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Meaningful Use Measures Series – Session 3 Objectives related to interoperability and exchanging data to outside entity. MU 3 Session Series. Physician Meaningful Use 3 Session Series Sept. 20 - Session #1 Drug, Medication, eRx related Oct. 18 - Session #2 Recording Patient Data
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Meaningful Use Measures Series – Session 3Objectives related to interoperabilityand exchanging data to outside entity
MU 3 Session Series Physician Meaningful Use 3 Session Series • Sept. 20 - Session #1 Drug, Medication, eRx related • Oct. 18 - Session #2 Recording Patient Data • Nov. 15 - Session #3 Interoperability, Exchanging Data Outside the Clinic Other Than to Patients TAKEAWAY: Use Your resources – GA-HITREC & HomeTown Health
25 Objectives in 5 Priority Outcomes • Improving quality, safety, efficiency and reducing health disparities • Engage patients and families in their health care • Ensure adequate privacy and security protections for personal health information • Improve care coordination • Improving population and public health
25 Objectives in 5 Priority Outcomes Stage I Meaningful Use for 2011 • – Eligible Professionals must complete: • 15 core objectives (e.g., maintain active medication list, etc.) • 5 objectives out of 10 from menu set (e.g., implement drug formulary checks, etc.) • 6 total Clinical Quality Measures(CQM) (3 core or alternate core, and 3 out of 38 from additional set)
Objective Requirements 15 Core Set Objectives • Eligible Professionals must meet all Core Objectives to qualify for incentive payments
Objective Requirements 10 Menu Set Objectives • Eligible Professionals will defer 5 Menu Objectives One of the remaining objectives must be from Improving population and public health priority
Selected Objectives Related to: Interoperability Exchanging data to outside entities
POLL QUESTION POLL QUESTION
Additional Information – Electronic Exchange • The test of electronic exchange of key clinical information must involve the transfer of information to another provider of care with distinct certified EHR technology or other system capable of receiving the information. Simulated transfers of information are not acceptable to satisfy this objective. • The transmission of actual patient information is not required for the purposes of a test. The use of test information about a fictional patient that would be identical in form to what would be sent about an actual patient would satisfy this objective. • When the clinical information is available in a structured format it should be transferred in a structured format. However, if the information is unavailable in a structured format, the transmission of unstructured data is permissible.
Additional Information – Electronic Exchange • EPs must test their ability to electronically exchange key clinical information at least once prior to the end of the EHR reporting period. Testing may also occur prior to the beginning of the EHR reporting period. Every payment year requires its own, unique test. If multiple EPs are using the same certified EHR technology in a shared physical setting, testing would only have to occur once for a given certified EHR technology. • An unsuccessful test of electronic exchange of key clinical information will be considered valid for meeting the measure of this objective.
CMS - FAQ FAQ: • To meet the meaningful use objective “capability to exchange key clinical information” for the EHR Incentive Programs, can different providers of care share EHR technology and successfully meet this objective? Answer: • In order to meet this objective, clinical information must be sent between different legal entities with distinct certified EHR technology and not between organizations that share a certified EHR technology or organizations that are part of the same legal entity, since no actual exchange of clinical information would take place in these latter instances. Distinct certified EHR technologies are those that can achieve certification and operate independently of other certified EHR technologies. It is possible for different legal entities to meet this objective by using separate instances of the same certified EHR technology (e.g. both entities using separate license of the same program), subject to the following limitations:
ONC Regulations - FAQ FAQ: Could an interface that transmits lab results in HL7 message format between a hospital laboratory system and a physician’s EHR (presuming that the transmissions were occurring between two different legal entities) satisfy the certification criteria related to the exchange of key clinical information in 45 CFR 170.304(i) and 45 CFR 170.306(f)? If not, please specify the required data types and exchange characteristics that must be part of the required clinical information exchange Answer: As implied in the question, for certification a Complete EHR or an EHR Module must have the capability to electronically receive and display, and transmit certain key clinical information in accordance with one of two separate certification criteria (45 CFR 170.304(i) or 45 CFR 170.306(f)), depending on the setting for which the EHR technology is designed (ambulatory or inpatient, respectively). Generally speaking, these certification criteria require two types of information exchange capabilities
ONC Regulations - FAQ 1. Electronically receive and display a patient’s summary record, from other providers and organizations including, at a minimum, diagnostic tests results, problem list, medication list, and medication allergy list in accordance with the continuity of care document (CCD) standard (and the HITSP/C321 implementation specifications) or the continuity of care record (CCR) standard and that upon receipt of a patient summary record formatted according to the alternative standard, display it in human readable format. 2. Electronically transmit a patient summary record to other providers and organizations including, at a minimum, diagnostic test results, problem list, medication list, and medication allergy list using the CCD standard (and the HITSP/C32 implementation specifications) or the CCR standard while also Representing specific named data elements (problems, laboratory test results, and medications) according to adopted standards. Note: The above uses language from 45 CFR 170.304(i). The certification criterion adopted at 45 CFR 170.306(f) also includes “procedures” as a required, standardized data element within these exchange capabilities
ONC Regulations - FAQ Therefore, an interface that transmits lab results in HL7 message format between a hospital laboratory system and a physician’s EHR (where the transmission is occurring between two different legal entities) would not qualify as an exchange of key clinical information that complies with the requirements of either of these two certification criteria. The interface would not satisfy the required capabilities included within the adopted certification criteria, and more specifically, the ability to transmit a patient summary record in accordance with the CCD standard (and the HITSP/C32 implementation specifications) or the CCR standard. 1HITSP Summary Documents Using HL7 Continuity of Care Document (CCD)
Azalea Lab Hub - Exchange http://www.azaleahealth.com/labhub
Attestation Requirements – Transition of Care The resulting percentage (Numerator ÷Denominator) must be more than 50 percent in order for an EP to meet this measure.
