A Deep Dive Into MU Stage 2



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A Deep Dive Into MU Stage 2 A Complimentary Webinar From healthsystemcio.com, Sponsored By Hyland Software, Developers of OnBase Your Line Will Be Silent Until Our Event Begins Thank You!

Housekeeping Moderator Anthony Guerra, editor-in-chief, healthsystemcio.com Ask A Question We will be holding a Q&A session after the formal presentations. You may submit your questions at any time by clicking on the QA panel located in the lower right corner of your screen, type in your questions in the text field and hit send. Please keep the send to default as All Panelists. Download the Deck Go to: http://healthsystemcio.com/presentation/meaningful-use-2-webinar.pdf Shortened link below appears on all slides. View the Archive You will receive an email when our archive recording is ready. Separate registration is required.

Agenda John Halamka, MD, CIO, Beth Israel Deaconess Medical Center (25 minutes) A Word From Our Sponsor: Lorna Green, Senior Healthcare Informaticist, OnBase (5 minutes) Q&A (20+ minutes)

Meaningful Use Stage 2 John Halamka, M.D. CIO Beth Israel Deaconess Medical Center

Overall Meaningful Use Policy Goals Improving quality, safety, efficiency, and reducing health disparities Engaging patients and families in their health care Improving care coordination Improving population and public health Ensuring adequate privacy and security protections for personal health information

What is Your Meaningful Use Path? For Medicare Hospitals: Webex Support 71-866-223-3239 7

2014 Changes 1. EHRs Meeting ONC 2014 Standards starting in 2014, all EHR Incentive Programs participants will have to adopt certified EHR technology that meets ONC s Standards & Certification Criteria 2014 Final Rule 2. Reporting Period Reduced to Three Months to allow providers time to adopt 2014 certified EHR technology and prepare for Stage 2, all participants will have a threemonth reporting period in 2014. 8

Meaningful Use: Changes from Stage 1 to Stage 2 Stage 1 Stage 2 Eligible Professionals 15 core objectives 5 of 10 menu objectives 20 total objectives Eligible Professionals 17 core objectives 3 of 6 menu objectives 20 total objectives Eligible Hospitals & CAHs 14 core objectives 5 of 10 menu objectives 19 total objectives Eligible Hospitals & CAHs 16 core objectives 3 of 6 menu objectives 19 total objectives 9

1. CPOE Stage 2 EP Core Objectives EPs must meet all 17 core objectives: Core Objective 2. E-Rx E-Rx for more than 50% Measure Use CPOE for more than 60% of medication, 30% of laboratory, and 30% of radiology 3. Demographics Record demographics for more than 80% 4. Vital Signs Record vital signs for more than 80% 5. Smoking Status Record smoking status for more than 80% 6. Interventions Implement 5 clinical decision support interventions + drug/drug and drug/allergy 7. Labs Incorporate lab results for more than 55% 8. Patient List Generate patient list by specific condition 9. Preventive Reminders Use EHR to identify and provide reminders for preventive/follow-up care for more than 10% of patients with two or more office visits in the last 2 years 10

Core Objective 10. Patient Access Stage 2 EP Core Objectives EPs must meet all 17 core objectives: Measure Provide online access to health information for more than 50% with more than 5% actually accessing 11. Visit Summaries Provide office visit summaries for more than 50% of office visits 12. Education Resources Use EHR to identify and provide education resources more than 10% 13. Secure Messages More than 5% of patients send secure messages to their EP 14. Rx Reconciliation Medication reconciliation at more than 50% of transitions of care 15. Summary of Care Provide summary of care document for more than 50% of transitions of care and referrals with 10% sent electronically and at least one sent to a recipient with a different EHR vendor or successfully testing with CMS test EHR 16. Immunizations Successful ongoing transmission of immunization data 17. Security Analysis Conduct or review security analysis and incorporate in risk management process 11

