Meaningful Use Update

1. Meaningful Use Update Cynthia Dane Judy Varela 7/18/11

2. MU Questions are Welcome at Anytime During Today’s Presentation

3. Today’s Agenda: • Review of “general” homework materials – 10 Minutes, Cynthia • Stage 2 and Burning Issues Log on MU COP – 5 Minutes, Judy • Closer look at 6 objectives with questions from staff – 45 Minutes • Capability to exchange key clinical information – Cynthia • Provide Clinical Summaries – JV • Provide Patients with e-copy of their health Info – JV • Computerized Provider Order Entry (CPOE) – JV • E-Prescribing – Cynthia • Record Demographics – Cynthia

4. Review of General CMS FAQ’s from Homework

5. 3 Main Points to take away from General FAQ’s: • 50% Rule for EPs practicing in multiple locations • MU Reports can be pulled from various, uncertified products but CQM reports MUST come from certified technology • Certified technology MUST be used to demonstrate MU (to capture the structured data)

6. Stage 2 of Meaningful Use

7. Stage 2 Meaningful Use Update • Final Policy Committee Recommendation: • Continue to allow attestation to Stage I in FY/CY 2013 • Recommendation accepted by FarzadMostashari, National HIT Coordinator • Though this is not an official rule, it indicates that federal policymakers will fully consider the advisory committee’s recommendation

8. Timing of EHR Certification and MU Stage Objectives

9. Burning Issues Log on the HITRC Portal

10. Burning Issues Page

11. Points to Note about the BI log • Questions should be submitted by the MU coordinators • BIW meets every Wednesday afternoon, turn around time is usually less than one week • We forward the questions that need additional guidance to Allen Traylor (ONC) and have a discussion with him every Friday

12. Watching a Page

13. Meaningful Use Objectives

14. Core 14: Exchange Key Clinical Information (aka Health Information Exchange) To meet the measure of this objective a provider must: • Use certified EHR technology to generate a continuity of care document (CCD)/continuity of care record (CCR) • Electronically transmit the CCD/CCR.

15. Core 14: Exchange Key Clinical Information(aka Health Information Exchange) To complete step 2, an eligible professional, eligible hospital, or critical access hospital may use any means of electronic transmission according to any transport standard(s) (SMTP, FTP, REST, SOAP, etc.) regardless of whether it was included by an EHR technology developer as part of the certified EHR technology in the eligible professional’s, eligible hospital’s, or critical access hospital’s possession.

16. Transmitting KCI for Core 14: • Acceptable Means of transmitting • Secure Email • “normal email” with test data only • FTP with test data • HIE if routed to a specific , intended provider • Unacceptable Means of transmitting • No portable medium (CD, USB, etc.) • General HIE Mailbox • E-faxing • Paper or Phone call with CCD information

17. MCEITA’s recommended approach to completing Core 14: • Contact the EHR vendor for confirmation of how system met this certification objective • Transmit dummy data from the live system to avoid the need for a patient authorization before completing the test • If email is the transmission method, be sure to have the provider encrypt the data • The test must be completed once from each practice location before the end of the EHR reporting period • Supporting documentation will be needed in case of an audit

18. Provide Clinical Summaries • Ability to provide to patient at check out depends on point of care documentation by the provider • Waiver statement needs to be added identifying the patient’s responsibility to maintain privacy when provided their health information • May need to be tracked manually, depending on product

19. Providing patients with e-copies of their health information • May need to track manually to capture compliance with the turn around time of 3 business days • Requests for electronic copies can come in any form (USPS, fax, walk in) • Waiver needed here too

20. CPOE • Medication order must be entered into the EHR by a licensed professional (according to state law) who can exercise clinical judgment and respond to any interaction alerts or CDS messages the order may generate • Should be entered by the licensed professional at time it becomes part of patients record • Need for documented protocols

21. Alternate Denominator Calculation if all 3 conditions apply to EP: • Prescribes more than 100 during EHR reporting period • Med lists include meds ordered by others • Calculated threshold is less than 30% Can opt to limit denominator cases to only those patients for which the EP has previously ordered meds

22. E-Prescribing (eRx) • Permissible prescriptions identified prior to Jan 13 changes (2-5) • Paper prescriptions get counted in denominator • Numerator does not include faxes from EHR • Faxing to pharmacy from HUB is permissible

23. Recording Demographics • Begin collecting now by modifying patient info sheet/face sheet used to input data into PM system (add Race, Ethnicity and Preferred Language questions) • Additional items to begin collecting via the patient info sheet: patient’semail address – for pt portal (M5) patient’s preferred pharmacy – eRx (C4) preferred method of communication – reminders (M4)