Transcript Slide 1

Protecting Your Peace of Mind
A Roadmap to Meaningful Use
Session One:
Unraveling What it Takes to be a Meaningful
User
August 24, 2010
Protecting Your Peace of Mind
Objectives
Navigating Stage One
Report/Attest
Menu criteria
Core
Criteria
Basics
Meaningful
User
Protecting Your Peace of Mind
Meaningful Facts
 ARRA
HITECH
EHR Incentive Program
 Program to Provide Monetary Incentives for the
“Meaningful Use” of Healthcare Technology
 Final Rule Published July 28, 2010
(http://edocket.access.gpo.gov/2010/pdf/2010-17207.pdf)
Protecting Your Peace of Mind
Meaningful Facts
Quality
Safety
Healthcare
Transformation
Information
Exchange
Efficiency
Improved
Health of
Americans
Protecting Your Peace of Mind
Implementation Approach
Stage
One
Stage
Two
Stage
Stage
One
Three
Protecting Your Peace of Mind
Stage One at a Glance
Menu Criteria
Core Criteria
Protecting Your Peace of Mind
Core Set Criteria
Patient Demographics
Vital Signs
Problem List
Medication List
Medication Allergy List
Smoking Status
Clinical Summaries or
Discharge Summary
 Electronic Copies of Patient
Health Information
 Electronic Prescriptions
(eRx)







 CPOE (Medications)
 Drug-Drug, Drug-Allergy
Interactions
 Electronically Exchange Key
Clinical Info Among
Providers and PatientAuthorized Entities
 Clinical Decision Support
 Privacy & Security
 Clinical Quality Reporting
Protecting Your Peace of Mind
Patient Demographics
Record patient demographics (sex,
race, ethnicity, date of birth,
preferred language, and in the case
of hospitals, date and preliminary
cause of death in the event of
mortality)
• Measure:
More than 50% of patient’s demographic data recorded as
structured data
• Denominator:
The number of unique patients seen by the EP or admitted
as IP or through ER during the EHR reporting period
• Numerator:
The number of patients in the denominator who have all
the elements of demographics (or a specific exclusion if the
patient declines to provide one or more elements)
recorded as structured data
Begins on pg 44340 of Federal Register
Helpful Link: http://www.whitehouse.gov/omb/inforeg_statpolicy/#dr
Protecting Your Peace of Mind
Vital Signs
Record vital signs and chart
changes (height, weight, blood
pressure, body-mass-index,
growth charts for children)
Begins on pg 44342 of Federal Register
• Measure:
More than 50% of patients 2 years of age or older have
height, weight, and blood pressure recorded as structured
data
• Denominator:
The number of unique patients age 2 or older seen by the
EP or admitted as IP or through ER during the EHR
reporting period
• Numerator:
The number of patients in the denominator who have at
least one entry of their height, weight and blood pressure
recorded as structured data
Protecting Your Peace of Mind
Problem List
Maintain up-to-date
problem list of current
and active diagnosis
Begins on pg 44336 of Federal Register
• Measure:
More than 80% of patients have at least one entry recorded
as structured data
• Denominator:
The number of unique patients seen by the EP or admitted
as IP or through ER during the EHR reporting period
• Numerator:
The number of patients in the denominator who have at
least one entry or an indication that no problems are
known for the patient recorded as structured data in their
problem list
Protecting Your Peace of Mind
Medication List
Maintain active
medication list
Begins on pg 44338 of Federal Register
• Measure:
More than 80% of patients have at least one entry recorded
as structured data
• Denominator:
The number of unique patients seen by the EP or admitted
as IP or through ER during the EHR reporting period
• Numerator:
The number of patients in the denominator who have a
medication (or an indication that the patient is not
currently prescribed any medication) recorded as
structured data
Protecting Your Peace of Mind
Medication Allergy List
Maintain active
medication allergy
list
Begins on pg 44339 of Federal Register
• Measure:
More than 80% of patients have at least one entry recorded
as structured data
• Denominator:
The number of unique patients seen by the EP or admitted
as IP or through ER during the EHR reporting period
• Numerator:
The number of patients in the denominator who have at
least one entry (or an indication that the patient has no
known medication allergies) recorded as structured data in
their medication allergy list
Protecting Your Peace of Mind
Smoking Status
Record smoking
status for patients 13
years of age or older
• Measure:
More than 50% of patients 13 years of age or older
have smoking status recorded as structured data
• Denominator:
The number of unique patients seen by the EP or
admitted as IP or through ER during the EHR
reporting period
• Numerator:
The number of patients in the denominator with
smoking status recorded as structured data.