Stage 2 EP Menu Objectives EPs must select 3 out of the 6: Menu Objective 1. Imaging Results Measure More than 10% of imaging results are accessible through Certified EHR Technology 2. Family History Record family health history for more than 20% 3. Syndromic Surveillance Successful ongoing transmission of syndromic surveillance data 4. Cancer Successful ongoing transmission of cancer case information 5. Specialized Registry Successful ongoing transmission of data to a specialized registry 6. Progress Notes Enter an electronic progress note for more than 30% of unique patients 12

Stage 2 Hospital Core Objectives Eligible hospitals must meet all 16 core objectives: 1. CPOE Core Objective Measure Use CPOE for more than 60% of medication, 30% of laboratory, and 30% of radiology 2. Demographics Record demographics for more than 80% 3. Vital Signs Record vital signs for more than 80% 4. Smoking Status Record smoking status for more than 80% 5. Interventions Implement 5 clinical decision support interventions + drug/drug and drug/allergy 6. Labs Incorporate lab results for more than 55% 7. Patient List Generate patient list by specific condition 8. emar emar is implemented and used for more than 10% of medication orders 13

Stage 2 Hospital Core Objectives Eligible hospitals must meet all 16 core objectives: Core Objective 9. Patient Access 10. Education Resources Measure Provide online access to health information for more than 50% with more than 5% actually accessing Use EHR to identify and provide education resources more than 10% 11. Rx Reconciliation Medication reconciliation at more than 50% of transitions of care 12. Summary of Care Provide summary of care document for more than 50% of transitions of care and referrals with 10% sent electronically and at least one sent to a recipient with a different EHR vendor or successfully testing with CMS test EHR 13. Immunizations Successful ongoing transmission of immunization data 14. Labs Successful ongoing submission of reportable laboratory results 15. Syndromic Surveillance 16. Security Analysis Successful ongoing submission of electronic syndromic surveillance data Conduct or review security analysis and incorporate in risk management process 14

Stage 2 Hospital Menu Objectives Eligible Hospitals must select 3 out of the 6: Menu Objective 1. Progress Notes 2. E-Rx 3. Imaging Results Measure Enter an electronic progress note for more than 30% of unique patients More than 10% electronic prescribing (erx) of discharge medication orders More than 10% of imaging results are accessible through Certified EHR Technology 4. Family History Record family health history for more than 20% 5. Advanced Directives Record advanced directives for more than 50% of patients 65 years or older 6. Labs Provide structured electronic lab results to EPs for more than 20% 15

CQM Selection and HHS Priorities All providers must select CQMs from at least 3 of the 6 HHS National Quality Strategy domains: Patient and Family Engagement Patient Safety Care Coordination Population and Public Health Efficient Use of Healthcare Resources Clinical Processes/Effectiveness 16

Changes to CQMs Reporting Prior to 2014 Beginning in 2014 EPs Report 6 out of 44 CQMs 3 core or alt. core 3 menu EPs Report 9 out of 64 CQMs Selected CQMs must cover at least 3 of the 6 NQS domains Recommended core CQMs: 9 for adult populations 9 for pediatric populations Eligible Hospitals and CAHs Report 15 out of 15 CQMs Eligible Hospitals and CAHs Report 16 out of 29 CQMs Selected CQMs must cover at least 3 of the 6 NQS domains

Overall Standards and Certification Goals Enhancing standards-based exchange Promoting EHR technology safety and security Enabling greater patient engagement Introducing greater transparency Reducing regulatory burden

Common MU Data Set

2014 Edition CEHRT Easy as 1, 2, 3 + C* MU Menu - 3 MU Core - 2 Base EHR 1 EP/EH/CAH would only need to have EHR technology with capabilities certified for the MU menu set objectives & measures for the stage of MU they seek to achieve. EP/EH/CAH would need to have EHR technology with capabilities certified for the MU core set objectives & measures for the stage of MU they seek to achieve unless the EP/EH/CAH can meet an exclusion. EP/EH/CAH must have EHR technology with capabilities certified to meet the Base EHR definition. *C = CQMs

