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Meaningful use stage 2 infrastructure wave

Meaningful use stage 2 infrastructure wave

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    Stage2mu final-120925161818-phpapp01 Stage2mu final-120925161818-phpapp01 Presentation Transcript

    • Meaningful Use Stage 2 – The Infrastructure Wave Adele Allison National Director of Government Affairs September 25, 2012
    • Stage 2 MU – Infrastructure Wave • • • • • • • Meaningful Use Look-Back Incentive Program Highlights Stage 1 Changes Stage 2 Measures Clinical Quality Measures Health IT Considerations Questions 888.879.7302 • www.SuccessEHS.com
    • Meaningful Use – Authority • • • ARRA Signed 2/17/09 in Denver, CO Purpose: Stimulate the economy through investments in infrastructure, unemployment benefits, transportation, education, and healthcare. $45B in HITECH Funding: $20B in Medicare Incentives o $14B in Medicaid Incentives o PROGRAM 2012 2013 2014 2015 2016 2017 Carrots Year 1: $21,250 Year 1: $21,250 Year 1: $21,250 Year 1: $21,250 Year 1: $21,250 Years 2-6: $8,500 Medicaid EHR Incentive Program Year 1: $21,250 Years 2-6: $8,500 Years 2-6: $8,500 Years 2-6: $8,500 Years 2-6: $8,500 Years 2-6: $8,500 Up to $8,000 Up to $4,000 Carrots Medicare EHR Incentive Program** Up to $18,000 Up to $15,00 Up to $12,000 Sticks -1.0% ** Meaningful Use incentives will vary based upon the EP’s year initiated and allowable charges. 888.879.7302 • www.SuccessEHS.com -2.0% -3.0%
    • Summing-up HITECH Goals 1. 2. 3. 4. • • • Adopt and Use Certified EHR Technology (CEHRT) Capture DATA – Vitals, Problems, Allergies, etc. Move DATA – Interoperability Report DATA – CQMs and PQRS $27B in “Carrots” Stage 1 Meaningful Use = Marks 1 and 2 Stage 2 Meaningful Use = Marks 3 and 4 888.879.7302 • www.SuccessEHS.com
    • Meaningful Use – State of the Union • 55% of Physicians had “adopted” any CEHRT o o o o • • • • • • • Among Physicians Under age 50 → 64% adoption rate Over age 50 → 49% adoption rate Hosted CEHRT → 41% 29% of Solos as compared to 86% among large practices (11+ MDs) 58% of PCPs have adopted CEHRT 55% of Medical Specialists have adopted CEHRT 48% of Surgical Specialists have adopted CEHRT 75% Physicians with CEHRT report meeting MU1 85% are somewhat (47%) or very (38%) satisfied 75% of CEHRT adopters → “It’s enhanced patient care” 50% with no CEHRT plan to purchase in next 12 months 888.879.7302 • www.SuccessEHS.com
    • Polling the Audience 888.879.7302 • www.SuccessEHS.com
    • Meaningful Use – State of the Union • • • • ↑ $3.6 Billion in Medicare Incentives Paid – Hospitals/Providers ↑ $3.3 Billion in Medicaid Incentives Paid – Hospitals/Providers ↑ 287,000 hospitals / providers registered 47 States have launched Medicaid Programs o o o o o D.C. – September 2012 MN – September 2012 NH – September 2012 Hawaii, Guam, Am. Samoa - Unknown Puerto Rico and Virgin Islands – Unknown 888.879.7302 • www.SuccessEHS.com
    • Meaningful Use – State of the Union • Active Registrations o o • Medicare Eligible Providers → 192,016 o • Hospitals → 3,973 Medicaid Eligible Providers → 91,130 Hospital Attestation → $4,523,283,457 Medicare EP Stage 1 Attestation → $1,267,068,609 Program to Date Eligible Professionals Payments 13,623 Internal Med. 14,467 Family Med. 5,095 Cardiology 2,860 OB/Gyn 2,897 Gastro 1,938 Urology 1,605 ENT 2,465 Gen’l Surgery 2,850 Ortho 2,019 Neurology 16,548 Other • Medicaid EP Year 1 & Year 2 Attestation → $1,140,158,421 to Date Eligible Professionals Payments Program AIU MU 39,612 Physicians 9,223 Nurse Prac. 1,159 Mid-Wives 3,366 Dentists 608 Physician Asst. 741 Physicians 258 Nurse Prac. 21 Mid-Wives 12 Dentists 12 Physician Asst. 888.879.7302 • www.SuccessEHS.com
