interim final rule summary


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Internal briefing of hospital focused IFR information. please be advised that this is not an official publication of HHS and is an interpretation of the summary document.

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interim final rule summary

  1. 1. interim final rule electronic medical records Meaningful Use Federal stimulus HITECH ACT - hospital overview Monday, January 11, 2010
  2. 2. EMR Meaningful use goals 1. Improve quality, safety, efficiency, and reduce health disparities 2. Engage Patients and Families 3. Improve Care Coordination 4. Ensure adequate privacy and security protections for Personal Health Info 5. Improve Population and Public Health Monday, January 11, 2010
  3. 3. Monday, January 11, 2010
  4. 4. Broad definitions of Meaningful EMR use • An EP and an eligible hospital shall be considered a meaningful EHR user for an EHR reporting period for a payment year if they meet the following three requirements: • – Use certified EHR in a meaningful manner (ex. E-Prescribing) • – Utilize certified EHR technology that is connected in a manner that provides for the electronic exchange of health information to improve the quality of healthcare such as promoting care coordination • – Submit information on clinical quality measures and other measures in a form and manner specified by the Secretary Monday, January 11, 2010
  5. 5. 3 Stages of Qualifications • Stage I – Electronic capture of health information in a coded format; tracking key clinical conditions and communicating outcomes for care coordinating; implementing clinical decision support tools to facilitate disease and medication management; and reporting outcomes for public health purposes. • Stage II – Expands on stage I. Encourages the use of health IT to enhance computerized provider order entry; transitions in care; electronic transmission of diagnostic test results; and, research. • Stage III – Expands on stage II. Promotes improvements to quality and safety; focuses on clinical decision support at a national level by encouraging patient access and involvement; and, improved population health data. Monday, January 11, 2010
  6. 6. meaningful EHR users before 2015. Please note that nothing in this discussion limits us to proposed changes to meaningful use beyond Stage 3 through future rulemaking. TABLE 1: Stage of Meaningful Use Criteria by Payment Year Payment Year First 2011 2012 2013 2014 2015 Payment Year +** 2011 Stage 1 Stage 1 Stage 2 Stage 2 Stage 3 2012 Stage 1 Stage 1 Stage 2 Stage 3 2013 Stage 1 Stage 2 Stage 3 2014 Stage 1 Stage 3 2015+* Stage 3 * Avoids payment adjustments only for EPs in the Medicare EHR Incentive Program. ** Stage 3 criteria of meaningful use or a subsequent update to the criteria if one is established through rulemaking. Please note that the number of payment years available and the last payment year that can be the first payment year for an EP or eligible hospital varies between the EHR incentive programs. The applicable payment years for each program are discussed in Monday, January 11, 2010
  7. 7. Summary of Stage 1 Hospital EMR requirements • Use of CPOE for orders (any type) directly entered by authorizing provider (for example, MD, DO, RN, PA, NP) (10% for stage 1) • Implement 5 clinical decision support rules related to a high priority hospital condition, including diagnostic test ordering, along with the ability to track compliance with those rules • Implement drug-drug, drug-allergy, drug- formulary checks • Report hospital quality measures to CMS or the States *Not a complete list- summarized Monday, January 11, 2010
  8. 8. Summary of Stage 1 Hospital EMR requirements • Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED • Maintain Active medication, and medication allergy list • Provide patients with an electronic copy of their health information • Provide patients with an electronic copy of their discharge instructions and procedures at time of discharge, upon request • Provide summary care record for each transition of care and referral • Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities *Not a complete list- summarized Monday, January 11, 2010
  9. 9. TABLE 2: Stage 1 Criteria for Meaningful Use Stage 1 Objectives Health Outcomes Eligible Policy Priority Care Goals Professionals Hospitals Stage 1 Measures Improving quality, Provide access to Use CPOE Use of CPOE for orders For EPs, CPOE is safety, efficiency, comprehensive (any type) directly used for at least 80% and reducing health patient health data entered by authorizing of all orders disparities for patient's health provider (for example, care team MD, DO, RN, PA, NP) For eligible hospitals, CPOE is used for Use evidence-based 10% of all orders order sets and Implement drug-drug, Implement drug-drug, The EP/eligible CPOE drug-allergy, drug- drug-allergy, drug- hospital has enabled formulary checks formulary checks this functionality Apply clinical Maintain an up-to- Maintain an up-to-date At least 80% of all decision support at date problem list of problem list of current unique patients seen the point of care current and active and active diagnoses by the EP or diagnoses based on based on ICD-9-CM or admitted to the Generate lists of ICD-9-CM or SNOMED CT ® eligible hospital have patients who need SNOMED CT ® at least one entry or care and use them an indication of none to reach out to recorded as patients structured data Generate and transmit At least 75% of all Report information permissible permissible for quality prescriptions prescriptions written improvement and electronically (eRx) by the EP are public reporting excerpt of complete table transmitted electronically using certified EHR technology Maintain active Maintain active At least 80% of all medication list medication list unique patients seen by the EP or admitted to the Monday, January 11, 2010 eligible hospital have