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Meaningful Use Stage 2 Kickoff

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Learn about the new Stage 2 requirements and get your specific questions answered during an open Q&A session.

Learn about the new Stage 2 requirements and get your specific questions answered during an open Q&A session.

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Meaningful Use Stage 2 Kickoff Meaningful Use Stage 2 Kickoff Presentation Transcript

  • Meaningful Use 2014 Stage 2 Kickoff Webinar Continue success with the EHR Incentive Program
  • Stages of Meaningful Use 1 STAGE Data capture and sharing 2 STAGE 3 STAGE Advanced clinical processes Improve outcomes
  • Stages of Meaningful Use (based on year of adoption) Year of adoption Year 2011 2012 2013 2014 2015 2016 2017 2011 1 1 1 2 2 2 3 2012 1 1 2 2 2 3 2013 1 1 2 2 3 2014 1 1 2 2 2015 1 1 2 2016 1 1
  • Stage 2 Requirements 9 Clinical Quality Measures (CQMs) + You must report at least 9 CQMs directly from Practice Fusion’s 2014 CQM report 17 CORE 3 MENU 20MEASURES
  • + Requirement: Report at least 9 CQMs that relate to at least 3 National Quality Strategy (NQS) domains: + CMS selected 9 recommended CQMs for adult and pediatric populations  The recommended CQM sets focus on areas that represent national public health priorities or disproportionately drive health care costs CQM Requirements in 2014 Patient and Family Engagement Patient Safety Care Coordination Population and Public Health Efficient Use of Healthcare Resources Clinical Processes/Effectiveness
  • CQM Reporting Methods in 2014 + Medicare EPs will submit CQMs to CMS electronically or via attestation + Medicaid EPs must submit CQM data to their State Medicaid Agency + Reporting period: Entire calendar year or 3 months tied to reporting period for Meaningful Use (Q1/Q2/Q3/Q4) + Electronic submission: January 1, 2015 – February 28, 2015  Medicare EPs have the option to submit a full year of data electronically to receive credit for the EHR Incentive Program and the Physician Quality Reporting System (PQRS) if using the PQRS EHR reporting mechanism.
  • + 2014 - 3 month quarter reporting period options:  Q1 (Jan 1 – March 31)  Q2 (Apr 1 – Jun 30)  Q3 (Jul 1 – Sept 31)  Q4 (Oct 1 – Dec 1) + Individual state Medicaid programs may allow different reporting periods.  Check with your state agency for more details Reporting Period
  • + Similar to Stage 1, you may qualify for exclusions for certain measures if they are outside the scope of your practice + Exclusions will no longer count towards meeting the requirements of the menu measures, so you must first select menu measures that are relevant to your scope of practice + If there aren’t enough menu measures for you to achieve 3 of the 6, you must attest to an exclusion for the remaining menu measures New Exclusion Definition for 2014
  • + You must record all patients you see, regardless of their insurance, in the outpatient setting for Meaningful Use + If you see patients in the hospital, you do not need to include them in Practice Fusion for Meaningful Use + At minimum, you must maintain more than 80% of your patients in the certified EHR for Meaningful Use Is Meaningful Use based on all patients?
