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
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.
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
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.
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.
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.
This presentation walks through the transition from chart abstracted quality reporting to electronic quality reporting for the CMS and The Joint Commission
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!
New clinical quality measure reporting in Practice Fusion [slides]Practice Fusion
Learn about the new data elements, which quality measures they can be used for, and information on reporting quality measures using Practice Fusion for Meaningful Use, PQRS EHR Reporting, and other quality improvement programs.
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.
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
CMS has stopped being nice about ICD10. As of October 1, 2016, the grace period for not using specific codes for certain diagnoses is gone. If you are not precise with these codes, your denial rates will go up.
This presentatio helps you learn how you can avoid high denial rates and also explains:
- Key changes and revisions
- Written guidance from CMS and OIG that may negate a new guideline
- Chapter specific changes
- How to tell when you need documentation and when you don’t
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.
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.
This presentation walks through the transition from chart abstracted quality reporting to electronic quality reporting for the CMS and The Joint Commission
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!
New clinical quality measure reporting in Practice Fusion [slides]Practice Fusion
Learn about the new data elements, which quality measures they can be used for, and information on reporting quality measures using Practice Fusion for Meaningful Use, PQRS EHR Reporting, and other quality improvement programs.
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.
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
CMS has stopped being nice about ICD10. As of October 1, 2016, the grace period for not using specific codes for certain diagnoses is gone. If you are not precise with these codes, your denial rates will go up.
This presentatio helps you learn how you can avoid high denial rates and also explains:
- Key changes and revisions
- Written guidance from CMS and OIG that may negate a new guideline
- Chapter specific changes
- How to tell when you need documentation and when you don’t
This report will identify global media trends, culture shifts and new technologies for an ever-changing society from a millennials perspective. At the intersection of trends research and business strategy, this will help marketers develop innovative brand campaigns and celebrate a culture designed for unique people, products and experiences.
Check complete setup of Play School, Primary School and High School. Interior and Exterior Paint and Art Work, Officer area and classroom setup, Play Area, Digital Classroom, Activity Corner, Fun Zone etc.
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
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.
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.
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.”
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.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
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.
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.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
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.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
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.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
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
How to get Prepared and Find Success with Meaningful Use Stage 2 and 3
1. Presented By: Iatric Systems
Presenter Name: Kay Jackson
PROPOSED NPRM: Meaningful Use Stage 3:
How You Can Succeed
2. Breaking News: 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 15 PM
https://s3.amazonaws.com/public-
inspection.federalregister.gov/2015-08514.pdf
3. What Does this Mean????
First Change for Eligible Hospitals, removing:
• Demographics
• Vitals
• Smoking Status
• Structured Lab Results
• Patient List
• Summaries of Care (Core 12.1 and Core 12.3
only)
• eMAR
• Advance Directives
• Electronic Notes
• Imaging Results
• Family Health History
4. 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!
5. Change Portal Measure Core 6
• The View/Download/Transmit
changed
• From >5% to AT LEAST 1 PATIENT
• Not 10 or 10%, but 1 patient!
6. 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
7. 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.
8. How Many Comments?
Medicare and Medicaid Programs; Electronic
Health Record Incentive Program--Modifications
to Meaningful Use in 2015 through 2017
http://www.regulations.gov/#!
documentDetail;D=CMS-2015-0045-0001
What is your guess for total?
10. How Many Comments? (Closed
5/29)
EHR Incentive Program Stage 3
http://www.regulations.gov/#!
documentDetail;D=CMS-2015-0033-0002
What is your guess for total?
11.
12. First Thing to Know About
Stage 3:
• Stage 3 info is All Proposed at this time
• Final regulations due this Fall??
• 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
13. 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
14. 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
15. 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
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”
• Have you seen the facelift for CHPL?
20.
21. 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”
22. 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 ongoing
24. 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
25. 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
26. 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.
27. 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
28. 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
29. Objective 4: Measure 1
• >80% Medication orders via CPOE
• Median score of 93%
• Stage 2 requirement is >60%
30. Objective 4: Measure 2
• >60% lab orders via CPOE
• Median score of 80%
• Stage 2 requirement is >30%
31. Objective 4: Measure 3
• >60% diagnostic imaging orders
• Unique Patient Measure
• Median score of 83% required
• Stage 2 requirement is >30%
32. 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
34. 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
35. 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
36. 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 %?
37. 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
38. 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%
39. 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.
40. 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”
41. 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
42. 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.
43. 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.”
44. 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.”
45. Proposed Objective 6 Measure 3:
>15% non clinical incorporated into EHR-ED
and inpatients
46. 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
47. 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
48. 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
49. 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
50. 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
51. Proposed Objective 7 Measure 3:
• >80% where provider has never encountered
the patient to perform clinical information
reconsolidation:
• Medication
• Medication allergy
• Problem list
52. 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”
53. 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
54. 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
55. Active Engagement Option 3:
• Production
• Completed testing and validation and
electrically submitting production date to the
PHA (Public Health) or CDR (Clinical Data
Registry)
56.
57. 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
60. FAQ 7/2/15
New FAQ related to reporting CQMs with a zero
numerator and/or denominator
61. Resources
• NPRM
https://www.federalregister.gov/regulations/0938-AS26/electronic-health-record-ehr-
incentive-programs-stage-3-cms-3310-p-
• Data and Reports Median
http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/
Downloads/March2015_HITPCPresentation.pdf
• HIMSS One Source
http://www.himss.org/library/meaningful-use
• Interoperable
http://www.healthit.gov/sites/default/files/CMS-Stage-3-Meaningful-Use-proposed-rule
%20_FactSheet.pdf
• Federal Register
https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-06685.pdf
• Infographic Stage 3
http://www.healthcareitnews.com/infographic/infographic-stage-3-objectives-hospitals?
mkt_tok=3RkMMJWWfF9wsRoisqjIZKXonjHpfsX56e8kX6G3lMI/0ER3fOvrPUfGjI4ETsZrI
+SLDwEYGJlv6SgFQ7LHMbpszbgPUhM=
• 20 Things to know about MU
http://www.beckershospitalreview.com/healthcare-information-technology/20-things-
to-know-about-meaningful-use.html
62. Meaningful Use Stage 3: How You
Can Succeed
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