Begins on pg 44344 of Federal Register
Helpful Link: http://www.cdc.gov/nchs/nhis/tobacco/tobacco_recodes.htm.
Protecting Your Peace of Mind
Office Visit Summaries / Discharge
Instructions
For individual professionals, provide
patients with clinical summaries for
each office visit; for hospitals,
provide an electronic copy of hospital
discharge instructions on request
Begins on pg 44358 of Federal Register
• Measure:
Summaries provided to patients for more than 50% of all office
visits within 3 business days; more than 50% of all patients who
are discharged from the IP department or ER department of
hospitals and who request an electronic copy of their discharge
instructions are provided with it
• Denominator:
The number of unique patients seen by the EP or admitted as IP
or through ER during the EHR reporting period
• Numerator:
The number of patients in the denominator who are provided a
clinical summary of their visit within three business days
Protecting Your Peace of Mind
Electronic Copies of Patient Health
Information
• Measure:
More than 50% of requesting patients receive an electronic
copy within 3 business days
• Denominator:
The number of patients of the EP or hospital who request
an electronic copy of their electronic health information
within 3 business days prior to the end of the EHR reporting
period
On request, provide patients with an
• Numerator:
electronic copy of their health
information (including diagnostic test
The number of patients in the denominator who receive an
electronic copy of their electronic health information
results, problem list, medication lists,
within 3 business days
medication allergies, and for hospitals,
discharge summary and procedures)
Begins on pg 44353 of Federal Register
Protecting Your Peace of Mind
CPOE (Medications)
Computer provided
order entry (CPOE)
for medication orders
Begins on pg 44332 of Federal Register
• Measure:
More than 30% of patients with at least one medication in
their list have at least one medication ordered through
CPOE
• Denominator:
The number of unique patients with at least one
medication in their medication list seen by the EP or
admitted as IP or through ER during the EHR reporting
period
• Numerator:
The number of patients in the denominator that have at
least one mediation order entered using CPOE
Protecting Your Peace of Mind
Electronic Prescriptions (eRx)
Generate and transmit
permissible prescriptions
electronically (does not
apply to hospitals)
• Measure:
More than 40% are transmitted electronically using
certified EHR technology
• Denominator:
The number of prescriptions written (for those patients
whose records are maintained using certified EHR
technology) for drugs requiring a prescription in order to be
dispensed other than controlled substances during the
reporting period
• Numerator:
The number of prescriptions in the denominator generated
and transmitted electronically
Begins on pg 44337 of Federal Register
Helpful Link: http://www.deadiversion.usdoj.gov/schedules/orangebook/e_cs_sched.pdf
Objective applies to EPs only.
Protecting Your Peace of Mind
Electronic Prescriptions (eRx)
200
Prescriptions
160
Prescriptions
80% (or
percentage
allowable by
law)
40% sent
electronically
160
prescriptions
allowable by
law
64
prescriptions
sent
electronically
Protecting Your Peace of Mind
Drug-Drug, Drug-Allergy Interactions
Implement drug-drug
and drug-allergy
interaction checks
Begins on pg 44334 of Federal Register
• Measure:
Functionality is enabled for these
checks for the entire reporting period
• Denominator:
N/A (Attestation)
• Numerator:
N/A (Attestation)
Protecting Your Peace of Mind
Electronically Exchange Key Clinical Info Among
Providers and Patient-Authorized Entities
Implement capability to
electronically exchange key
clinical information among
providers and patientauthorized entities
Begins on pg 44360 of Federal Register
• Measure:
Perform at least one test of EHR's
capacity to electronically exchange
information
• Denominator:
N/A (Attestation)
• Numerator:
N/A (Attestation)
Protecting Your Peace of Mind
Clinical Decision Support (CDS)
EPs: Implement one CDS rule relevant to
specialty or high clinical priority along with
the ability to track compliance.
