drug and drug to allergy contraindication based on medication list, medication allergy, list, age, and CPOE Note: CPS 9.5 will support contraindication based on age Slide 14

15 Objective 2 Implement Drug to Drug, Drug to Allergy, Drug Formulary Checks Objective 2 4th Section :Automatically and electronically track, record, and generate report on the number of alerts responded to by a user. Slide 15

16 Objective 7 - Record Demographics Enable a user to electronically record, modify, and retrieve patient demographic data including preferred language, insurance type, gender, race, ethnicity, and date of birth. Note: Additional Fields for ethnicity and insurance type planned for CPS 9.5 Slide 16

17 Objective 10 Incorporate clinical lab test results into EMR as structured data: Objective 10 3rd Section Electronically display all information for a test report specified. (e.g. Addition of Lab directors name to the test report) Note: Additional Fields for director s name to test report planned Slide 17

18 Objective 12 - Reporting quality measures to CMS or the States Objective 12 1st Section Calculate and electronically display quality measure results as specified by CMS or states Note: Clarity expected from ONC on: 1. Formats 2. State specific measures to report *** Please join us for the MQIC Presentation on Nov 19 th *** Slide 18

19 Objective 12 - Reporting quality measures to CMS or the States Objective 12 2nd Section Enable a user to electronically submit calculated quality measures. *** Please join us for the MQIC Presentation on Nov 19 th *** Slide 19

20 Objective 13 - Send reminders to patients per patient preference for preventive / follow up care Electronically generate, upon request, a patient reminder list for preventive or follow-up care according to patient preferences based on demographic data, specific conditions, and/or medication list. This functionality will be added to EMR 9.5 Note: Objective 13 is currently available in CPS Slide 20

21 Objective 14 - Implement 5 clinical decision support rules Objective 14 3 rd Section Automatically and electronically track, record, and generate report on the number of alerts responded to by a user Slide 21

22 Objective 17 Provide patients with an electronic copy of their health information upon request. Enable a user to create an electronic copy of a patients clinical information Note: Plans to add CCR Viewer Plans to add diagnostic test results, immunizations, and procedures to CCD Slide 22

23 Objective 20 Provide clinical summaries for patients for each office visit Objective 20 1st Section Enable a user to provide clinical summary to patients (in paper or electronic form), for each office visit that includes: Clinical Summary Diagnostic Test Results Medication List Medication Allergy List Procedures Problem Lists Immunizations Slide 23

24 Objective 20 Provide clinical summaries for patients for each office visit Objective 20 2nd Section If the clinical summary is provided electronically, it must be in a human readable format and in accordance with the standards specified: Slide 24

25 Objective 21 Capability to exchange key clinical information among providers of care and patient authorized entities electronically Objective 21 1st Section Electronically receive a patient summary record, from other providers and organizations including, at a minimum: Note: Clinical Summary Diagnostic Test Results Medication List Medication Allergy List Procedures Problem Lists Immunizations Plans to add CCR Viewer Slide 25

26 Objective 21 Capability to exchange key clinical information among providers of care and patient authorized entities electronically Objective 21 2nd Section Enable a user to electronically transmit a patient summary record to other providers on organizations including at a minimum: Clinical Summary Diagnostic Test Results Medication List Medication Allergy List Procedures Problem Lists Immunizations Note: Plans to add diagnostic test results, immunizations, and procedures to CCD. Centricity Messenger or Medfusion for secure method of transmission Slide 26

27 Objective 25- Protect electronic health information Objective 25 4th Section Encrypt and decrypt electronic health information according to user-defined preferences (e.g. back-ups, removable media, at log-on/off) Objective 25 5th Section Encrypt and decrypt electronic health information when exchanged Department of Health and Human Services is recommending, and including as a measure, that practices conduct a security risk analysis and implement security updates as necessary to correct identified security deficiencies. Measures Requirement Description Of Criteria 15 Yes/No Conduct or review security risk analysis and implement security updates (1) Any encryption algorithm identified by the National Institute of Standards and Technology (NIST) as an approved security function of the Federal Information Processing Standards (FIPS) Publication. (2) Exchange. Any encrypted and integrity protected link. EHI Slide 27

28 Objective 25- Protect electronic health information Objective 25 6 th Section Record actions (e.g. deletion) related to electronic health information (i.e., audit log) Note: Plan to add support for Audit Trail and Node Authentication (ATNA) Objective 25 7th Section Verify that electronic health information has not been altered in transit and detect the alteration on deletion of electronic health information and audit logs. Note: Plan to support SHA-1. SHA-1 is a cryptographic hash function designed by the National Security Agency (NSA) Slide 28

29 Questions and Answers Thank you for attending! Tom