    • Meaningful Use – Highest / Lowest • Top 5 States – Hospitals/Providers State Medicare Medicaid Paid Count Texas California Florida New York Pennsylvania • $268,799,000 $345,233,522 9,487 $222,294,768 $353,096,067 9,083 $268,485,118 $203,126,345 8,172 $215,608,873 $177,350,910 7,052 $204,156,197 $146,275,623 7,973 Lowest 5 States – Hospitals/Providers State Medicare Medicaid Paid Count Total $614,032,521 $575,391,835 $471,611,464 $392,959,783 $350,431,820 Total North Dakota $11,128,406 $3,021,084 262 $14,149,490 Idaho $10,280,322 $2,678,361 197 $12,958,683 South Dakota $7,104,719 $5,671,423 296 $12,776,142 Wyoming $1,813,941 $5,893,626 126 $7,707,567 District of Columbia $2,921,701 $0 177 $2,921,701 888.879.7302 • www.SuccessEHS.com
    • CEHRT Impact • Gains in Population Health Management o  Cleveland Clinic Florida 9.6% Pre-CEHRT Hypoglycemia insulin order sets → dropped to 3.8% Post-CEHRT adoption  60% Pre-CEHRT Normal Blood Sugar rates → 65% Post-CEHRT adoption o SuccessEHS Customers 1,274 Clinic Sites using ePrescribing  1,102 Clinic Sites using Extended eRx 1,156 Clinic Sites using Clinical Event Manager  762 Clinic Sites using Patient Portal   888.879.7302 • www.SuccessEHS.com
    • Measuring Knowledge 888.879.7302 • www.SuccessEHS.com
    • Stage 2 MU – Infrastructure Wave • • • • • • • Meaningful Use Look-Back Incentive Program Highlights Stage 1 Changes Stage 2 Measures Clinical Quality Measures Health IT Considerations Questions 888.879.7302 • www.SuccessEHS.com
    • MU – Objectives & Measures • • • • Objectives are broad spanning goals/activities Measures are specific task(s) requirements Meeting the measures = meeting the Objectives for that Stage Stage 1 MU (July, 2010) o 15 Core Measures required by all EP’s 10 Menu Measures from which EP’s choose 5 o 13 Exclusion Clauses o • Stage 2 MU (August, 2012) o o o 17 Core Measures required by all EP’s 6 Menu Measures from which EP’s choose 3 20 Exclusion Clauses 888.879.7302 • www.SuccessEHS.com
    • Incentive Payouts First Calendar Year in which the EP Receives an Incentive • MU Incentives are not funded by Senate Appropriations Payment 2015 and • Calendar Year are an Entitlement Incentives subsequent 2011 2012 2013 2014 • Money cannot “run out” years 2011 $18,000 2012 $12,000 $18,000 2013 $8,000 $12,000 $15,000 2014 $4,000 $8,000 $12,000 $12,000 2015 $2,000 $4,000 $8,000 $8,000 $2,000 $4,000 $4,000 2016 $44,000 $44,000 $39,000 $24,000 TOTAL Shortage Area Totals* $48,400 $48,400 $42,900 $26,400 * Providers practicing in a federally identified shortage area are eligible for a 10% increase . 888.879.7302 • www.SuccessEHS.com $0 $0 $0 $0
    • Incentive Payouts Calendar Year First Calendar Year in which the EP Receives an Incentive Payment 2011 2012 2013 2014 2015 2016 2011 $21,250 2012 $8,500 $21,250 2013 $8,500 $8,500 $21,250 2014 $8,500 $8,500 $8,500 $21,250 2015 $8,500 $8,500 $8,500 $8,500 $21,250 2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,250 2017 $0 $8,500 $8,500 $8,500 $8,500 $8,500 2018 $0 $0 $8,500 $8,500 $8,500 $8,500 2019 $0 $0 $0 $8,500 $8,500 $8,500 2020 $0 $0 $0 $0 $8,500 $8,500 2021 $0 $0 $0 $0 $0 $8,500 TOTAL $63,750 $63,750 $63,750 $63,750 $63,750 $63,750 888.879.7302 • www.SuccessEHS.com
    • MU2 Highlights • • • Published in the Federal Register September 4, 2012 Delayed Stage 2 by one year to CY2014 CY2014 attesters (MU1 or MU2) → any quarter o o • • • • • 3 month reporting period for ‘Care attesting Stage 1/2 in 2014 First year ‘Caid EPs either any 90-days or quarters, by state option Everyone gets 2 years in each Stage Changes to Quality measures with expectation they will be electronically submitted Patient Engagement → Big theme Stage 2 allows for batch or group reporting Production HIE will be required 888.879.7302 • www.SuccessEHS.com