  • Review of Stage 2 Measures
  • Changes in Stage 2 Measures with Minor Changes Measures with Additions Brand New Measures
  • PF Workflows are suggestions and may not be the only way to meet a measure
  • Measures with Minor Changes from Stage 1 Measure Change Demographics Threshold increases to 80% Smoking Status Threshold increases to 80% Protect Health Information Security risk analysis includes additional criteria Clinical Summaries Timeframe decreases to 1 business day Clinical Lab Test Results Now a core measure; Threshold increases to 55% Generate Patient List Now a core measure Medication reconciliation Now a core measure Patient-specific education Now a core measure
  • + Measure: Provide clinical summaries to patients within 1 business day of the office visit for more than 50% of all office visits.  Because this measure is time sensitive and is based on the total number of office visits, and not based on the number of unique patients, it is important that you and your practice develop a sustainable workflow for meeting this measure’s requirements. + Exclusion: Any provider who has no office visits during the reporting period is excluded from this measure. + Business Day: The 24 hour weekday period after midnight on the DOS is "1 business day."  For example: If your patient is seen on Friday, the clinical summary needs to be provided by 11:59 PM on the following Monday. Clinical Summaries
  • + PF Suggested Workflow: Enroll patients in the Patient Portal  You can achieve this measure by enrolling a patient in the PHR under Patient Actions from their chart.  Once a patient is enrolled in the Patient Portal, you will automatically achieve credit for this measure at the conclusion of each office visit since the Patient Portal is updated with any new information that results from each encounter. Clinical Summaries
  • + If patient declines the clinical summary:  You will receive credit for this measure as long as you offer all of your patients clinical summaries at the conclusion of their office visit.  If the patient declines to receive the clinical summary, you must notate this in the chart note from that date of service prior to signing it.  In the Finalize section of the SOAP note, mark “Patient declined to receive clinical summary” under the Quality of Care section. Clinical Summaries
  • + Measure: Incorporate more than 55% of all clinical lab test results ordered during the reporting period into the EHR as structured data. + Exclusion: Any provider who orders no lab tests with results that are either in positive/negative or numeric format during the reporting period is excluded. Clinical Lab Test Results as Structured Data
  • + In order to receive credit, navigate to the Labs/Imaging section and select an individual lab result. Clinical Lab Test Results as Structured Data
  • + Attribute the result to the correct patient and ensure that the provider seeking credit for the measure signs the result. Clinical Lab Test Results as Structured Data
  • Measures with additions and multiple sub-measures Measure Change eRx • Threshold increase to 50% • Incorporation of drug formulary Vital Signs • Threshold increases to 80% • New age requirements for height, weight, and blood pressure Clinical Decision Support A minimum of 5 CDS rules now required to be enabled during the entire reporting period Syndromic Surveillance Data Submission Successful ongoing submission now required
  • Measures with additions and multiple sub-measures Measure Change CPOE • Addition of lab and radiology orders • Medication orders threshold increases to 60% Preventative Care Reminders • No age limitation • Based on patients seen at least twice in last 24 months Summary of Care • Now includes 3 sub-measure requirements which includes sending electronic summary of care records Immunization Registry Data Submission • Successful ongoing submission now required • Now a core measure
  • + Measure: Use computerized physician order entry (CPOE) to record the following items during your reporting period:  Measure 1: More than 60% of medication orders  Measure 2: More than 30% of lab orders  Measure 3: More than 30% of radiology orders + Exclusion: Any provider who writes fewer than 100 medication, radiology, or laboratory orders during the reporting period is excluded from the corresponding measure. CPOE for Medication, Lab, and Radiology Orders
  • + PF Workflow:  From the Plan tab of a SOAP note or the patient’s Rx List, select Add Medication.  Choose the medication you would like to order and select Save and Prescribe.  On the next screen, enter the details for the prescription including quantity, SIG, and refills, then select Print Rx, Record Rx or Send e-Rx. CPOE for Medication Orders
  • + PF Suggested Workflow: Under the Patient Actions menu of a patient’s chart, select Add Order (Beta) to gain access to the ordering workflow. CPOE for Lab & Imaging Orders + Then, select the type of order you want to record.
