MU/REG 06: Stage 2 and. Preview. Presented by: Presented by: Robert Forrest Marketing Comm Manager

Transcription

1 MU/REG 06: Stage 2 and Stage 3 Meaningful Use Preview Presented by: Presented by: Robert Forrest Marketing Comm Manager

2 Stage 2 and Stage 3 Meaningful Use Preview Agenda Session Audience - All Audiences - All Platforms Learning Objectives 1. Preview the proposed requirements for Stage 2 Meaningful Use for EHs 2. Review revised rollout of Stage 2 for early adopters 3. Preview the proposed requirements for Stage 3 Meaningful Use for EHs

3 Stage 2 Preview

4 Timing of Stage 2 Legislation HIT Policy Committee Recommendations Jan 2011 Proposed Rule January 2012 Comment Period 60 days following publication Final Rule June 2012

5 Stage 2 Guiding Objectives Expand on Stage 1 MU to encourage use of HIT Broader application of existing criteria (increased thresholds) Achievement of all objectives required (no Menu Set) New criteria added to existing objectives Continuous Quality Improvement Health Information Exchange

6 Increased Thresholds Stage 1 Stage 2 CPOE for medication orders (30%) Drug-drug and drug allergy interaction checks enabled Record demographics (50%) CPOE for medication, lab, radiology order of 60% of unique patients Employ drug-drug and drug allergy interaction checking on evidence based interactions Record demographics for 80% and be able to use them for quality reporting Record vital signs (50%) Record vital signs (80%) Record smoking status (50%) Record smoking status (80%) Perform test of HIE Connect to at least three external providers in primary referral network (but outside delivery system that uses the same EHR) or establish an ongoing bidirectional connection to at least one health information exchange

7 Increased Thresholds Stage 1 Stage 2 Provide e-copy of discharge instructions at discharge (50%) Offer e-copy of discharge instructions at time of discharge to at least 80% of patients Perform Medication Reconciliation at Perform Medication Reconciliation at transition of care (50%) transition of care (80%) Implement 1 Clinical Decision Support (CDS) Rule Use CDS rules to improve performance on high-priority health conditions. Attributes for purposes of certification: 1. Authenticated; 2. Credible, evidence-based; 3. Patient-context sensitive; 4. Invokes relevant knowledge; 5. Timely; 6. Efficient workflow; 7. Integrated with EHR; 8. Presented to the appropriate party who can take action

8 New Criteria 1. 30% of EH patient days have at least one electronic note by a physician, NP, or PA % of medication orders tracked by EMAR % of patients offered the ability to view and download via a web-based portal, within 36 hours of discharge, relevant information contained in the record about EH inpatient encounters. Data are available in human-readable and structured forms (HITSC to define). 4. Patient preferences for communication medium recorded for 20% of patients. 5. List of care team members (including PCP) available for 10% of patients in EHR. 6. Record a longitudinal care plan for 20% of patients with high-priority health conditions. 7. For medications that are continue upon discharge, transmit as erx (50%).

9 Stage 2 Summary Stage 1 Core Objectives are continued in Stage 2 Stage 1 thresholds h are increased in Stage 2 Stage 1 Menu Set become Core Objectives in Stage 2 New objectives will be added in Stage 2

10 Stage 2 Revised Rollout

11 MU Stage Requirements Stage 1 Final Rule 1 st Fiscal Year Payment Year Stage 1 Stage 1 Stage 2 Stage 2 TBD 2012 Stage 1 Stage 1 Stage 2 TBD 2013 Stage 1 Stage 1 TBD 2014 Stage 1 TBD 2015 TBD

12 Implications of Deadlines Stage 2 Final Rule July - Aug 2012 EHR Development & Certification for Stage 2 Oct 1, 2012 June 2012 Stage 2 EHR Sept 2012 Certification Body 90 days* Implement EHR and begin Stage 2 EHR Reporting Period *process for stage 1 took ~150 days

13 MU Stage Requirements June 2011 Revision 1 st Fiscal Year Payment Year Stage 1 Stage 1 Stage 1 Stage 2 TBD 2012 Stage 1 Stage 1 Stage 2 TBD 2013 Stage 1 Stage 1 TBD 2014 Stage 1 TBD 2015 TBD

14 Implications of Extension Stage 2 Final Rule July - Aug 2012 EHR Development & Certification for Stage 2 Oct 1, 2013 June 2012 Stage 2 EHR Certification Body 14 months Implement EHR and begin Stage 2 EHR Reporting Period

