Executive Brief: Cloud-Based Communication Service for Hospitals Fulfills Meaningful Use Requirement for State Reporting

Transcription

1 Executive Brief: Cloud-Based Communication Service for Hospitals Fulfills Meaningful Use Requirement for State Reporting

2 Many Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs) are racing to meet the quickly approaching deadline for Meaningful Use Stage 2 (MU2). They assume, however, that achieving Public Health Reporting (PHR) for MU2 simply requires the establishment of an interface connection from their electronic health record to a Public Health Agency (PHA). Federal guidelines leave it up to the state In order to avoid a penalty in 2015, providers will need to attest successfully at least three months before the end of the 2014 payment year. to determine the data transport mechanisms and message filtering requirements. These guidelines vary by state and can quickly transform PHR into a daunting and time-consuming exercise for hospitals and health systems. Meeting the Deadline The Stage 2 final rule published by the Centers for Medicare and Medicaid Services (CMS) in September 2012 established a timeline for how adjustments in Medicare reimbursement will be calculated for EHs, CAHs and other Eligible Providers. Hospitals that fail to meet the MU2 requirements will be penalized with reduced Medicare payments. In order to avoid penalties that start in 2015, providers will need to attest successfully at least three months before the end of the 2014 payment year. Initial Submission Challenges To qualify for Stage 2 incentives, EHs must meet all 16 MU2 core objectives during the EHR reporting period. Three of the 16 core objectives require the capability to submit electronic reportable results to PHAs at a state level. These three objectives include reporting on: Electronic Laboratory Results Data for Syndromic Surveillance Immunization Administrations For more information, please reference the Stage 2 Meaningful Use Fact Sheet: Public Health Reporting Objectives.

3 Even though four out of five EHs are able to meet several core measures, (according to a Q HIMSS Analytics poll of 418 hospitals) fewer than half were capable of providing these three reporting objectives listed above. Furthermore, although these measures are prescribed at a federal level, each state may require different protocols for receiving the data. There is no centralized location listing each state s requirements, nor a centralized regulatory authority within each state. Some states require information be sent through a Health Information Exchange (HIE), including several HIEs that are data repositories and others that simply serve as routers to the PHA. Finally, some states require hospitals to send data directly to the PHA. Organizations are finding that there is a considerable learning curve involved in meeting their states requirements. MEDHOST has worked with states that don t have a strong understanding of the PHR submission process. In fact, states have changed requirements for data transportation, created additional HL7 message requirements and communicated inconsistently about the onboarding processes. Consider the following anecdotal examples: Illinois initially wanted to use a Web services process for receiving data but later modified that requirement to a batch method using SFTP. Indiana published their requirements online at their Department of Public Health site, but this standard did not meet the published CMS standard. When this discrepancy was brought to their attention, they realized the problem and explained that they needed to modify their Website. There was a delay with a hospital in Kentucky because the local HIE required that lab results be accompanied by demographic data. This was problematic because demographics were captured in the ADT messaging, a common type of HL7 message associated with the syndromic reporting requirement. When the data transfer continued to fail after including the demographics, the MEDHOST consultant realized that syndromic measures needed to be sent first so that the state could associate demographics with the lab results, at which time it was decided that labs should go live last. HL7 Standard Even though CMS provided the criteria for data submission to PHAs, HL7 is meant to be a point-to-point messaging envelope; it is a directional messaging protocol that requires a significant effort to implement, maintain and monitor on an ongoing basis.

4 Adoption and Resource Constraints It is not clear that many hospitals have fully adopted HL7 standards and are capable of transmitting data in a manner required by CMS for MU2 PHR. To achieve this requirement, hospitals will need to invest significantly in software, technical staff and interface expertise. Employing a team of HL7-certified professionals, an integration engine and the ability to continuously monitor the interfaces is the minimum investment required to meet these objectives without outside consultation or assistance. However, according to HL7, there are only 902 certified HL7 specialists in the U.S., few of whom manage their own integration engines. Hospitals with fewer resources have found it necessary to hire staff to manage these communications, hire consultants on a temporary basis or outsource this service to a third party. YourCareLink Because hospitals need to communicate with many third parties in the case of Meaningful Use, PHAs, many are relying on YourCareLink by MEDHOST, a core service for providing an outsourced cloud-based technology solution to help facilitate communication. YourCareLink has already established the necessary connections and relationships with the myriad and various states to support MU submission requirements. YourCareLink allows hospital staff to focus on your core business taking care of and cultivating loyalty in your patient community. We provide you with the in-house expertise to manage state-driven HL7 filtering and delivery requirements, obtain the appropriate state certifications, monitor the ongoing submissions to the appropriate PHAs, identify and correct transmission errors and provide you with current and historical reporting of ongoing submissions required to meet MU requirements. Accountability of service is the foundation of YourCareLink. Some of the most common questions asked include: What happens when a state changes reporting requirements? o YourCareLink leads the effort to manage national, regional and local changes that might impact your organization. Who will be responsible for monitoring that your submissions are successfully transmitted to the state on an ongoing basis: the hospital, your EHR vendor or the state? o We monitor submissions for the hospital. Daily transmission reports are automatically generated to validate successful submissions to the state. If there is an error in transmission, the YourCareLink team will perform a root-cause analysis, identify the source of the issue and perform the necessary steps to resolve the error. With YourCareLink, if CMS comes to town for an audit, you will be ready.

5 The YourCareLink team works directly with hospital staff to ensure that PHR data from their facility s ONC-ACB certified EHR are successfully delivered to the appropriate PHA on an ongoing basis. YourCareLink presents a central data gateway between the hospital and the state registries that utilize secure means of transport. With minimal setup, the YourCareLink team leads registration of intent, onboarding processes, message configuration, interface testing and monitoring and support of ongoing submissions. By managing these processes, hospital staff are free to focus their attention on other areas of operations.

6 Summary The drive toward achieving Meaningful Use, as prescribed by CMS starting in 2011, has been an onerous and timeconsuming ordeal for many eligible hospitals. Common ongoing issues include registration difficulties to providing patient-specific education materials, and often solutions have included creating new departments to manage these processes, onboarding new staff and purchasing and training personnel on new software. Unfortunately the difficulties of meeting Meaningful Use standards are not limited to internal process improvements. Three of the 16 core measures of MU2 require building out capabilities to communicate externally with state departments. External communications also command significant understanding for the appropriate format and methods for sending data, where the data should be sent, the frequency for sending data and the process of troubleshooting issues when transmissions fail or when confirmations are not received from the state. There is at least one way to help sidestep the headaches inherent in meeting the stringent requirements of reporting to state health departments. Because YourCareLink by MEDHOST provides an external communications service for hospitals to third parties, checking the box on Meaningful Use requirements has never been simpler. YourCareLink enables hospitals to relieve this pain point and focus on the business of practicing medicine. MEDHOST Solutions Corp Carothers Parkway, Suite 100, Franklin, TN Toll free MEDHOST Solutions Corp. All rights reserved.