  • + Add a Diagnosis to the order + Add the test you would like to order + Click next to move to the next screen CPOE for Lab and Imaging Orders
  • + Ensure that the provider seeking credit for this measure is selected as the ordering physician + Click “Record” to record the order CPOE for Lab and Imaging Orders
  • + Measure: Send a reminder for more than 10% of all unique patients who had two or more office visits within the 24 months before the beginning of the reporting period, per patient preference when available. + Exclusion: Any provider who has had no office visits in the 24 months before the reporting period. Preventative Care Reminders
  • + PF Suggested Workflow: To find out which of your patients qualify for this measure, use the Gap Report function of the Meaningful Use Dashboard that applies to this measure under the Status column. Preventive Care Reminders
  • + This report will list the patients that have had two or more office visits in the past 24 months so that you can send them an appropriate reminder. Preventive Care Reminders
  • + Once you send the appropriate reminder to those patients, click the Patient reminder sent from button in the Appointments tab of the patient's chart and select your name to receive credit for this measure.  Anyone in your practice can select the Patient reminder sent from button as long as you are selected as the provider from which the reminder was sent. Preventive Care Reminders
  • + Measure: Provide a summary of care record when you transition or refer a patient to another setting or provider:  1) Provide a summary of care record for more than 50% of transitions  2) Provide an electronic summary of care record for more than 10% of transitions  3) Conduct one or more successful electronic summary of care exchanges with a recipient using a different certified EHR OR with a CMS designated test EHR (completed through DIRECT messaging protocol) + Exclusion: Any provider who transfers a patient to another setting or refers a patient to another provider less than 100 times during the reporting period is excluded from all three measures. Summary of Care
  • + PF Suggested Workflow: Electronic summary of care records can be sent by using the digital referral in Practice Fusion.  From Charting shortcuts or Patient Actions, select “Send referral.” Summary of Care (Measure 1 & 2)
  • + Ensure the referral contains either a Chart note, clinical summary, or a clinical document. + Your referral must be sent within 24 hours of the patient’s date of service. Summary of Care (Measure 1 & 2)
  • + First, ensure you are enabled for Direct messaging and your colleague’s Direct address is entered under My connections + Before sending a direct message, create a Referral Summary for the patient ▪ Under the Patient Actions drop down menu from the chart, create the referral summary by selecting “Create clinical document” Summary of Care (Measure 3) – Direct Method 34
  • + Select Referral Summary from the Select a document type drop-down + Include all data elements and click Generate + After the Referral Summary has generated, you can exit the window by clicking Dismiss + Then, navigate to your patient’s chart and initiate the referral Summary of Care (Measure 3) – Direct Method 35
  • + In the referral window, select the provider who will receive the Direct message + Select a Clinical Document for the patient and send the referral + Keep documentation that indicates you have sent a Direct message referral with a clinical document to a provider who uses an EHR other than Practice Fusion. Summary of Care (Measure 3) – Direct Method 36
  • + Measure: Successful ongoing submission of electronic immunization data to an immunization registry for the entire reporting period, except where prohibited, and in accordance with applicable law and practice. + Exclusion: Any of the following can apply. Any provider who:  Does not administer any immunizations during the reporting period  Operates in a jurisdiction where no immunization registry can receive the data electronically according to the specific certification standards  Operates in a jurisdiction where no immunization registry provides timely information on capability to receive immunization data  Operates in a jurisdiction where no immunization registry that is capable of accepting the specific certification standards at the start of the reporting period can enroll additional providers. Immunization Registry Data Submission
  • + Any of the four criteria below are included under the umbrella of ongoing submission:  Ongoing submission was already achieved for a reporting period in a prior year and continues throughout the current reporting period.  Registration with the PHA or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline (within 60 days of the start of the reporting period) and ongoing submission was achieved.  Registration of intent to initiate ongoing submission was made by the deadline and the provider is still engaged in testing and validation of ongoing electronic submission.  Registration of intent to initiate ongoing submission was made by the deadline and the provider is awaiting invitation to begin testing and validation. How is ongoing submission defined?
  • + PF Suggested Workflow: You can access and export a patient’s immunization file under the Patient Actions menu of the patient chart. Immunization Registry Data Submission + Visit our Help Forum post on this measure and find details for your state if available. Otherwise, contact your state registry for submission instructions.