    • MU2 Launch Date • • • MU2 begins for EP in CY2014 MU1 or MU2 EPs in 2014 → quarter EHR reporting period MU1 Latecomers starting after 2014 → full year EHR reporting period Quarters / Yearly reporting supports data integrity with other Federal initiatives (E.g. PQRS, ACOs) Medicare Penalties Begin • First Payment Year 2011 2012 2013 Stage of Meaningful Use 2014 2015 2016 2017 2018 2019 2011 1 1 1 2* 2 3 3 TBD TBD 2012 1 1 2* 2 3 3 TBD TBD 2013 1 1* 2 2 3 3 TBD 2014 1* 1 2 2 3 3 2015 1 1 2 2 3 2016 1 1 2 2 *3-month quarter EHR reporting period for Medicare; continuous 90-day EHR 1 reporting period (or 2 2017 1 3-months at state option) for Medicaid. All first year EPs in 2014 use any continuous 90-days. 888.879.7302 • www.SuccessEHS.com 2020 2021 TBD TBD TBD TBD 3 3 2 TBD TBD TBD TBD TBD 3 3
    • Medicare Penalties • • • • • • • • Applies to EPs treating Medicare Part B PFS Patients HITECH requires Payment Adjustment if no MU by 2015 Adopt, Implement or Upgrade (AIU) is NOT MU Payment Adjustment based on prior year’s reporting period – 2 year lag Any MU in 2013 = No Adjustment in 2015 Medicare MU registration & attestation by 10.1.2014 = No Adjustment in 2015 This means 90-day reporting period no later than 7.1.2014 EP must continue to meet MU annually to avoid adjustments in subsequent years 888.879.7302 • www.SuccessEHS.com
    • Medicare Penalties • Penalties are cumulative with other CMS Programs 2015 EP subject to MU adjustment only EP also subject to eRx adjustment EP also subject to PQRS adjustment EP also subject to Value-Based Modifiers (VBM) 2016 2017 2018 2019 2020+ 99% 98% 97% 96% 95% 95% 98% 98% 97% 96% 95% 95% 96.5% 96% 95% 94% 93% 93% +/TBD +/TBD +/TBD +/TBD +/TBD +/TBD • EP Hardship Exceptions 1. 2. 3. 4. 5. Infrastructure → E.g. Lack of Broadband New EP → 2-year limited exception Unforeseen Circumstances → E.g. Natural Disaster Lack of Face-to-Face or F/up Need with Patients → E.g. Pathology, Radiology, Anesthesiology Multiple Locations and Lack of control over availability of CEHRT for more than 50% of patient encounters 888.879.7302 • www.SuccessEHS.com
    • Medicaid Patient Volume Expansion • Required Thresholds o Pediatricians → 20% - 30% o FQHC / RHC → 30% using “Needy” Encounter in Numerator o All Other → 30% • Calculations from auditable data source and documentation • MU2 → Look-back period now the 12-months preceding attestation, not CY • Includes encounters for anyone enrolled in Medicaid o Medicaid CHIP expansion encounters (except standalone Title 21) o Encounters with Zero-pay claims • Zero-pay encounters include o o o o Denied due to Max-out Service Limit Denied for non-coverage under Medicaid Program Paid at $0 due to another payer’s payment Denied for lack of timely submission 888.879.7302 • www.SuccessEHS.com
    • Measuring Knowledge 888.879.7302 • www.SuccessEHS.com
    • Stage 2 MU – Infrastructure Wave • • • • • • • Meaningful Use Look-Back Incentive Program Highlights Stage 1 Changes Stage 2 Measures Clinical Quality Measures Health IT Considerations Questions 888.879.7302 • www.SuccessEHS.com
    • Stage 1 Changes – CY2013-14 • Core CPOE Denominator o Currently: # of Unique Patients with 1 Rx seen by EP o “New” Option: # of orders for Rx during EHR Reporting Period o CY2013 and beyond → EPs can use either • Core Vitals Exclusion Clause o o o o Currently: BP and Height/Weight not relevant “New”: EP can split to exclude 1 only CY2013 → EPs can use either exclusion CY2014 → New Exclusion Only • Core Vitals Age Requirements o o o o Currently: See no patients age 2+ “New”: Sees no patients age 3+ CY2013 → EPs can use either exclusion CY2014 → New Exclusion Only 888.879.7302 • www.SuccessEHS.com
