Meaningful Use Stage Two: The Future of Care Coordination


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The future of Meaningful Use has many over-arching effects on the health care industry beyond Stage Two measures. Care coordination teams, technology partnerships, data capture, practice redesign, and provider assessment are a few others to be considered when moving forward.

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Meaningful Use Stage Two: The Future of Care Coordination

  1. 1. Meaningful Use Stage 2 – The Future of Care Coordination Adele Allison National Director of Government Affairs, SuccessEHS
  2. 2. New Focus – Care Coordination
  3. 3. <ul><li>Big Tactic Step in next wave of health care reform </li></ul><ul><ul><li>Accountable Care Organizations (ACOs) </li></ul></ul><ul><ul><li>Patient-Centered Medical Homes (PCMHs) </li></ul></ul><ul><li>PPACA -> CMS Medicare FFS: Establish ACOs by 1.1.2012 </li></ul>
  4. 4. <ul><li>ACO Final Rule ( Issued 10.20.2011 , 696 pages) </li></ul><ul><ul><li>New Care Model for FFS Medicare – anticipating 270 to contract </li></ul></ul><ul><ul><li>Focus on Care Coordination as a Community </li></ul></ul><ul><ul><li>Must be Patient-Centered (definition follows) </li></ul></ul>
  5. 5. <ul><li>Patient-Centered is defined to include: </li></ul><ul><ul><li>Patient Survey, Communication and Involvement in governance </li></ul></ul><ul><ul><li>Population Management </li></ul></ul><ul><ul><li>Targeting high-risk patients </li></ul></ul><ul><ul><li>Technologies to Coordinate Care </li></ul></ul><ul><ul><li>Performance Measuring and Ongoing Process Improvements </li></ul></ul>
  6. 6. <ul><li>PPACA -> § 3007 - CMS apply a MD value-based modifier by 2015 </li></ul><ul><li>CMS Payment Final Rule ( Issued 11.2.2011 , 1,235 pages) </li></ul><ul><ul><li>2012 EHR-Based PQRS Reporting – includes all 44 Stage 1 MU CQMs </li></ul></ul><ul><ul><li>Participation in the PQRS EHR-based Incentive Pilot satisfies MU CQM reporting and provides incentives above MU </li></ul></ul>
  7. 7. <ul><li>SuccessEHS is 2011 CMS Qualified for EHR-based PQRS reporting </li></ul><ul><li>SuccessEHS is testing for 2012 </li></ul>
  8. 8. Key Stage 2 Recommendations
  9. 9. <ul><li>> 60% structured lab results with at least 1 order in CPOE </li></ul><ul><li>1 Radiology Test Ordered using CPOE </li></ul><ul><li>> 10% of patients – record care plan fields (goals and instructions) </li></ul><ul><li>> 10% of patients - record care team members (including PCP, if applicable) </li></ul>
  10. 10. <ul><li>> 25 unique patients with advance directives </li></ul><ul><li>25 patients sent secure online messages </li></ul><ul><li>20% of patients recorded for preferences in communication </li></ul><ul><li>Summary of Care Record sent electronically for 25 Transactions </li></ul>
  11. 11. Clinical Quality Measures & National Quality Strategy
  12. 12. <ul><li>No “alternative core” measures -> just Core </li></ul><ul><li>Selection from 69 NQF Measures – e Reporting Ready </li></ul><ul><li>23 new clinical measures proposed – ↑ provider diversity </li></ul>
  13. 13. <ul><li>Menu measures divided into 6 domains to align with the 6 National Quality Strategies </li></ul><ul><ul><li>Population and Public Health Management </li></ul></ul><ul><ul><li>Care Coordination </li></ul></ul><ul><ul><li>Clinical Process </li></ul></ul><ul><ul><li>Patient and Family Engagement </li></ul></ul><ul><ul><li>Efficiency </li></ul></ul><ul><ul><li>Patient Safety </li></ul></ul>
  14. 14. Practice Redesign Considerations
  15. 15. <ul><li>Clinic Culture Assessment </li></ul><ul><li>Think about Users and Roles </li></ul><ul><li>Create a Vision Statement </li></ul><ul><li>Identify Leadership (Formal / Informal) </li></ul><ul><li>Communicate Plans </li></ul>
  16. 16. <ul><li>Workflow Self-Assessment </li></ul><ul><li>Identify sources of: </li></ul><ul><ul><li>Assessment Worksheet </li></ul></ul><ul><ul><li>Inefficiency / Delay / D uplication </li></ul></ul><ul><ul><li>Risk / Liability / Non-Compliance (e.g. HIPAA) </li></ul></ul><ul><ul><li>Quality concerns </li></ul></ul><ul><ul><li>High costs </li></ul></ul>
  17. 17. <ul><li>Leadership in Administration </li></ul><ul><li>Remember – this is a Provider Program </li></ul><ul><li>Remember – the Providers are part of a Clinic / Group Practice </li></ul><ul><li>Plan for Administration Ease </li></ul><ul><ul><li>Consistency in measures </li></ul></ul><ul><ul><li>Evaluate Technology and Workflows </li></ul></ul>
  18. 18. <ul><li>Provider Assessment </li></ul><ul><li>Identify potential barriers before reengineering </li></ul><ul><ul><li>Low comfort level with technology (Provider / Support Staff) </li></ul></ul><ul><ul><li>Gaps in Hardware </li></ul></ul><ul><ul><li>Impact on productivity </li></ul></ul><ul><ul><li>What additional problems can be solved? </li></ul></ul><ul><li>Workflows MUST BE CONSISTENT for data capture and reporting </li></ul>
