Transcript Document

Meaningful Use for the
Physician Office
Carol Aperahama
September 23, 2011
The information contained in this presentation has been obtained from the
CMS website and is current as of September 23, 2011.
The information contained in this presentation is intended to be a general
summary of the Meaningful Use Final Rule. It is not intended to take
the place of the written law.
Additions, deletions and modifications to the Final Rule occurring after this
date may change the information contained in this presentation.
What is “Meaningful Use”?
The American Recovery and Reinvestment Act of 2009 specifies three
main components of Meaningful Use:
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The use of a certified EHR in a meaningful manner.
The use of certified EHR technology for electronic exchange of health information to
improve quality of health care.
The use of certified EHR technology to submit clinical quality and other measures.
Simply put, "meaningful use" means providers need to show they're using
certified EHR technology in ways that can be measured significantly in
quality and in quantity.
www.cms.gov/EHRIncentivePrograms
EHR Meaningful Use Criteria
The criteria for meaningful use will be staged in three steps over the
course of the next five years.
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Stage 1 will be implemented in 2011 and 2012. This stage sets the baseline for
electronic data capture and information sharing.
Stage 2 is expected to be implemented in 2013.
Stage 3 is expected to be implemented in 2015.
Stages 2 and 3 will continue to expand on this baseline and be developed through future
rule making.
www.cms.gov/EHRIncentivePrograms
Meaningful Use Requirements
What are the requirements for Stage 1 of Meaningful Use?
Meaningful use includes both a core set and a menu set of objectives
that are specific to eligible professionals.
There are a total of 25 meaningful use objectives. To qualify for an
incentive payment, 20 of these 25 objectives must be met.
– There are 15 required core objectives.
– The remaining 5 objectives may be chosen from the list of 10 menu
set objectives.
www.cms.gov/EHRIncentivePrograms
Meaningful Use Requirements
Meeting Meaningful Use criteria is a team effort.
− Front desk personnel will be responsible for updating and adding
required demographic information.
− Clinical staff will be responsible for updating and adding required
health information.
− Providers will be responsible for adding required information in the
electronic health record.
Provider Responsibilities
Core Measure 1 of 15
Use computerized provider order entry (CPOE)
for medication orders to directly enter medication
orders from a computer or mobile device.
More than 30 percent of all unique patients with at least one medication
in their medication list that are seen by the provider during the reporting
period have at least one medication order entered using CPOE.
Core Measure 1 of 15
EHR Workflow
Core Measure 2 of 15
Drug-drug and drug-allergy interaction checks
All providers must have this functionality enabled for the entire EHR
reporting period.
Core Measure 2 of 15
EHR Workflow
Core Measure 3 of 15
Maintain an up-to-date problem list of current and
active diagnoses
More than 80 percent of all unique patients seen by the provider must
have at least one entry on the problem list, or an indication that no
problems are known for the patient recorded as structured data.
Core Measure 3 of 15
EHR Workflow
Core Measure 4 of 15
Generate and transmit permissible prescriptions
electronically (eRx)
More than 40 percent of all permissible prescriptions written by the
provider are transmitted electronically using certified EHR technology.
Core Measure 4 of 15
EHR Workflow
Nurse Responsibilities
Core Measure 5 of 15
Maintain active medication list
More than 80 percent of all unique patients seen by the provider have
at least one entry (or an indication that the patient is not currently
prescribed any medication) recorded as structured data.
Core Measure 5 of 15
EHR Workflow
Core Measure 6 of 15
Maintain active medication allergy list
More than 80 percent of all unique patients seen by the provider have
at least one entry (or an indication that the patient has no known
medication allergies) recorded as structured data.
Core Measure 6 of 15
EHR Workflow
Core Measure 8 of 15
Record and chart changes in the following vital signs:
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Height
Weight
Blood pressure
Calculate and display body mass index (BMI)
Plot and display growth charts for children 2-20 years,
including BMI
For more than 50 percent of all unique patients age 2 and over seen
by the provider, height, weight, and blood pressure are recorded as
structured data.