    • Stage 1 Changes – CY2013-14 • Core Test of Exchanging Key Clinical Information → Removed from Stage 1 effective CY2013 • Core ePrescribing Exclusion → Added where EP not within 10 mile radius of ePharmacy effective CY2013 • 3 Menu Measures → Data submission to Public Health for Immunizations, Reportable Labs and Syndromic Surveillance o Removed “except where prohibited” o Encouraging submission even if not state required • 2 Measures → Core Electronic Copy and Menu Timely Electronic Access o 2014 Edition Vendor Certification = obsolete o Replaced: CY2014 Stage 2 measure of Patient View, Download and Transfer • Core Submission of CQMs Eliminated and Incorporated into definition of “Meaningful EHR User” • Stage 1 EPs must choose 5 Menu Measures if available 888.879.7302 • www.SuccessEHS.com
    • Measuring Knowledge 888.879.7302 • www.SuccessEHS.com
    • Stage 2 MU – Infrastructure Wave • • • • • • • Meaningful Use Look-Back Incentive Program Highlights Stage 1 Changes Stage 2 Measures Clinical Quality Measures Health IT Considerations Questions 888.879.7302 • www.SuccessEHS.com
    • Stage 2 Measures – 17 Core 17 Core Objectives No. Objective Measure Threshold 1 Computerized Provider Order Entry (CPOE) Use CPOE for medication, lab and radiology orders entered by any professional permitted by law 60% Rx (↑ from 40%), 30% Labs, 30% Radiology 2 Generate and Transmit Permissible Prescriptions Electronically Using a certified EHR technology and compared to at least 1 drug formulary (still excludes controlled substance [Sch. II-V] and OTC) Record Patient Demographics Gender, race, ethnicity, DOB, and preferred language as structured data 3 4 5 Height & weight (all ages), blood pressure (ages 3+), BMI Record Vital Signs (all ages), and growth charts and Chart Changes for children (0-20) as structured data Record Smoking Status Patients age 13 and older as structured data 888.879.7302 • www.SuccessEHS.com New, Revised, Expanded, Consolidated or Unchanged Exclusions Health IT Needs 50% (↑ from 40%) • • • Orders Management Orders Audit Trails Delinquency Alerts • Expanded EP has < 100 Rx, lab, radiology orders collectively • • • Rx Database Interaction Alerting eRx (E.g., Surescripts) Formulary Checking Expanded and • Consolidated EP writes < 100 Rx; or, No pharmacy w/in 10 miles of the practice • • 80% (↑ from 50%) Expanded None • • 80% (↑ from 50%) 80% (↑ from 50%) Revised and Expanded Expanded • No pts. age 3+ Ht., Wt., BP irrelevant BP only irrelevant • • • • • EP does not see pts. age 13+ • • Patient Administration Master Patient Index Vitals Capture Tool Detailed Entry Normal Ranges and Graphing Automated BMI and Growth Charts Smoking Status Alerting to lack of Documentation
    • 17 Core Objectives No. 6 7 Stage 2 Measures – 17 Core Objective Measure Implement Clinical Decision Support and Track Compliance Implement CDS to improve on highpriority condition: 1.5 CDS interventions for 5 or more CQMs during entire reporting period; and 2.Enable drug-drug and drug-allergy checks for entire reporting period. Incorporate Clinical Incorporated as structured data – Lab Test Results into positive/negative or numerical format – within the EHR EHR Threshold New, Revised, Expanded, Consolidated or Unchanged Exclusions Health IT Needs • 2 measure only – EP writes < 100 Rx nd 5 Rules and Rx alerting by attestation Expanded and Consolidated • • • 55% (↑ from 40% and made Core) Expanded EP orders no lab tests during • EHR reporting period • 8 9 10 Generate Lists of Patients by Condition 1 List with a Specific Condition for By attestation (Made use in quality improvement, reduction of disparities, research or Core) outreach Preventative and follow-up care for 10% (↓ from 20%, all Send Reminders to all patients based on clinically patients and Made relevant info for anyone with an OV Patients Core) in past 24 months Timely Electronic Access to Health Information Patients can view online, download 1. and transfer info within 4 days of being available to EP, subject to EPs 2. discretion to withhold certain info 888.879.7302 • www.SuccessEHS.com 50% of all pts., and 5% of pts. access • None Unchanged • • • • • EP