15 Stage 3 Preview

16 Stage 3 Guiding Objectives Promote improvements in quality, safety, and efficiency Decision support for national high-priority conditions Patient access to self-management tools Access to comprehensive patient data Improve population health

17 Increased Thresholds Stage 2 Stage 3 CPOE for medication, lab, radiology order of 60% of unique patients Employ drug-drug and drug allergy interaction checking on evidence based interactions Record demographics for 80% and be able to use them for quality reporting CPOE for medication, lab, radiology order of 80% of patients Employ: drug-drug interaction checking, drug allergy checking, drug age checking (medications in the elderly), drug dose checking (e.g., pediatric dosing, chemotherapy dosing), drug lab checking, and drug condition checking (including pregnancy and lactation) on appropriate evidence-based interactions Record demographics for 90% and be able to use them for quality reporting Record smoking status (80%) Record smoking status (90%)

18 Increased Thresholds Stage 2 Stage 3 50% of orders (outpatient and 80% of orders (outpatient and hospital discharge) transmitted as erx hospital discharge) transmitted as erx Maintain problem list (80%) 80% problem lists are up-to-date Maintain active medication list (80%) Maintain active medication allergy list (80%) Implement drug formulary checks 50% of patients >=65 years old have recorded in EHR the result of an advance directive discussion and the directive itself if it exists Generate patient lists for multiple patient-specific parameters 80% medication lists are up-to-date 80% medication-allergy lists are upto-date 90% of patients >=65 years old have recorded in EHR the result of an advance directive discussion and the directive itself if it exists Patient lists are used to manage patients for high-priority health conditions

19 Increased Thresholds Stage 2 Stage 3 Incorporate lab results as structured data (40%) 90% of lab results electronically ordered by EHR are stored as structured t data in the EHR and are reconciled with structured lab orders 30% of patient days have at least one 80% of patient days have at least one electronic note by a physician, NP, or electronic note by a physician, NP, or PA PA 30% of medication orders automatically tracked via EMAR Provide electronic copy of health information, upon request (50%) Provide electronic copy of discharge instructions at discharge (80%) EHR-enabled patient-specific educational resources (10%) 80% of medication orders automatically tracked via EMAR Provide electronic copy of health information, upon request (90%) Provide electronic copy of discharge instructions at discharge (80%) in the common primary language 20% offered patient-specific educational resources online in the common primary languages

20 Increased Thresholds Stage 2 Stage 3 Patient preferences for communication medium recorded for 20% of patients Connect to at least 3 external providers in primary referral network Medication reconciliation conducted at 80% of care transitions by receiving provider Summary care record provided electronically ll for 50% of transitions i and referrals List of care team members (including PCP) available for 10% of patients in EHR Record a longitudinal care plan for 20% of patients with high-priority health conditions Patient preferences for communication medium recorded for 80% of patients Connect to at least 30% of external providers in primary referral network Medication reconciliation conducted at 90% of care transitions by receiving provider Summary care record provided electronically ll for 80% of transitions i and referrals List of care team members (including the PCP) available for 50% of patients via electronic exchange Longitudinal care plan available for electronic exchange for 50% of patients with high-priority health conditions

21 New Criteria 1. Offer electronic self-management tools to patients with high priority health conditions. 2. EHRs have capability to exchange data with PHRs using standards-based health data exchange. 3. Patients offered capability to report experience of care measures online. 4. Offer capability to upload and incorporate patient-generated data (e.g., electronically collected patient survey data, biometric home monitoring data, patient suggestions of corrections to errors in the record) into EHRs and clinician i i workflow. 5. Public Health Button: Mandatory test and submit if accepted. Submit notifiable conditions using a reportable public-health submission button. EHR can receive and present public health alerts or follow up requests. 6. Patient-generated data submitted to public health agencies.

22 Potential SW Needs

23 Potential SW Needs Stage 2 Personal Health Record Patient Portal Bar-Coded Medication Administration (BCMA) Stage 3 Public Health Button Interface to Patient Generated Data Subject to change with publication of forthcoming Final Rules!

24 Stage 2 and Stage 3 Meaningful Use Preview Learning Objectives Recap 1. Preview the proposed requirements for Stage 2 Meaningful Use for EHs 2. Review revised rollout of Stage 2 for early adopters 3. Preview the proposed requirements for Stage 3 p p q g Meaningful Use for EHs

25 Questions?