Meaningful Use encompasses multiple stages, each with specific timeline and measure requirements that continue to be a moving target. This can be a confusing process, sending providers in a tailspin in their attempts to stay current. This webinar focuses on the overall details of Meaningful Use and provides a nice outline of all of its details.
Meaningful Use encompasses multiple stages, each with specific timeline and measure requirements that continue to be a moving target. This can be a confusing process, sending providers in a tailspin in their attempts to stay current. This webinar focuses on the overall details of Meaningful Use and provides a nice outline of all of its details.
PYA Consulting Manager Linda ClenDening helped connect the dots between the data at the 2013 AHIMA Convention and Exhibit in Atlanta. She spoke during the Innovation educational track on the topic: “Beyond Meaningful Use: Connecting Quality Data Requirements to Business Operational Improvements.”
Measuring & Monitoring Clinical Quality Measures Using Practice FusionPractice Fusion
Review CMS quality measures, how to capture the data in Practice Fusion, and how this data can be used to earn incentive payments through quality reporting programs, including Meaningful Use and PQRS.
MACRA will help us move more quickly towards our goal of value-based care. MIPS combines parts of the Physician Quality Reporting System (PQRS), the Value Modifier (VM or Value-based Payment Modifier), and the Medicare Electronic Health Record (EHR) incentive program into one single program. Have a look at the objectives & measures, quality scoring methodology, clinical practice improvements and other pertinent details.
EHR certification requirements, and the capabilities an EHR should build to be eligible for QPP. Interoperability, data access and security are some of the core of QPP.
Incorporating emerging technologies with independent pharmacy careCody Midlam
Program Description:
This program will identify emerging technologies affecting the practice of pharmacy in a transitional healthcare delivery system, with a focus on those technologies that increase interconnectivity of electronic health records, tools to improve pharmacist-patient communication, and tools that aide in drug therapy monitoring.
Objectives:
1. Chart the data flow to and from electronic health records and what pharmacists can expect in the future
2. Identify mobile health devices and applications (apps) to monitor blood pressure, blood glucose, and other patient-centric labs
3. Differentiate between historical, current, and future programs to aide in medication adherence and compliance
4. Distinguish which technologies enable the independent pharmacy to further enmesh itself within existing healthcare systems
The growing demand for mobile services across sectors ranging from media and entertainment to retail and financial services raises both commercial opportunities and IT challenges.
PYA Consulting Manager Linda ClenDening helped connect the dots between the data at the 2013 AHIMA Convention and Exhibit in Atlanta. She spoke during the Innovation educational track on the topic: “Beyond Meaningful Use: Connecting Quality Data Requirements to Business Operational Improvements.”
Measuring & Monitoring Clinical Quality Measures Using Practice FusionPractice Fusion
Review CMS quality measures, how to capture the data in Practice Fusion, and how this data can be used to earn incentive payments through quality reporting programs, including Meaningful Use and PQRS.
MACRA will help us move more quickly towards our goal of value-based care. MIPS combines parts of the Physician Quality Reporting System (PQRS), the Value Modifier (VM or Value-based Payment Modifier), and the Medicare Electronic Health Record (EHR) incentive program into one single program. Have a look at the objectives & measures, quality scoring methodology, clinical practice improvements and other pertinent details.
EHR certification requirements, and the capabilities an EHR should build to be eligible for QPP. Interoperability, data access and security are some of the core of QPP.
Incorporating emerging technologies with independent pharmacy careCody Midlam
Program Description:
This program will identify emerging technologies affecting the practice of pharmacy in a transitional healthcare delivery system, with a focus on those technologies that increase interconnectivity of electronic health records, tools to improve pharmacist-patient communication, and tools that aide in drug therapy monitoring.
Objectives:
1. Chart the data flow to and from electronic health records and what pharmacists can expect in the future
2. Identify mobile health devices and applications (apps) to monitor blood pressure, blood glucose, and other patient-centric labs
3. Differentiate between historical, current, and future programs to aide in medication adherence and compliance
4. Distinguish which technologies enable the independent pharmacy to further enmesh itself within existing healthcare systems
The growing demand for mobile services across sectors ranging from media and entertainment to retail and financial services raises both commercial opportunities and IT challenges.