has no office visit in previous 24 months Expanded • • New • • • • • • • EP has no orders / creates info required >50% visit in county with >50% with 3Mbps • • broadband available Evidence-based guidelines Population Management Tool Point-of-Care Alerting for non-adherence Static and Customizable Interventions Bidirectional Lab Interface for in-house and/or reference labs Evidence-based guidelines Population Management Tool Action Tracking and Escalation Patient Portal Alerting Form letter merging Phone Lists Evidence-based guidelines Population Management Tool Action Tracking and Escalation Patient Portal Alerting Form letter merging Phone Lists Advanced Patient Portal Robust Portal Integration to CEHRT Access Tracking Patient Administration
    • 17 Core Objectives Threshold New, Revised, Expanded, Consolidated or Unchanged 50% (Unchanged) Expanded and Consolidated Stage 2 Measures – 17 Core No. 11 Objective Measure For each office visit to patients within 1 business day, which includes up-toProvide Patients with date lists of problems, medications and Clinical Summaries Rx allergies (paper and electronic must be avail. to pt.) 12 Use of secured messaging with Patients 13 Use EHR for PatientSpecific Education Resources Provide patient-specific education resources to all patients 14 Perform Medication Reconciliation During transitions of care (TOC) into care of EP Send secured messages to patients seen during reporting period 5% 10% (Unchanged but made Core and “if appropriate” removed) 50% (Made Core) 1. 15 Provide Summary of Care Record Patients referred or transitioned to another provider or setting and electronically transmit to a different system. 2. Exclusions EP has no office visit during EHR • reporting period • Advanced Patient Portal Robust integration of Portal to CEHRT New EP has no office visit during EHR • reporting period • Advanced Patient Portal Messaging Capabilities Expanded EP has no office visit during EHR • reporting period • Integrated Patient Education Tools Static and Customizable forms Multi-language HIE (Direct or Exchange) Rx History CCDA HIE (Direct or Exchange) HIE Tracking Unchanged EP not recipient of any TOC during EHR reporting period 50% of TOC or EP neither transfers nor refers referrals patient during EHR reporting (Made core) Expanded and New period < 100 times 10% electronically transmitted • 16 Submission of Electronic Immunization Data to Ongoing submission Registry / Information Systems Conduct/review a security risk analysis; Implement Systems to implement security updates as Protect Privacy and necessary and correct security Security of Patient deficiencies; encrypt data at rest in accordance with 45 CFR 164.312(a)(2) Data 888.879.7302 • www.SuccessEHS.com (iv) and 45 CFR 164.306(d)(3) 17 • During Entire EHR Reporting Period (Made Core) Expanded • • During Reporting Period by attestation Health IT Needs EP does not admin. • immunizations, No electronic registry available* No timely provision of • information on available registry No registry that accepts • CEHRT standards available* • None Expanded • • • • • • • • • Immunization Registry Interface or HIE submission to Immunization Registry CEHRT Immunization Guideline Adherence Tracking Tool Detailed Immunization Tool Thin-Client CEHRT Operations Encryption Technology (Optional) Data-hosting Internet Access