2014 Edition EHR Certification Criteria Mapped to the 2014 CEHRT Definition for EHs & CAHs Seeking to Achieve MU Stage 2 in and after CY 2014 2014 Edition EHR Certification Criteria Mapped to the 2014 CEHRT Definition for EHs & CAHs Seeking to Achieve MU Stage 2 in and after FY 2014 2014 Certification Criteria associated with MU Core Stage 2: Drug-drug, drug-allergy interaction checks (170.314(a)(2)) Vital signs, BMI, & growth charts (170.314(a)(4)) Smoking status (170.314(a)(11)) Patient list creation (170.314(a)(14)) Patient-specific education resources (170.314(a)(15)) emar (170.314(a)(16)) Clinical information reconciliation (170.314(b)(4)) Incorporate lab tests & values/results (170.314(b)(5)) View, download, & transmit to 3 rd Party (170.314(e)(1)) Immunization information (170.314(f)(1)) Transmission to immunization registries (170.314(f)(2)) Transmission to PH agencies syndromic surveillance (170.314(f)(3)) Transmission of reportable lab tests & values/results (170.314(f)(4)) *= optional MU Menu MU Core Base EHR 2014 ed. certification criteria for which certification may be required: Automated numerator recording (170.314(g)(1)) Automated measure calculation (170.314(g)(2)) Safety-enhanced design (170.314(g)(3)) Quality management system (170.314(g)(4)) 2014 Certification Criteria associated with a Base EHR: CPOE (170.314(a)(1)) Demographics (170.314(a)(3)) Problem list (170.314(a)(5)) Medication list (170.314(a)(6)) Medication allergy list (170.314(a)(7)) Clinical decision support (170.314(a)(8)) Transitions of care (170.314(b)(1) & (2)) Data portability (170.314(b)(7)) Clinical quality measures (170.314(c)(1) - (3)) Privacy and Security CC: oauthentication, access control, & authorization (170.314(d)(1)) oauditable events & tamper resistance (170.314(d)(2)) oaudit report(s) (170.314(d)(3)) oamendments (170.314(d)(4)) oautomatic log-off (170.314(d)(5)) oemergency access (170.314(d)(6)) oend-user device encryption (170.314(d)(7)) ointegrity (170.314(d)(8)) oaccounting of disclosures* (170.314(d)(9)) 2014 Certification Criteria associated with MU Menu Stage 2: Electronic notes (170.314(a)(9)) Drug-formulary checks (170.314(a)(10)) Image results (170.314(a)(12)) Family health history (170.314(a)(13)) Advance directives (170.314(a)(17)) erx (170.314(b)(3)) Transmission of e-lab tests & values/results to providers (170.314(b)(6))

A Deep Dive Into MU Stage 2 Lorna Green Senior Healthcare Informaticist Hyland Software

OnBase brings all of your content into one Repository. Makes it available to everyone who needs access Automates Manual processes

Content Sources Microsoft Office Paper Documents & Files Mail Enterprise Applications Graphics, Video, & Audio Fax Electronic Documents Health Level Seven Email E-Mail Print Output Reports Forms XML & Meta Data Web Pages

OnBase Integrates with all EMR s and other business process software

Meaningful Use Audit Import, Store, Retrieve all documents related to attestation Scan, Cold Feed, Document Import, scheduled reports printed into OnBase, etc. Stored in organized folders User level security Automate the processes Checklists, Workflow, Document creation, Outlook Integration

Hyland Software: http://www.hyland.com/ Lorna Green RN, BSN Healthcare Informatics Executive Advisor Lorna.green@hyland.com 912-346-9070 Savannah, GA Follow us. Facebook: https://www.facebook.com/hylandsoftware?fref=ts Twitter: https://twitter.com/hylandsoftware Hyland Blog: http://blog.hyland.com/category/healthcare/

Q&A Click on the Q&A panel located in the lower right corner of your screen, type in your questions in the text field and hit send. Please keep the send to default as All Panelists.

Thank You! You will receive an email when our archive recording is ready. (Separate registration is required) Questions/Comments Anthony Guerra aguerra@healthsystemcio.com Thanks to our sponsor: Hyland Software, developers of OnBase Go to www.healthsystemcio.com/webinars to view our upcoming schedule and see all archived events.