This talk outlines opportunities, disruptions and innovations in Healthcare. Devices both consumer and medical, data science, and creative destruction of medicine (Doctors 2.0) will help create value for patients, providers and payers!
On February 19, 2014, the Federal Trade Commission staff hosted a seminar on Mobile Device Tracking.
The speakers discussed how retailers and other businesses have been tracking consumers’ movements throughout and around retail stores and other attractions using technologies that identify signals emitted by their mobile devices. While the technologies differ, many work by identifying and collecting the MAC address – which is unique to a particular device – broadcast when a mobile device searches for Wi-Fi networks. Companies can use these technologies to reveal information about consumers including the path taken throughout a location, length of time in one location, whether a visitor is new or returning, and the frequency of visits to a location. According to media reports, major retailers in the United States are using or have tested the technology in their stores in order to gain insights into the behavior of their customers.
In most cases, this tracking is invisible to consumers and occurs with no consumer interaction. As a result, the use of these technologies raises a number of potential privacy concerns and questions.
FTC Spring Privacy Series: Consumer Generated and Controlled Health DataBrian Ahier
Increasingly, consumers are taking a more active role in managing and generating their own health data. For example, consumers are researching their health conditions and diagnosing themselves online. Consumers are also uploading their information into personal health records and apps that allow them to manage and analyze their data, and utilizing connected health and fitness devices that regularly collect information about them and transmit this information to other entities.
The movement of health data outside the traditional medical provider context has many potential benefits; however, it also raises potential privacy concerns. The seminar will address questions such as:
What types of websites, products, and services are consumers using to generate and control their health data, and how are consumers using them?
Who are the companies behind these websites, products, and services, what are their business models, and what does the current marketplace look like?
How can consumers benefit from these companies’ websites, products, and services?
What actions are these companies taking to protect consumers’ privacy and security?
What do consumers expect from these companies regarding privacy and security protections?
Do consumers differentiate between these companies and those that offer traditional medical products and services that are covered by HIPAA?
What restrictions, if any, do advertising networks and others impose on tracking of health data?
The background on Creating a Big Data Platform in a private Cloud for HealthCare using OpenStack virtualization and Datastax with RightScale orchestration within a RESTful Service Oriented Architecture to deliver an ICD-10 Computer Assisted Coding solution.
In this file, you can ref it job interview tips with interview questions & answers, other it job interview tips materials such as: interview thank you letters, types of interview questions
In this file, you can ref consulting interview tips with interview questions & answers, other consulting interview tips materials such as: interview thank you letters, types of interview questions
Οι σχέσεις των καταναλωτών με τις τράπεζες είναι πλέον ένα ζήτημα που ξεφεύγει από τις συνηθισμένες διαστάσεις μίας απλής συναλλακτικής σχέσης μεταξύ προμηθευτή και καταναλωτή...
Stage 2 Meaningful Use brings more stringent requirements for the Stage 1 measures, a host of new measures, and a greater focus on clinical quality measures. In this instructive session, our expert faculty members review:
*The requirements and timeline for implementation of Stage 2 Meaningful Use
*The top five questions you need to ask to determine if your organization is ready for Stage 2
*The steps you can take to prepare your organization to successfully meet the Stage 2 requirements and get the most out of your EHR system
Due to popular demand, the Comprehensive Primary Care Plus (CPC+) team hosted a repeat of the webinar that was originally held on Thursday, April 21, 2016. During this webinar Model team members provided an overview of the model specifically for health IT vendors.
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Meaningful Use: Programs, Penalities, and PaymentsBen Quirk
Meaningful Use is not dead!
MIPS may be just around the corner, but MU is still very much in the picture. There is enough time, however, for your practice to optimize 2016 reporting and increase 2018 payments and avoid penalties.