    • 3 of 6 Menu Objectives Stage 2 Measures – 3 of 6 Menu No. Objective Measure Threshold New, Revised, Expanded, Consolidated or Unchanged Exclusions • 1 Imaging Results and Information Are accessible through the CEHRT 10% New • EP does not perform diagnostic interpret. of scans/test whose result is an image during reporting period, or EP orders imaging results < 100 times Health IT Needs • • • 2 Patient Family Health History Structured data entry for one or more first-degree relatives 20% New EP has no office visits during reporting period • • 3 Record Electronic Notes At least 1 note created, edited and signed by EP for patients with at least 1 OV during EHR reporting period • 30% New • • 4 Submission of Electronic Syndromic Surveillance Data Ongoing data submission to Public Health agencies (where agencies can accept electronic data) During Entire EHR Reporting Period Expanded • • 888.879.7302 • www.SuccessEHS.com PACS Results Interface PACS Portal for image retrieval Structured Knowledge Base for documentation Family Health History clinical concepts No office visits during • reporting period, or >50% visit in county with >50% with • 3Mbps broadband • available • Structured Knowledge Base for documentation, Voice Recognition, Customizable Forms, and/or Ability to type note EP does not collect • any data, No electronic registry available* No timely provision • of information on available registry No registry that accepts CEHRT standards available* Public Health Registry Interface or HIE submission to Public Health Registry CEHRT Surveillance tracking tools
    • Stage 2 Measures – 3 of 6 Menu 3 of 6 Menu Objectives No. Objective Measure Threshold New, Revised, Expanded, Consolidated or Unchanged Exclusions • • 5 Submission of Cancer Cases Ongoing data submission to a state cancer registry During Entire EHR Reporting Period New • • • • 6 Submission of Specialized Cases Ongoing data submission to a specialized registry During Entire EHR Reporting Period New • • *Exclusion does not apply if data can be accepted through a designated HIE 888.879.7302 • www.SuccessEHS.com EP does not diagnose or directly treat CA No public health agency is capable of receiving data No timely provision of information on available registry No registry that accepts CEHRT standards available EP does not diagnose or directly treat CA No public health agency is capable of receiving data No timely provision of information on available registry No registry that accepts CEHRT standards available Health IT Needs • • • • State Cancer Registry Interface or HIE submission to State Cancer Registry CEHRT Cancer tracking tools Specialized Registry Interface or HIE submission to Specialized Registry CEHRT Specialized Case tracking tools
    • Measuring Knowledge 888.879.7302 • www.SuccessEHS.com
    • Stage 2 MU – Infrastructure Wave • • • • • • • Meaningful Use Look-Back Incentive Program Highlights Stage 1 Changes Stage 2 Measures Clinical Quality Measures Health IT Considerations Questions 888.879.7302 • www.SuccessEHS.com
    • Clinical Quality Measures (CQMs) • Removed as MU Measure → Now Part of Definition of “Meaningful EHR User” • Electronic reporting by CY2014 for ‘Care regardless of Stage • PQRS will be the vehicle for Clinical Reporting for ‘Care • Clinical Reporting will drive VBM under ACA • Reporting will be reported publicly on “Physician Compare” • ACA requires CMS to align MU with other Federal programs (E.g. PQRS and eRx) • No change in ‘Care CQMs through CY2013 → 2 Reporting Methods o Manual calculation / Attestation on CMS website o eReporting under PQRS EHR Incentive Program Pilot • ‘Caid EPs → Look to State on process and timelines 888.879.7302 • www.SuccessEHS.com
    • Clinical Quality Measures (CQMs) • Prior to CY2014 → Manual attestation of 6:44 CQMs • CY2014 and Beyond → Electronic submission of 9:64 CQMs o First year EP → Aggregated data for All Payers through attestation o Subsequent Years, 2 Options   Electronic reporting of Aggregate data for All Payers, or Individual Continuity-of-Care Document (CCD) on Medicare only through PQRS EHR Direct using CEHRT • 9 CQMs must include 1 measure in 3 Nat’l Quality Strategy Domains, minimal (Core Sets of 9 Recommended) 1. 2. 3. 4. 5. 6. Patient and Family Engagement Patient Safety Care Coordination Population and Public Health Efficient Use of Healthcare Resources Clinical Processes / Effectiveness 888.879.7302 • www.SuccessEHS.com