EHs/CAHs: Implement one CDS rule
related o a high priority hospital condition
along with the ability to track compliance
Begins on pg 44350 of Federal Register
• Measure:
One clinical decision support rule
implemented
• Denominator:
N/A (Attestation)
• Numerator:
N/A (Attestation)
Protecting Your Peace of Mind
Privacy & Security
Implement systems to
protect privacy and
security of patient data
in the EHR
• Measure:
Conduct or review a security risk analysis,
implement security updates as necessary,
and correct identified security deficiencies
• Denominator:
N/A (Attestation)
• Numerator:
N/A (Attestation)
Begins on pg 44368 of Federal Register
Helpful Link: http://edocket.access.gpo.gov/cfr_2003/octqtr/pdf/45cfr164.308.pdf
Protecting Your Peace of Mind
Clinical Quality Measures
Report clinical
quality measures
to CMS or states
• Measure:
EPs report on a minimum of three
Core Clinical Quality Measures and
three optional Clinical Quality
Measures (from 44 available
options). EHs, CAHs, MA Hospitals
report on 15 hospital specific
measures
Begins on pg 44380 of Federal Register
Helpful Link: http://www.ama-assn.org/ama1/pub/upload/mm/399/ehr-clinical-quality-measures.pdf
Protecting Your Peace of Mind
Menu Set Criteria












Drug Formulary Checks
Clinical Laboratory Test Results as Structured Data
Report Patients By Condition
Patient-Specific Education
Medication Reconciliation
Summary of Care Records for Transitions of Care
Submit Immunization Data
Syndromic Surveillance Reporting
Advanced Directives Indicator (EH or CAH ONLY)
Lab Results Reports (EH or CAH ONLY)
Patient Reminders for Preventative Care (EP OPTION ONLY)
Provide Patients Timely Electronic Access to Health Information
(EP OPTION ONLY)
Protecting Your Peace of Mind
Drug Formulary Checks
Implement drug
formulary checks
Begins on pg 44334 of Federal Register
• Measure:
Drug formulary check system is
implemented and has access to at least
one internal or external drug formulary for
the entire reporting period
• Denominator:
N/A (Attestation)
• Numerator:
N/A (Attestation)
Protecting Your Peace of Mind
Clinical Laboratory Test Results as
Structured Data
Incorporate clinical
laboratory test results
into EHRs as structured
data
Begins on pg 44346 of Federal Register
• Measure:
More than 40% of clinical laboratory test results whose results are in
positive/negative or numerical format are incorporated into EHRs as
structured data
• Denominator:
The number of lab tests ordered during the EHR reporting period by
the EP or authorized providers of the eligible hospital or CAH for
patients admitted to and EH or CAH's IP or ER dept whose results are
expressed in a positive or negative affirmation or as numbers
• Numerator:
The number of lab test results whose results are expressed in a
positive or negative affirmation or as a number which are
incorporated as structured data
Protecting Your Peace of Mind
Report Patients By Condition
Generate lists of patients by
specific conditions to use for
quality improvement,
reduction of disparities,
research or outreach
Begins on pg 44325 of Federal Register
• Measure:
Generate at least one listing of
patients with a specific condition
• Denominator:
N/A (Attestation)
• Numerator:
N/A (Attestation)
Protecting Your Peace of Mind
Patient-Specific Education
• Measure:
More than 10% of patients are provided with
patient-specific education resources
• Denominator:
The number of unique patients seen by the EP or
admitted as IP or through ER during the EHR
reporting period
Use EHR technology to identify • Numerator:
patient-specific education
The number of patients in the denominator who
resources and provide those to are provided patient education specific resources
the patient as appropriate
Begins on pg 44359 of Federal Register
Protecting Your Peace of Mind
Medication Reconciliation
• Measure:
Medication reconciliation is performed for more
than 50% of transitions of care
• Denominator:
The number of transitions of care during the EHR
reporting period for which the EP or hospital's IP or
The EP, eligible hospital or CAH who
ER dept was the receiving party of the transition
receives a patient from another
• Numerator:
setting of care or provider of care or
The number of transitions of care in the
believes an encounter is relevant
denominator where medication reconciliation was
should perform medication
performed
reconciliation
Begins on pg 44362 of Federal Register
Protecting Your Peace of Mind
Summary of Care Records for Transitions
of Care
Provide summary of care
record for patients
referred or transitioned to
another provider or setting
Begins on pg 44363 of Federal Register
• Measure:
Summary of care record is provided for more than
50% of patient transitions or referrals
• Denominator:
The number of transitions of care during the EHR
reporting period for which the EP or hospital's IP or
ER dept was the transferring or referring provider
• Numerator:
The number of transitions of care and referrals in
the denominator where a summary of care record
was provided
Protecting Your Peace of Mind
Submit Immunization Data
• Measure:
Perform at least one test of data
submission and follow-up submission
(where registries can accept electronic
submission)
• Denominator:
Submit electronic
N/A (Attestation)
immunization data to
registries or immunization • Numerator:
N/A (Attestation)
information systems (IIS)
Begins on pg 44325 of Federal Register
Helpful Link: : http://www.cdc.gov/vaccines/programs/iis/stds/cvx.htm
Helpful Link: http://www.cdc.gov/vaccines/programs/iis/contacts-state-iis.htm#a
Protecting Your Peace of Mind
Syndromic Surveillance Reporting
Submit electronic
syndromic surveillance
data to public health
agencies
Begins on pg 44367 of Federal Register
• Measure:
Perform at least one test of data
submission and follow-up submission
(where public health agencies can accept
electronic data)
• Denominator:
N/A (Attestation)
• Numerator:
N/A (Attestation)
Protecting Your Peace of Mind
Advanced Directive Indicator
Record advanced
directives for patients
65 years of age or older
Begins on pg 44345 of Federal Register
Applies to EHs, CAH, and MA Hospitals Only
• Measure:
More than 50% of patients 65 years of age or older
have an indication of an advanced directive status
recorded
• Denominator:
The number of unique patients admitted as IP or
through ER during the EHR reporting period
• Numerator:
The number of patients in the denominator who
have an indication of an advanced directive status
record
Protecting Your Peace of Mind
Lab Results Reports
Submit of electronic
data on reportable
laboratory results to
public health agencies
Begins on pg 44366 of Federal Register
Applies to EHs, CAH, and MA Hospitals Only
• Measure:
Perform at least one test of data
submission and follow-up submission
(where public health agencies can accept
electronic data)
• Denominator:
N/A (Attestation)
• Numerator:
N/A (Attestation)
Protecting Your Peace of Mind
Preventative Care Reminders
Send Reminders to patients
(per patient preference) for
preventative and follow up
care
Begins on pg 44357 of Federal Register
Applies to EPs Only
• Measure:
More than 20% of patients 65 years of age or older of 5
years of age or younger are sent appropriate reminders
• Denominator:
The number of unique patients (for those patients
whose records are maintained using certified EHR
technology) ages 65 and older or 5 years and younger
• Numerator:
The number of patients in the denominator who were
sent the appropriate reminder
Protecting Your Peace of Mind
Provide Patients Timely Access to Health
Information
Provide patients with timely
electronic access to their health
information (including laboratory
results, problem list, medication
list, medication allergies)
Begins on pg 170 of Federal Register
Applies to EPs Only
• Measure:
More than 10% of patients are provided electronic access to
information within 4 days of its being updated in the EHR
(subject to the EP's discretion to withhold certain information)
• Denominator:
The number of unique patients seen by the EP during the EHR
reporting period
• Numerator:
The number of patients in the denominator who have timely
(available to the patient within 4 business days of being updated
in the certified EHR technology) electronic access to their health
information online
Protecting Your Peace of Mind
Next Steps
Enroll
Identify Gaps
Create
Implementation
Plan
Menu Set Objectives
Select Program
Core Set Objectives
Review Vendor
Plan?
Gauge EHR
Readiness
Eligibility
Purchase?
Change Management
Certified Technology
 Complete Assessments
Select five
criteria
Identify Gaps
Create
Implementation
Plan
Protecting Your Peace of Mind
MMIC Meaningful Use Resources
 Visit us at: www.mmicgroup.com
 Join us for future MU webinars
– Meaningful Evaluation: Assessments for MU Success
• Tuesday, September 21, 2010
– Building and Implementing your MU Strategy
• Tuesday, October 12, 2010
 Review MU reference material
– MU Program Overview and FAQs
– MU Core Criteria FAQs
– MU Menu Criteria FAQs
Protecting Your Peace of Mind
MMIC Meaningful Use Services
 Contact MMIC Health IT for:
– EHR Incentive Program Eligibility Assessment
– EHR Gap Analysis and Summary Report Services
– Meaningful Use Roadmap and Project Planning
 Contact Information:
– Beth Schultz, Implementation Manager
– [email protected]
– 952-838-6854
Protecting Your Peace of Mind
Helpful Websites
http://www.cms.gov/EHRIncentivePrograms/
http://healthit.hhs.gov
Additional Questions/Support? Contact: [email protected]
Thank you