This presentation takes you through the steps needed to successfully attest for 2016 and be prepared for upcoming changes.
Keynote Presentation "Meaningful Use Stage 2 and Meaningful Use Audit Insight"
Think far beyond just threshold increases. The differences between Meaningful Use (MU) Stage 1 and Stage 2, including the 2014 Clinical Quality Measures, are technically and clinically challenging. And just when you thought you could safely look at Stage 1 in the rearview mirror, here come the audits! I will highlight the Stage 1 and Stage 2 differences and talk about the challenges they have initiated at Tenet. I will touch on the impact of Quality measures and will also provide you with insight into the basics of MU Audits and will take you through the actual audit experience at Tenet.
Learning Objectives:
∙ Review the program and measure changes from Stage 1 to Stage 2 and how the changes are being managed at Tenet
∙ Provide insight into the 2014 Clinical Quality Measures chosen by Tenet, the challenges posed, solutions that work and a little about the overall
impact of Quality measures
∙ Discuss Meaningful Use Audits, covering the basics as well as providing the benefit of the Tenet experience
Go deeper with athenahealth specialists to discover all that you need to know and some things you may not know about Meaningful Use Stage 2 and the newest government updates.
PYA Highlights Next Steps of Meaningful UsePYA, P.C.
At the 2013 AICPA Healthcare Industry Conference, PYA Principal David McMillan and Senior Manager Chris Wilson recently explored the “new normal” of meaningful use as compliance and strategic standards in new care/reimbursement-model development.
PCMH: Part 4 – Learn How to Start or Improve Your Quality Improvement ProgramJulie Champagne
We wrap up our PCMH series with a deep dive into Standard 5-Care Coordination and Care Transitions and Standard 6- Performance Measurement and Quality Improvement. How are you handling referrals and transitions of care today? Do you need to make changes to optimize the process? We’ll review care coordination elements and factors as well as the performance improvement standards, elements, and associated factors in this webinar to complete your practice’s PCMH transformation!
What Covered Entities Need to Know about OCR HIPAA AuditsIatric Systems
Learn how to be better prepared to comply with today's patient privacy rules and regulations.
Hosted by HealthITSecurity.com, you'll get insight directly from HIPAA officer Iliana L. Peters, J.D., LL.M. As senior advisor for HIPAA Compliance and Enforcement, she is today's leading source for understanding HIPAA requirements.
Ms. Peters presents OCR’s 2017 to 2018 goals and objectives and tells you how you can:
-Uncover the patient privacy risks and vulnerabilities in your healthcare organization
-Determine where you can use technology to assist in and encourage consistent compliance
-Manage risk when vendors have access to your patient data
Macra and Hospitalists: Get Your Questions AnsweredIatric Systems
Hospitals still have so many unanswered questions about their requirements for participation in MACRA.
This webinar gives hospitalists an opportunity to ask their questions.
We also cover the following topics:
• MIPS requirements for In-Hospital Physicians
• MIPS program components
• Impact on payments
• Individual and group reporting
• CMS June 30, 2017 deadline
• How to get help defining your plan
How MEDITECH Hospitals Can Meet The New eCQM Reporting Requirements using QRDAIatric Systems
Learn how our QRDA Assist team can prepare you to start capturing data on eight eCQMs as required by CMS.
The ruling went into effect on January 1 of this year, so don't miss learning how you can:
- Select the eCQMs for electronic reporting
- Conduct a gap assessment to determine the current state of the QRDA-1 format
- Get expert guidance for MEDITECH Best Practice interpretation
- Be successful with your QRDA validation and testing in QualityNet Pre-Submission Validation Application (PSVA)
- Take advantage of the ARRA Report Manager
Mac McMillan on how to prepare your organization for an OCR HIPAA AuditIatric Systems
In this session, Mac McMillan provided several key takeaways that healthcare providers and vendors need to know before they receive an OCR audit letter.