    • EHR Direct Reporting & CMS • CMS wants EHR Direct Submission of Quality Data • Claims-based / Registry-based = bit of data only • EHR-based = Continuity of Care Document (CCD) on each individual Patient • Stage 1 MU Final Rule: “… the HIT Policy Committee proposed the goal as, ‘Report to patient registries for quality improvement, public reporting, etc.’ We have modified this care goal, because we believe that patient registries are too narrow a reporting requirement to accomplish the goals of quality improvement and public reporting.” • 20 Vendors CMS EHR Direct Qualified → 15 ONC CEHRT as Complete EHRs → Only 9 eRx Incentive Program through EHR Direct Aprima Medical Software, Inc. ASP.MD, Inc. AZZLY™ Digital Medical Solutions, Inc. e-MDs Epic LSS Data Systems Medical Informatics Engineering SuccessEHS, Inc. • 51 Data Submission Vendors → The 2012 Reality 888.879.7302 • www.SuccessEHS.com
    • Clinical Quality Measures (CQMs) • 64 Measures were finalized in the Final Rule (Table 7) • Preference given to NQF-endorsed Measures o Average 3-year endorsement process o Dentists – 0 Dental CQMs in Stage 1; NQF endorse 4 measures in Aug, 2011 • 2 Oral Health Measures o Primary Caries Prevention (FV as part of EPSDT) – NQF 1419 o 6-month exams on children ages 1-17 – NQF 1335 • Note → White Paper on MU and Dental Slated for October, 2012 888.879.7302 • www.SuccessEHS.com
    • Stage 2 MU – Infrastructure Wave • • • • • • • Meaningful Use Look-Back Incentive Program Highlights Stage 1 Changes Stage 2 Measures Clinical Quality Measures Health IT Considerations Questions 888.879.7302 • www.SuccessEHS.com
    • Fed. Programs & Patient Engagement • • • • Behavioral Economics requires an Engaged Patient Transition from Episodic Care to Long-Term Healing and Wellness Patient Engagement ↑ Quality and ↓ Costs 4 Federal Initiatives with Patient Engagement Regulations o o o o Meaningful Use Stage 2 - 7 Measures Accountable Care Organizations – 7 Measures NCQA Patient-Centered Medical Home – 66 Factors Value-based Purchasing – CAPHS 888.879.7302 • www.SuccessEHS.com
    • Patient Portal A Must Push Information Model Pull 888.879.7302 • www.SuccessEHS.com
    • HIE and TOC / Referrals • 10% of Transitions or Care and Referrals → Electronic Summary of Care Record • Problem Focus: 75% of PCPs → No info about a patient’s hospitalization post-discharge = Readmissions • HIE Message (Direct) to PCP from the Hospital • Hospitalization Care Gaps o o o o o o o o Discharge Rx Reconciliation Lack of Understanding of Discharge Plan of Care Non-compliance or Untimely Post-discharge Plan of Care No appointments with a PCP Logistics (E.g. Transportation) PCP unawareness of hospitalization Lack, delay or inadequate communication with downstream provider Lack or inadequate communication with home care provider (includes family) 888.879.7302 • www.SuccessEHS.com
    • Transformation – Your IT Vendor • Meaningful Use and Other Dashboards? o Metrics / Analytics by Provider o Facilitates quick numerators/denominators for MU attestation o Practice analytics with drill-through details • Patient Portal Inherent with System? o Additional license or support fees o Additional vendor and integration considerations • • • Single database solution for PM and EHR EHR Direct PQRS More than just first call support o Initiative Toolkits (E.g. MU, PCMH, PQRS) o Consulting Support with domain experts • • Ongoing Client Educational Offerings REC and QIO Alignment 888.879.7302 • www.SuccessEHS.com
    • Added to The BRIEF or Questions: adelea@successehs.com Follow me on Twitter: www.twitter.com/Adele_Allison Copies of Presentation: webinars@successehs.com Next Month: MU2 and Patient Engagement, TOC, HIE 888.879.7302 • www.SuccessEHS.com