  19. 19. <ul><li>Practice Redesign </li></ul><ul><li>Compliant and Certified for MU EHR Software </li></ul><ul><li>Senior Leadership and Staff – Awareness and Understanding </li></ul><ul><li>Identified Champions – Formal and Informal </li></ul>
  20. 20. <ul><li>Practice Redesign </li></ul><ul><li>Key Partner Collaboration </li></ul><ul><ul><li>Lab Interfaces : (ORM/ORU) Results to Patient Chart </li></ul></ul><ul><ul><li>Immunization Interface : (VXU) Single entry / upload to Registry </li></ul></ul><ul><ul><li>HIE Interface : (CDA, C32, XDS) Human Readable Format </li></ul></ul>
  21. 21. <ul><li>Practice Redesign </li></ul><ul><li>HIPAA Security Analysis </li></ul><ul><li>Implementing New Technologies </li></ul><ul><ul><li>Patient Portal, CDS, Formulary Management, HIE, Structured Knowledge Base, etc. </li></ul></ul><ul><ul><li>IT Needs such as iPads, Smartphones, Business Continuity Plans </li></ul></ul>
  22. 22. <ul><li>Practice Redesign </li></ul><ul><li>Data Collection Considerations </li></ul><ul><ul><li>Must be consistent </li></ul></ul><ul><ul><li>Like CDS - Identifying the “ 5 Rights ” in Workflow </li></ul></ul><ul><ul><ul><li>Right Information </li></ul></ul></ul><ul><ul><ul><li>Right Person Collecting </li></ul></ul></ul><ul><ul><ul><li>Right Format </li></ul></ul></ul><ul><ul><ul><li>Right Channel (e.g. EHR, Portal, PM) </li></ul></ul></ul><ul><ul><ul><li>Right Time in Workflow </li></ul></ul></ul>
  23. 23. <ul><li>Practice Redesign </li></ul><ul><li>Consider Data Needs – E.g., Vitals, Smoking Status, Rx Reconciliation, Refills, Health Disparities </li></ul>
  24. 24. Technology Partner – Critical Importance
  25. 25. <ul><li>SuccessEHS & HIE </li></ul><ul><li>SuccessEHS can produce a C32 message (CDA/CCD) </li></ul><ul><li>SuccessEHS has developed an Interoperability engine to automate support of interoperability </li></ul>
  26. 26. <ul><li>SuccessEHS & HIE </li></ul><ul><li>This transport engine can be leveraged to provide data to: </li></ul><ul><ul><li>State Registries </li></ul></ul><ul><ul><li>Lab results to public health agencies </li></ul></ul><ul><ul><li>Quality Reporting to CMS and other collaboratives </li></ul></ul>
  27. 27. <ul><li>SuccessEHS & HIE </li></ul><ul><li>SuccessEHS will leverage this transport/support engine for a variety of CCDs used in transitions of care </li></ul>
  28. 28. <ul><li>SuccessEHS & ACOs </li></ul><ul><li>SuccessEHS is strongly positioned to integrate PCP into the ACO model </li></ul><ul><li>EHR-based PQRS </li></ul>
  29. 29. <ul><li>SuccessEHS & ACOs </li></ul><ul><li>Health IT Tools SuccessEHS can deliver: </li></ul><ul><ul><li>Prospective / Retrospective Payment System </li></ul></ul><ul><ul><li>Utilization Trending and Reporting </li></ul></ul><ul><ul><li>Evidence-based Clinical Decision Support Tools </li></ul></ul><ul><ul><li>Patient Survey Tools </li></ul></ul><ul><ul><li>Tele-health Tools </li></ul></ul>
  30. 30. <ul><li>SuccessEHS & ACOs </li></ul><ul><li>Health IT Tools SuccessEHS can deliver: </li></ul><ul><ul><li>Population Management Technology </li></ul></ul><ul><ul><li>Digital Dashboard </li></ul></ul><ul><ul><li>Health Information Exchange </li></ul></ul><ul><ul><li>Lab, Radiology and Device Interfacing </li></ul></ul><ul><ul><li>Enterprise Business Intelligence </li></ul></ul>
  31. 31. <ul><li>SuccessEHS & PCMH </li></ul><ul><li>SuccessEHS is working with the ONC CCBC to recertify 13 of its CHCs for PCMH </li></ul><ul><li>SuccessEHS has created a PCMH Development Branch that includes: </li></ul><ul><ul><li>Secured Messaging to the Patient through Patient Portal </li></ul></ul><ul><ul><li>Patient Questionnaires available through Portal or Kiosk </li></ul></ul><ul><ul><li>Robust Order Tracking </li></ul></ul>
  32. 32. <ul><li>SuccessEHS & PCMH </li></ul><ul><li>SuccessEHS has created a PCMH Development Branch that includes: </li></ul><ul><ul><li>Pre-defined, evidence-based clinical decision support rules </li></ul></ul><ul><ul><li>Leveraging MEDCIN for use in Care Plan workflows </li></ul></ul><ul><ul><li>Ability for patients to request test results / consults through Portal </li></ul></ul><ul><ul><li>PCMH-specific reporting </li></ul></ul>
  33. 33. <ul><li>SuccessEHS & PCMH </li></ul><ul><li>SuccessEHS has created a PCMH Development Branch that includes: </li></ul><ul><ul><li>PCMH data capture and reporting for referral management and transitions of care </li></ul></ul>
  34. 34. For more information about MU 2 & industry trends, visit for white papers, articles, blog posts and more! Click here for our industry blog