Portals, Mobile Devices, and Patient EngagementIatric Systems
Why aren't patients engaging in their own healthcare? Let's explore why they aren't, and changes that will encourage patients to engage in their healthcare. Frank Fortner, President at Iatric Systems, discusses these topics on an HISTalk Tweet chat.
If you’re joining an HIE, watch this webcast to learn the many ways that you can save development time, and reduce the cost of implementing and managing an HIE.
Understanding HL7 version 2.5.1 and Meaningful Use data considerationsIatric Systems
You know that not doing Meaningful Use correctly can impact your incentives. In this Webcast you'll learn what is needed to support HL7 v2.5.1 and its impact on Meaningful Use data exchange.
Improving the Patient Experience with HIT WebcastIatric Systems
Learn how to improve patient experience, weave patient-facing HIT and engagement protocols into your plans, and create a roadmap to improve patient care.
3 Ways to Overcome Your Interface ChallengesIatric Systems
Even though your interface projects may be pushed aside for other high profile IT priorities, we have 3 ways to help you overcome your interface challenges. You’ll learn 3 ways that you can:
• Make your interface projects a priority with a solid plan
• Overcome top challenges of interface implementation
• Handle lack of interface staff resources
To provide answers to many questions hospitals and providers have about Meaningful Use in 2015, we’re offering this educational webcast.
This session covers Stage 2 requirements and looks ahead at what’s coming with Stage 3, including:
• Recent updates from CMS
• Keys to successful tracking, attesting, and preparing for an audit
• How to handle difficult measures
• An overview of what we know about Stage 3
5 Ways to Keep Your Interface Projects Under ControlIatric Systems
In this presentation you’ll find out how you can get your hospital interface projects completed on time and on budget. Learn how we can help you:
• Get interfaces built efficiently
• Deploy higher quality interfaces
• Increase staff productivity
How to Interpret and Plan for the 2014 CMS CEHRT Rule Iatric Systems
* Flexibility Plan 2014 and what we know
* Mickey Waters, IT Director at Conway Medical Center – Why he chose to take advantage of the rule
* Lyndel Mead, RN, MSN, Clinical Informatics Coordinator at Peterson Regional Medical Center – Why he chose not to take advantage of the rule
* Making the best decision for your organization
* How to get personalized, expert MU advice
Preparation is the Key to Meaningful Use SuccessIatric Systems
To help hospitals and eligible providers navigate the changing landscape of Meaningful Use, we created an educational webcast.
This session provides valuable Meaningful Use information including:
• Recent updates from CMS
• Keys to audit preparation
• How to identify and correct gaps in your Meaningful Use plan
• How to ensure IMO data terminology mapping is completed accurately and on-time
MUSE Successfully Navigating the HIE LandscapeIatric Systems
What is HIE? The verb means the electronic sharing of health-related information among organizations and the act of data sharing or exchange. The noun HIE indicates an organization that provides services to enable sharing of health-related information. It also means Health Information Organization (HIO or HIEO). The presentation comes from former hospital CIO Rick Edwards, currently the director of Integration Strategy at Iatric Systems.
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
2. Please note:
On the following slides, when the regulation is
referenced, I have referenced the associated
page number at the bottom of the slide for
your review.
3. Breaking News as of Friday,
April 10th
• New NPRM Outlines Proposed EHR Requirements
• Providers in 2015 through 2017
• May not release final until August.
Comment Period closed on June 15th
https://s3.amazonaws.com/public-
inspection.federalregister.gov/2015-08514.pdf
4. What Does this Mean????
First Change for Eligible Hospitals, removing:
• Demographics
• Vitals
• Smoking Status
• Structured Lab Results
• Patient List
• Summaries of Care (TEST and PAPER methods
ONLY)
• eMAR
• Advance Directives
• Electronic Notes
• Imaging Results
• Family Health History
5. Change in Reporting Period
• Proposing a 90-day MU period for
2015 only-any 90 days!
• 2015 Reporting Period: Hospitals
would be able to choose any 90-
day range between 10/1/14
through 12/31/15-does not
need to match a quarter!
