The document summarizes changes to the 2016 requirements for meaningful use of electronic health records (EHRs). Key changes include replacing core and menu objectives with a single set of objectives and measures for eligible professionals (EPs) and hospitals. EPs have 10 objectives and hospitals have 9 objectives. The objectives focus more on patient outcomes than technology use. Providers will also have more flexibility to customize goals. Audits of EHR meaningful use attestations will continue to ensure compliance. Providers should maintain documentation for at least 6 years to support any audits.

1. Taino Consultants Inc.
Dr. Jose I. Delgado

2. 2016 Program
Requirements
 Final Rule Released October 15, 2015
 Modified Stage 2 (2015 to 2017)
 Stage 3 (2018 and beyond)
 Jan 11, 2016
 “Meaningful use will likely end in 2016”
- Andy Slavitt, Acting Administrator
Centers for Medicare and Medicaid Services
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3. “The Meaningful Use program as it has
existed, will now be effectively over and
replaced with something better.”
 focus will move away from the use of technology
and towards patient’s outcome
 providers will be able to customize their goals
 leveling the technology playing field by requiring
open application program interfaces (APIs)
 interoperability
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4. Medicare Access and CHIP
Reauthorization Act of 2015
(MACRA)
 Repeals the sustainable growth rate (SGR)
methodology for determining updates to the Medicare
physician fee schedule.
 Establishes annual positive or flat fee updates for 10
years and institutes a two-track fee update beginning
in 2019.
 Establishes the Merit-based Incentive Payment
System (MIPS) that consolidates existing Medicare
quality programs.
 Establishes a pathway for physicians to participate in
an Alternative Payment Model (APM).
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6. Objectives and Measures
 Core and menu objectives replaced with a
single set of objectives and measures.
 Eligible providers (EP) have 10 objectives,
 Eligible hospitals and CAHs have 9 objectives.
 All providers must use 2014 certified EHR
technology
 Providers may attest using 2015 certified
technology EHR technology, or a combination of
the two (if the 2015 Edition is available).
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7. EP Objectives and
Measures
1. Protect electronic protected health information
 HIPAA (Security Risk Analysis, updates, other)
2. Use clinical decision support to improve
performance on high-priority health conditions.
 Implement five clinical decision measures
 Enabled and implemented the functionality for drug-drug
and drug-allergy interaction check
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8. EP Objectives and
Measures
3. Use computerized provider order entry for
medication, laboratory, and radiology by
licensed healthcare professional
 More than 60 percent of medication orders
 More than 30 percent of laboratory orders
 More than 30 percent of radiology orders
4. Generate and transmit permissible prescriptions
electronically (eRx).
 More than 50 percent of all permissible prescriptions
written by the EP are queried for a drug formulary
and transmitted electronically using CEHRT.
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9. EP Objectives and
Measures
5. Health Information Exchange
 Transitions or refers their patient to another setting of
care or provider of care must
1. Use CEHRT to create a summary of care record; and
2. Electronically transmit summary (10% or more).
6. Identify patient-specific education resources and
provide those resources to the patient.
 Provide education resources to patients for more
than 10 % of all unique patients with office visits
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10. EP Objectives and
Measures
7. Medication Reconciliation
 Performs medication reconciliation for more than 50
% of transitions of care
8. Patient electronic access within 4 business days
of the information being available to the EP.
 Provide timely access to more than 50 % of all
unique patients seen during the reporting period
 2016, at least one patient during the EHR reporting
period (or patient-authorized representative) views,
downloads or transmits his or her health information
to a third party during the EHR reporting period.
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11. EP Objectives and
Measures
9. Secure electronic messaging communications.
 At least 1 patient during the reporting period was
sent a message using the electronic messaging
function of CEHRT
10. Public Health - submit electronic public health
 Three Measure Options
○ Immunization Registry Reporting
○ Syndromic Surveillance Reporting
○ Specialized Registry Reporting
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12. Changes to Specific Objectives
 The Objective 9, Secure Electronic
Messaging:
 Phased approach for its measure’s threshold.
 For 2016, the measure is “for at least 1 patient seen
during the reporting period, a secure message was
sent using the electronic messaging function of
CEHRT, or in response to a secure message sent by
the patient.
 Objective 10, Public Health Reporting, 2016
 EPs must meet two measures,
 Eligible hospitals and CAHs must meet three measures.
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13. EHR Reporting Period for 2016
 Returning participants
 Full calendar year
(Jan 1, 2016 through Dec 31, 2016.
 For 1st year participants
 Any continuous 90-day period.
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14. Regulations leading to
audits
 Meaningful Use,
 HIPAA Omnibus Rule,
 Affordable Care Act,
 ICD-10 and
 MACRA
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15. What to expect
1. Electronic letter from audit company from a
CMS e-mail address;
 Letter will be addressed to email address
provided during registration
2. Attachment with a request for support
documentation
3. About four weeks to submit documentation
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16. Sample Attachment
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18. Highlights
 Measure 1 – Protect Patient Health
Information
 Security Risk Analysis with a date not earlier
than the start of the reporting year and not
later than the date of attestation
 Implementation plan with completion dates if
deficiencies were identified
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19. Highlights
 Measures 3,4,5,6,7, and 8
 Provide EHR report
 Measures 2 and 9
 Provide Support Documentation
 Measure 10
 Stage 1 – one measure
 Stage 2 – two measure
 Note: an exclusion of one measure doesn’t
count unless they meet or exclude themselves
from the other measures
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20. Trends Experienced
 Expect e-mail with deficiencies
indicating failure to meet meaningful use
 Extensions timelines have been
shortened
 Explanations of trends may be asked
 Letter from EHR company with basic
information been requested
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21. Key Items to keep in mind
 Proof of use Certified EHR.
 Need Copy of licensing agreement with the vendor or
invoices for the period.
 Letter with same information from HER Vendor may
be requested.
 List of office or outpatient facility where
Provider sees patients. Identify if records are
kept outside of EHR.
 Report showing compliance with specific Core
Measures must display vendor’s logo or step by step
screenshots which demonstrate that the report was
generated by the EHR.
KEEP INFORMATION FOR A MINIMUM OF
SIX YEARS!
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22. Summary
 Meaningful use not going away
 Audits will continue
 Maintain your own copies of information
submitted for at least six years
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23. Questions
Taino Consultants Inc.
Dr. Jose I. Delgado BP 904-794-7830
E-mail DrDelgado@TainoConsultants.com
Web Site: www.TainoConsultants.com
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