The Future of Meaningful Use

Changes Beginning with Stage 3 in 2017 All EPs and EHs will be attesting to Stage 3 objectives and measures in 2018; 2017 is an optional year Starting in 2018, all Medicare EPs and EHs will be required to report CQMs electronically Stage 3 attestation will require an upgrade to a 2015 Edition CEHRT 2015 Edition CEHRTs are not longer going to be certified just for MU 3

New Technology Options for EPs & EHs in Stage 3 Application Programming Interface (API) Allows providers to enable new functionalities to support data access to patients Two objectives: Patient Electronic Access to Health Information Coordination of Care Through Patient Engagement Should provide more flexibility than current patient portals Providers would only need to fully enable the API functionality and provide detailed instructions to the patient to fulfill a measure 4

Proposed Stage 3 s All objectives are the same for EPs and EHs with slight variations in some measures 8 objectives vs. 10 for Modified Stage 2 These are all PROPOSED Stage 3 s (Proposed) Protect Electronic Health Information Electronic Prescribing (erx) Clinical Decision Support Computerized Provider Order Entry (CPOE) Patient Electronic Access to Health Information Coordination of Care Through Patient Engagement Health Information Exchange Public Health and Clinical Data Registry Reporting 5

Protect Electronic Health Information Protect electronic protected health information (ephi) created or maintained by the CEHRT through the implementation of appropriate technical, administrative and physical safeguards Stage 3 Measure Yes/No Stage 2 Measure Yes/No 6

Electronic Prescribing (erx) EPs must generate and transmit permissible prescriptions electronically, and eligible hospitals and CAHs must generate and transmit permissible discharge prescriptions electronically (erx). Stage 3 Measure Stage 2 Measure EP: 60% EP: 50% EH: 25% EH: 10% 7

Clinical Decision Support Implement clinical decision support (CDS) interventions focused on improving performance on highpriority health conditions Stage 3 Measure 1 CDS EP: 5 each EH: 5 each Stage 3 Measure 2 Drug Interaction Checks EP: Yes/No EH: Yes/No Stage 2 Measure 1 CDS EP: 5 each EH: 5 each Stage 2 Measure 2 Drug Interaction Checks EP: Yes/No EH: Yes/No 8

Computerized Provider Order Entry (CPOE) Use computerized provider order entry (CPOE) for medication, laboratory, and diagnostic imaging orders directly entered by any licensed healthcare professional, credentialed medical assistant, or a medical staff member credentialed to and performing the equivalent duties of a credentialed medical assistant, who can enter orders into the medical record per state, local, and professional guidelines. Stage 3 Measure 1 Medications Stage 2 Measure 1 Medications EP: 60% EP: 60% EH: 60% EH: 60% Stage 3 Measure 2 Labs Stage 2 Measure 2 Labs EP: 60% EP: 30% EH: 60% EH: 30% Stage 3 Measure 3 Images Stage 2 Measure 3 Images EP: 60% EP: N/A (was radiology) EH: 60% EH: N/A 9

Patient Electronic Access to Health Information aka Patient Portal & APIs The EP, eligible hospital or CAH provides patients (or patient-authorized representative) with timely electronic access to their health information and patient-specific education. Stage 3 Measure 1 VDT & API Stage 2 Measure 1 (excluded API) EP: 80% EP: 50% EH: 80% EH: 50% Stage 3 Measure 2 Educations Resources Stage 2 Measure 2 Education Resources EP: 35% EP: 10% EH: 35% EH: 10% 10

Coordination of Care Through Patient Engagement aka Patient Portal & APIs Use CEHRT to engage with patients or their authorized representatives about the patient's care. Stage 3 Measure 1 Actively Engage with EHR EP: 5% (2017 only), 10% (2018 & beyond) EH: 5% (2017 only), 10% (2018 & beyond) Stage 3 Measure 2 Secure Messaging (bi-directional) EP: 5% (2017 only), 25% (2018 & beyond) EH: 5% (2017 only), 25% (2018 & beyond) Stage 3 Measure 3 Patient generated/non-clinical data incorporated EP: 5% EH: 5% 11

Health Information Exchange aka Transition of Care The EP, eligible hospital, or CAH provides a summary of care record when transitioning or referring their patient to another setting of care, receives or retrieves a summary of care record upon the receipt of a transition or referral or upon the first patient encounter with a new patient, and incorporates summary of care information from other providers into their EHR using the functions of CEHRT. Stage 3 Measure 1 Summary of care sent electronically EP: 50% Stage 3 Measure 2 Summary of care received EH: 50% electronically EP: 40% Stage 3 Measure 3 Reconciliation (med, med EH: 40% allergy, prob list) EP: 80% EH: 80% 12

Public Health and Clinical Data Registry Reporting The EP, eligible hospital, or CAH is in active engagement with a public health agency or clinical data registry to submit electronic public health data in a meaningful way using certified EHR technology, except where prohibited, and in accordance with applicable law and practice. Stage 3 Measure 1 Immunization Registry Stage EP: Yes/No 3 Measure 2 Syndromic Surveillance EP: EH: Stage Yes/No 3 Measure 3 Electronic Case Reporting EH: EP: Yes/No Stage 3 Measure 4 Public Health Registry EH: EP: Stage Yes/No 3 Measure 5 Clinical Data Registry EH: EP: Yes/No EH: Yes/No Stage 3 Measure 6 Electronic Lab Results EP: N/A EH: Yes/No 13