6. Change Portal Measure Core 6
• The View/Download/Transmit
changed
• From >5% to AT LEAST 1 PATIENT
Not 1 or 10%, but 1 patient!
7. eRX Will be Required-Menu now
• No more Menu and Core
• The remainder of the measures will be required
• BUT FYI:
Stage 2 objectives for an EHR
reporting period in 2015 who were not
intending to attest to the eRx menu
objective and measure may also claim
an exclusion
8. What About Core 12?
Goodbye Core 12.1 and Core 12.3:
(1) uses CEHRT to create a summary of care
record; and (2) electronically transmits
such summary to a receiving provider for
more than 10 percent of transitions of care
and referrals.
9. How Many Comments?
Medicare and Medicaid Programs; Electronic
Health Record Incentive Program--Modifications
to Meaningful Use in 2015 through 2017
What is your guess for total?
11. How Many Comments? (Closed
5/29)
EHR Incentive Program Stage 3
What is your guess for total?
12.
13. First Thing to Know About
Stage 3:
• Stage 3 info is All Proposed at this time
• Final regulations due later this year
• NPRM released on March 20, 2015
• Comment Period ended: Friday May 29th
• Cost of program from 2017-2020 is $3.7 billion
• Have not yet seen the Method Description
Overview:
• EHs, CAHs and EPs have same 8 Objectives
• Core and Menu no longer apply
14. Proposed Transitions of Care
• All discharges from an inpatient setting
are considered transitions of care
• For transitions from an emergency
department, eligible hospitals and CAH's
must count any discharge where follow up
care is ordered by an authorized provider,
regardless of how complete the
information available to the receiving
provider
15. Stage 3 will bring enormous
change:
• Data deluge and unprecedented access and
interoperability of clinical information in
electronic health records
• Liberation of clinical data
• Empowering payer to push for standardized
data and assist ACO’s
• $45 billion annually paid by Medicare for medical
care that was medically unnecessary or not
acceptable documentation
16. Electronic Submission of Medical
Documentation (esMD )
• Uses C-CDA (term used over 100 times in the
proposed rule)
• ID and reduce cost for federal payers
• Private payers will also use
Reference:
http://www.hieanswers.net/floodgates-in-stage-3-
of-meaningful-use/
17. What are key dates?
1/1/2017
• Changing reporting period to calendar year and full 365 days
• Voluntary Stage 3 reporting
• Attestation between 1/1/18 and 2/28/2018
1/1/2018
• All providers regardless of Stage must to track Stage 3 and EP, EH
and CAH all same measures
• Attestation between 1/1/19 and 2/28/2019
12/31/2019
• Stage 3 ends-as of now Stage 4 will not occur
• Attestation between 1/1/2020 and 2/28/2020
• BUT appears you may need to continue to report measures
18. Payment Adjustments and
Hardships
• Lack of internet
• New EP or EH-one time exception
• Natural disasters case by case
• EP only exceptions due to a combination of
clinical features limiting a provider's
interaction with patients
19. Certification Requirements
• Some changes in criteria
• 2015 Edition Health IT Certification Criteria-
all providers use starting 2018
• API cert added
• ONC ACBs has new and revised conduct
• “Common Clinical Data Set” replaces
“Common MU Dataset”
*Reference: Page 31
20. New Terms
• “ONC HIT Certification Program” to “ONC
Health IT Certification Program”
• “EHR Module” to “Health IT Module”
• “EHR” and “EHR Technology” to “Health IT”
21. Proposed Objective 1:
Protect Health Information
• Yes/No Measure
• Expanded explanation
• Administrative safeguards
• Risk Analysis-reviewed each year-365 days
• Risk Analysis upon upgrade to a new Edition
of certified EHR technology
• Review and update
*Reference: Pages 60-66
23. Proposed Objective 2:
Electronic Prescribing
• >80% measure
• Permissible prescriptions
• Controlled substances (EPCS) now legal in many
states-why?