Core Measure 8 of 15
EHR Workflow
Core Measure 9 of 15
Record smoking status for patients 13 years old
or older
More than 50 percent of all unique patients 13 years old or older seen
by the provider have smoking status recorded as structured data.
Core Measure 9 of 15
EHR Workflow - Pediatrics
Core Measure 9 of 15
EHR Workflow - Adults
Core Measure 11 of 15
Implement one clinical decision support rule
relevant to specialty or high clinical priority along
with the ability to track compliance with that rule.
Implement one clinical decision support rule.
There are numerous ways to meet this rule. You have to attest that
you have met one measure. Some examples include the alerts the
system provides for overdue health maintenance/disease management
indicators or when BP is out of range. To demonstrate this we are using
the pneumonia vaccine.
Core Measure 11 of 15
EHR Workflow A
Core Measure 11 of 15
EHR Workflow B
Core Measure 11 of 15
EHR Workflow C
Core Measure 11 of 15
EHR Workflow D
Front Office Responsibilities
Core Measure 7 of 15
Record all of the following demographics:
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Preferred language
Gender
Race
Ethnicity
– Date of birth
More than 50 percent of all unique patients seen by the
provider have demographics recorded as structured data.
Core Measure 7 of 15
EHR Workflow A
Core Measure 7 of 15
EHR Workflow B
Core Measure 12 of 15
Provide patients with an electronic copy of their
health information, including diagnostic test
results, problem list, medication lists and
medication allergies ( “upon request”)
More than 50 percent of all patients who REQUEST an electronic copy
of their health information are provided it within 3 business days.
Core Measure 12 of 15
EHR Workflow
Core Measure 12 of 15
EHR Workflow
Core Measure 12 of 15
EHR Workflow
Core Measure 13 of 15
Provide clinical summaries for patients for each
office visit
Clinical summaries provided to patients for more than 50 percent of all
office visits within 3 business days.
Core Measure 13 of 15
EHR Workflow A
Core Measure 13 of 15
EHR Workflow B
Menu Set Measures
Providers must meet four of the Menu Set Measures
in addition to Measure 9 OR Measure 10.
Menu Set Measure 9 and 10 of 10
Capability to submit electronic data to immunization registries or
immunization information systems and actual submission
according to applicable law and practice
Performed at least one test of certified EHR technology’s capacity to submit electronic
data to immunization registries and follow up submission if the test is successful
Capability to submit electronic syndromic surveillance data to
public health agencies and actual submission according to
applicable law and practice
Performed at least one test of certified EHR technology’s capacity to provide
electronic syndromic surveillance data to public health agencies and follow-up
submission if the test is successful.
Menu Set Measure 1 of 10
Implement drug formulary checks
The provider has enabled this functionality and has access to at least
one internal or external formulary for the entire EHR reporting period.
Menu Set Measure 2 of 10
Incorporate clinical lab test results into EHR as
structured data
More than 40 percent of all clinical lab test results ordered by the
provider during the EHR reporting period whose results are either in a
positive/negative or numerical format are incorporated in certified EHR
technology as structured data.
Menu Set Measure 3 of 10
Generate lists of patients by specific conditions
to use for quality improvement, reduction of
disparities, research, or outreach
Generate at least one report listing patients of the EP with a specific
condition.
Menu Set Measure 3 of 10
EHR Workflow A
Menu Set Measure 4 of 10
Send reminders to patients per patient preference
for preventive/follow-up care
More than 20 percent of all patients 65 years or older or 5 years old or
younger were sent an appropriate reminder during the EHR reporting
period.
Menu Set Measure 4 of 10
EHR Workflow
Summary Slide
Meaningful use is an ongoing process and implementation will continue
for the next several years.
Items that are required today may not be required in the future. New
regulations will be released periodically by CMS.
As new rules are passed, we will keep you notified of all these new
requirements and how they will impact your practice.