0 What is Meaningful Use and where are we? 0 What is the Physician Quality Reporting System and where stage are we on?

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2 Outline 0 What is Meaningful Use and where are we? 0 What is the Physician Quality Reporting System and where stage are we on? 0 How can we leverage the EMR to demonstrate the quality of our care?

3 Meaningful Use Medicare VS. Medicaid

4 Meaningful Use Criteria Report on all 17 Core Objectives: 1. Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders 2. Generate and transmit permissible prescriptions electronically (erx) 3.Record demographic information 4.Record and chart changes in vital signs 5.Record smoking status for patients 13 years old or older 6.Use clinical decision support to improve performance on high-priority health conditions 7.Provide patients the ability to view online, download and transmit their health information 8.Provide clinical summaries for patients for each office visit 9.Protect electronic health information created or maintained by the Certified EHR Technology 10.Incorporate clinical lab-test results into Certified EHR Technology 11.Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach 12.Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care 13.Use certified EHR technology to identify patient-specific education resources 14.Perform medication reconciliation 15.Provide summary of care record for each transition of care or referral 16.Submit electronic data to immunization registries 17.Use secure electronic messaging to communicate with patients on relevant health information Report on 3 of 6 Menu Objectives: 1. Submit electronic syndromic surveillance data to public health agencies 2. Record electronic notes in patient records 3. Imaging results accessible through CEHRT 4. Record patient family health history 5. Identify and report cancer cases to a State cancer registry 6. Identify and report specific cases to a specialized registry (other than a cancer registry)

5 Meaningful Use Incentive Reference:

6 Meaningful Use Timeline

7 Benefits of Using the EMR 0 Increase patient access to information and communication 0 Enhance interventions 0 Reduce patients costs 0 Facilitate tracking of chronic conditions and preventive care 0 Monitoring of sick patients 0 Reduce medical errors and drug-drug interactions

8 Clinical Quality Measures 0 Requirements as part of Meaningful Use 0 Measures applicable for PQRS 0 9 measures across 3 different domains Available Domains: 1. Patient and Family Engagement 2. Patient Safety 3. Care Coordination 4. Population/Public Health 5. Efficient Use of Healthcare Resources 6. Clinical Process/Effectiveness

9 CQMs Geriatrics 1 Patient Safety NQF0022 Use of High Risk Medications in the Elderly 2 Public Health NQF0028 Tobacco Use Screening and Cessation Intervention 3 Public Health NQF0418 Screening for Depression 4 Patient Safety NQF0419 Documenting Medications in the EMR 5 Public Health NQF0421 BMI Screening and F/U 6 Care Coordination CMS50 Closing the Loop 7 Public Health NQF0041 Influenza Immunization 8 Clinical Process NQF0043 Pneumonia Immunization 9 Clinical Process NQF0059 Hemoglobin A1c Poor Control(HbA1 > 9%) Clinical Process NQF0068 Use of Antithrombotic in Ischemic Vascular Disease/CAD Patient Safety NQF0101 Falls: Screening for Future Fall Risk Clinical Process NQF0105 Anti-Depression Medication Management Clinical Process CMS149v2 Dementia: Cognitive Assessment 1 Clinical Process NQF0018 Controlling High Blood Pressure

10 Physician Quality Reporting System Quality Reimbursement started in 2007 with 1.5% incentive and went up to 2% in Year Incentive Penalty for not participating 0.5% for reporting; 0.5% if participation in MOC none 0.5% for reporting; 0.5% if participating in MOC; 1.5% in EPs: 0 to 2.0x(x represents Value Based Payment Modifier) > 10 EPs: - 4 to 4.0x(x represents Value Based Payment Modifier) 0.5% incentive; Upward/Neu tral/downw ard Adjustment based on # EPs 2% in % in Payment-Adjustments.pdf

11 Our Experience 0 Participating in MU since PQRS since by Claims by Electronic Submission(via EMR) 0 Uses as much resources on the EMR as possible to facilitate 0 Data Capturing 0 Reporting 0 Enhance Clinical Processes based on the EMR workflow

12 Our Experience 0 Start the process early 0 Engage the whole team 0 Decentralize 0 Lean Thinking 0 Frequent Reporting 0 MU Monthly 0 Quality Quarterly 0 Certified EMR 0 Prepare for Investments on Upgrades and Training

13 UCF Health at University Thank you! UCF College of Medicine

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