• Median Rate 53%
• OTC not included
• EP and EH exclusions
• Stage 3 will be only new and changed RX
• Formulary unavailable –can count
*Reference: Pages 67-74
24. Proposed Objective 3:
Clinical Decision Support (CDS)
• Two Yes/No Measures
• Same as Stage 2 except:
• Explained relevant point of care
• Types of CDS allowed
• Implement CDS interventions which relate to care
quality improvement goals and a related outcome
measure CQM
• Only exclusions are for EP
*Reference: Page 75
25. Objective 3: Measure 1
• Must implement five clinical decision support
interventions related to four or more CQMs at a
relevant point in patient care for the entire EHR
reporting period.
• Absent four CQMs related to an EP, EH, or CAH's
scope of practice or patient population, the
clinical decision support interventions must be
related to high-priority health conditions.
26. Objective 3: Measure 2
• The Provider must enable and implement the
functionality for drug-drug and drug-allergy
interaction checks for the entire EHR
reporting period
27. Proposed Objective 4:
CPOE
• Three % Measures to track (just like Stage 2) but
Stage 3 expands to include diagnostic imaging to
included ultrasound, magnetic resonance and
computed tomography
• Orders entered by any licensed healthcare professional or
credentialed medical assistant
• CPOE function should be used the first time the order
becomes part of the patient's medical record and
before any action can be taken on the order
• Protocol and standing orders still excluded
28. Objective 4: Measure 1
• >80% Medication orders via CPOE
• Median score of 93%
• Stage 2 requirement is >60%
29. Objective 4: Measure 2
• >60% lab orders via CPOE
• Median score of 80%
• Stage 2 requirement is >30%
30. Objective 4: Measure 3
• >60% diagnostic imaging orders
• Median score of 83% required
• Stage 2 requirement is >30%
31. Proposed Objective 5:
Patient Electronic Access to Health
Information
• Two % measures to track
• Some exclusions
• Unique patient measure
• API-new functionality to support data access
and patient exchange (application
programming interface)
• Patients will be able to collect their health
information from multiple providers and
potentially incorporate all of their health
information into a single portal
*Reference: Pages 89-103
32. NEW for Stage 3: API
If the provider elects to implement an API,
the provider would only need to:
• Fully enable the API functionality
• Provide patients with detailed instructions
on how to authenticate
• Provide supplemental information on
available applications which leverage the API
33. Proposed Objective 5 Measure 1:
• >80% The EP, EH or CAH provides access for
patients to view online, download, and transmit their
health information, or retrieve their health information
through an API, within 24 hours of its availability
• Stage 2 requirement is >50%
• Stage 2 currently is EH/CAH within 48 hours, and EP
is within 4 business days
** Use Demo Recall –historical measures
34. Quote from CMS:
“The Objective does not require the Provider to
made extraordinary efforts to assist patients in
use or access of the information, but the
provider must inform patients of these options,
and provide sufficient guidance so that all
patients could leverage this access.”
WHAT???? How else would you reach the %?
35. Proposed Objective 5 Measure:
Three Options:
1. Access provided with a portal
2. Access provided with an ONC-certified API
3. Access provided to an ONC-certified API that
can be used by third-party applications or
devices to provide patients (or patient-
authorized representatives) access to their
health information
36. Proposed Objective 5 Measure 2:
• >35% The EP, EH or CAH must use clinically
relevant information from CEHRT to identify
patient-specific educational resources and
provide electronic access to those materials
of unique patients seen by the EP or discharged
from the EH or CAH inpatient or emergency
department (POS 21 or 23) during the EHR
reporting period
• For Stage 2, Patient Education was covered in
Core 10 and required >10%
37. In Proposed Objective 5:
• The providers may withhold from online
disclosure any information either
prohibited by federal, state, or local
laws or if such information provided through
online means may result in significant
harm.