  • + Patient Electronic Access & View/Download/Transmit (Core) + Secure Electronic Messaging (Core) + Imaging Results (Menu) + Electronic Notes (Menu) + Family History (Menu) + Cancer Case Registry (Menu)* + Specific Case Registry (Menu)* *Practice Fusion does not support this measure at this time. Achieving this measure is not required to meet Meaningful Use. Brand New Measures
  • + Measure 1: Provide more than 50% of all unique patients seen during the reporting period online access to their health information within four business days. + Measure 2: More than 5% of all unique patients seen during the reporting period must view, download their health information or transmit to a 3rd party. + Exclusion: Any provider who:  Doesn’t order or create any of the information listed for inclusion as part of both measures, except for "Patient name" and "Provider's name and office, contact information,” may exclude both measures.  Conducts 50% or more of their patient encounters in a county that doesn’t have 50% or more of its housing units with 3Mbps broadband availability according to the latest information available from the FCC on the first day of the reporting period may exclude only the second measure. Patient Electronic Access
  • + PF Suggested Workflow:  Enroll patients in the Patient Portal from the Patient Actions drop-down menu. Patient Electronic Access (Measure 1)
  • + PF Suggested Workflow: After you enroll patients in the Patent Portal, they will receive an email with instructions for creating an account. Patients View Online / Download / Transmit (Measure 2)
  • + Encourage your patients to complete the Patient Portal enrollment either at the office or as soon as they get home from the appointment using the PIN code that you give them during the visit.  Your patients must log into the Patient Portal at least once during the reporting period in order for you to get credit for this measure. Patients View Online / Download / Transmit (Measure 2)
  • + Measure: More than 5% of unique patients seen during the reporting period must send the provider a secure message using the electronic messaging function of the Patient Portal. + Exclusion: Any provider who has no office visits during the reporting period or any provider who conducts 50% or more of their patient encounters in a county that doesn’t have 50% or more of its housing units with 3Mbps broadband availability according to the latest information available from the FCC on the first day of the reporting period is excluded from this measure. Secure Electronic Messaging
  • + PF Suggested Workflow: You must first enable secure messaging by adjusting your message settings in the New Messaging (beta) section. Secure Electronic Messaging + Once messaging is enabled, every provider in your practice can use the new feature.
  • + After your patient has successfully logged into the Patient Portal, they must send you a message. + You need to access your inbox with your patient messages, but do not need to open the messages or respond to them in order to achieve credit for this measure. Secure Electronic Messaging
  • + Measure: More than 10% of imaging tests ordered during the reporting period whose result is an image should be accessible through the EHR. + Exclusion: Any provider who orders less than 100 tests whose result is an image during the reporting period or has no access to electronic imaging results at the start of the reporting period. Imaging Results
  • + PF Suggested Workflow: Connect with your imaging center to set up your EHR for results. Attribute the results to the applicable patient and provider and sign the results when they are received. + Images and imaging results that are scanned into Practice Fusion and stored in the documents folder may be counted towards this measure.  Imaging results that are scanned into the EHR will not be counted in the Meaningful Use Dashboard. You will need to keep track of these results on your own and maintain the appropriate documentation that supports the value you use during attestation for at least 6 years. Imaging Results
  • + Measure: Record patient family health history as structured data for one or more first-degree relatives for more than 20% of all unique patients seen during the reporting period. + Exclusion: Any provider who has no office visits during the reporting period. Family Health History
  • + PF Suggested Workflow:  Click Record New Relative from the Family History section of the patient chart.  Select a first degree relative (mother, father, sister, brother, daughter, son), enter a diagnosis, and click Save. Family Health History
  • + You must select encounter type “Office visit” or “Home visit” and sign the SOAP note to receive credit for Meaningful Use measures based on unique patients seen during the reporting period. + Providers must navigate to the new HTML chart note to select an encounter type by clicking “Finalize.” + Only the provider who signs the note receives denominator credit. Choosing An Encounter Type for Meaningful Use
  • Resources www.practicefusion.com/meaningfuluse Meaningful Use Center Practice Fusion Blogs Practice Fusion Forum
  • Next Steps Familiarize yourself with the new measures Use the new Dashboard, MU Center, and Forum Engage your patients