Additional Information – Transition of Care Sum • Only patients whose records are maintained using certified EHR technology should be included in the denominator for transitions of care. • The transferring party must provide the summary care record to the receiving party. • The EP can send an electronic or paper copy of the summary care record directly to the next provider or can provide it to the patient to deliver to the next provider, if the patient can reasonably expected to do so. • If the provider to whom the referral is made or to whom the patient is transitioned to has access to the medical record maintained by the referring provider then the summary of care record would not need to be provided, and that patient should not be included in the denominator for transitions of care.
Additional Information – Immunization Registries • The test to meet the measure of this objective must involve the actual submission of information to a registry or immunization information system, if one exists that will accept the information. Simulated transfers of information are not acceptable to satisfy this objective. • The transmission of actual patient information is not required for the purposes of a test. The use of test information about a fictional patient that would be identical in form to what would be sent about an actual patient would satisfy this objective. • If multiple EPs are using the same certified EHR technology in a shared physical setting, testing would only have to occur once for a given certified EHR technology.
Additional Information – Immunization Registries • An unsuccessful test to submit electronic data to immunization registries or immunization information systems will be considered valid and would satisfy this objective. • If the test is successful, then the EP should institute regular reporting with the entity with whom the successful test was conducted, in accordance with applicable law and practice. There is not a measurement associated with this reporting. • The transmission of immunization information must use the standards at 45 CFR 170.302(k).
Additional Information – Syndromic Surveillance Data • The test to meet the measure of this objective must involve the actual submission of electronic syndromic surveillance data to public health agencies, if one exists that will accept the information. Simulated transfers of information are not acceptable to satisfy this objective. • The transmission of electronic syndromic surveillance data is not required for the purposes of a test. The use of test information about a fictional patient that would be identical in form to what would be sent about an actual patient would satisfy this objective. • An unsuccessful test to submit electronic syndromic surveillance data to public health agencies will be considered valid and would satisfy this objective. • If the test is successful, then the EP should institute regular reporting with the entity with whom the successful test was conducted, in accordance with applicable law and practice. There is not a measurement associated with this reporting.
Additional Information – Syndromic Surveillance Data • EPs must test their ability to submit electronic syndromic surveillance data to public health agencies at least once prior to the end of the EHR reporting period. Testing may also occur prior to the beginning of the EHR reporting period. Each payment year requires it own unique test. • If multiple EPs are using the same certified EHR technology in a shared physical setting, testing would only have to occur once for a given certified EHR technology. • The transmission of syndromic surveillance information must use the standards at 45 CFR 170.302(l).
IMPORTANT DATES! • October 3, 2011 – Last day for eligible professionals to begin their 90-day reporting period for calendar year 2011 for the Medicare EHR Incentive Program. • December 31, 2011 – Reporting year ends for eligible professionals. • February 29, 2012 – Last day for eligible professionals to register and attest to receive an Incentive Payment for calendar year (CY) 2011.
2015 Payment Adjustments Begin Reduction in reimbursement if meaningful use of certified EHR technology is NOT successfully demonstrated • 2015 – 99% of Medicare FFS covered amount • 2016 – 98% of Medicare FFS covered amount • 2017 – 97% of Medicare FFS covered amount • 2018 – if determined, payment adjustment can occur by 1% point each year until payment adjustment reaches 95%
Resources • CMS Web Site for the Medicare and Medicaid EHR Incentive Program www.cms.gov/EHRIncentivePrograms • Meaningful Use Measures Links http://www.cms.gov/EHRIncentivePrograms/Downloads/EP-MU-TOC.pdf • ERx Manual • http://www.trailblazerhealth.com/Publications/Training%20Manual/E-Prescribing.pdf • Georgia HITREC • http://www.ga-hitrec.org/gahitrec/ • We have 4 mid-level providers that are billed incident to the physician for the most part. We have a EHR and are going for meaningful use. Is it necessary for them to fill out a hardship waiver for the electronic prescriptions since they do less than 100 prescriptions/yr under their own billing #s.
EDUCATION – GA-HITREC.ORG PROMO CODE - HITREC
Q&A The patient should be on the forefront of every decision you make
Regional Extension Center Your Meaningful Use Expert Resource. Contact us today! For More information go to: www.ga-hitrec.org This presentation is compliments of www.IowaHITREC.org In Partnership with: The Office of the National Coordinator for Health Information Technology (ONC) U.S. Department of Health and Human Services grant 90RC0004/01. IA-HITREC-03/11-219