38. Proposed Objective 6:
Coordination of Care through
Patient Engagement
• Three % Measures and Providers must report
on all three but must meet two
• Some exclusions
• Unique patient measure
• Stage 3 removed “paper communications”
39. Proposed Objective 6 Measure 1:
• >25% VDT patient or authorized representative
• Stage 2 requirement is >5% and EH struggled
• EH Median score of 11%
• Two options:
• Standard method portal
• Or API
40. Proposed Objective 6 Measure 2:
• >35% a secure message was sent using
electronic messaging function of CEHRT to
the patient OR in response to a secure
message sent by the patient (or authorized
representative) and provider must respond.
41. Provider/Patient situation:
“For measure 2, we propose to include in the
measure numerator situations where providers
communicate with other care team members
using the secure messaging function of certified
EHR technology, and the patient is engaged in
the message and has the ability to be an active
participant in the conversation between care
providers.”
42. Q: What types of communication
is excluded?
A: “However, we note that messages with
content exclusively relating to billing questions,
appointment scheduling, or other
administrative subjects should not be included
in the numerator.”
43. Proposed Objective 6 Measure 3:
>15% non clinical incorporates into EHR-ED
and inpatients
44. Proposed Objective 7:
Health Information Exchange
• Three % Measures and providers must report
on all three but must meet two
• Some exclusions
• Stage 3 must include the requirements and
specifications included in the Common
Clinical Data Set (CCDS)
• Unique device identifier (UDI) for implantable
medical devices
*Reference: Pages 116-135 and 130-135
45. Note: Big Changes to Summary
of Care
• The purpose of this objective is to ensure a
summary of care record is transmitted or
captured electronically and incorporated
into the EHR for patients seeking care among
different providers in the care continuum,
and to encourage reconciliation of health
information for the patient
• Provider incorporates summary of care
information from other providers into their
EHR using the functions of certified EHR
technology
46. Referral Definition
• Referrals are cases where one provider refers
a patient to another provider, but the
referring provider also continues to provide
care to the patient
• Stage 3 Change: The inclusion of
transitions of care and referrals in which
the recipient provider may already have
access to the medical record maintained
in the referring provider's CEHRT, as long as
the providers have different billing
identities within the EHR Incentive Program
47. Proposed Objective 7 Measure 1:
• >50% patients create a summary of care
and electronically exchange
• Stage 2 requirement is combination of paper
and electronic paper-NO MORE PAPER
• Allows just clinically relevant lab tests
• Provider discretion where beneficial
48. Proposed Objective 7 Measure 2:
• >40% of transitions or referrals incorporated
in the EHR
• Recipients actively seek to incorporate
an electronic summary of care into the
patients record
49. Proposed Objective 7 Measure 3:
• >80% where provider has never encountered
the patient to perform clinical information
reconsolidation:
• Medication
• Medication allergy
• Problem list
50. Proposed Objective 8:
Public Health and Clinical Data Registry
Reporting:
• Yes/No measures
• EH and CAH must attest to a total of 4
• Importance of communication that should
exist between providers and public health
agencies
• Some exclusions
• Remove "ongoing submission" requirement
and replace it with an "active engagement”
51. Active Engagement Option 1:
• Registration to submit data
• Completed within 60 days of the start of the
reporting period
• If you are already registered, do not need to
submit registration
52. Active Engagement Option 2:
• Testing and validation
• Providers must respond from PHA within 30
days
• Failure to response twice within a reporting
period –would not meet the measure
53. Active Engagement Option 3:
• Production
• Completed testing and validation and
electrically submitting production date to the
PHA (Public Health) or CDR (Clinical Data
Registry)
54.
55. CQMs
• 16 required CQMs
• Alignment between EHR Incentive Program and
CQM reporting programs such as IQR or PQRS
• CMS encourages EH/CAH to submit eCQMs for
2017
• Starting 1/1/2018 must submit eCQMs
• CQM measure Certification not required until RP
2018
• Between now and 2017, CQM can attest with
Core Measures, any version of the CQM’s OK
56. Resources
• NPRM
• Data and Reports Median
• HIMSS One Source
• Interoperable
• Federal Register
• Infographic Stage 3
• 20 Things to know about MU
57. Meaningful Use Stage 3
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