preparing for meaningful use stage 2
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By Bill Presley September 27, 2013
Transforming Data to Knowledge…
Preparing for Meaningful Use Stage 2
Significant Accomplishment for
Acmeware
Total Certified EHR Vendors
2011 Edition
2014 Edition
http://www.ihealthbeat.org/articles/2013/9/26/fewer-stage-2-certified-ehr-systems-could-pose-problems
OneView 2014 Edition Transition
Customer wants to know what the transition will be for the 2014 Edition?
OneView will need to be upgraded to 4.0 2014 Edition including changes for Core, Menu set and Clinical Quality measures. We are developing a 2014 Edition implementation project plan which will be available in October.
Agenda
Attestation Process for a Hospital
Attestation Process in OneView
Meaningful Use 2014 Edition
Stage 1 and Stage 2
Hospital Attestation Process
A successful and active Registration in the CMS website. https://ehrincentives.cms.gov
Completed the appropriate reporting period and met measures
Obtain EHR Certification Identification Number
Attest online!
Registration and Attestation
System
• Registration User Guide
• Step-by-Step guide for EH's. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/EHRHospital_RegistrationUserGuide.pdf
Registration and Attestation
System
• Attestation User Guide
• Step-by-Step guide for EH's. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/HospAttestationUserGuide.pdf
Registration and Attestation
System
• Timelines http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/HIT-Programs-Timeline-2012-.pdf
EHR Certification Identification
Number
CMS EHR Certification Identification Number is a number generated by the Certified Health IT Product List (CHPL) used for reporting to CMS for Meaningful Use attestation.
It represents a product or combination of products in the CHPL.
EHR Certification Identification
Number (Cont.)
Warning!!! Do not use the vendor product certification number.
EHR Certification Identification
Number (Cont.)
Each Hospital must obtain their your own unique CMS HER Certification ID from the Certified Health IT Product List website cart.
Steps to obtaining CMS EHR
Certification ID Number
• Visit Certified Health IT Product List website at http://oncchpl.force.com/ehrcert.
• Select which edition of ONC HIT EHR Certification are you attesting?
• Select the practice type by selecting the Ambulatory or Inpatient buttons.
Steps to obtaining CMS EHR
Certification ID Number (Cont.)
• Search for the Certified EHR Products being used. There is the option of browsing all products, searching by product name, number, vendor, or searching by criteria met.
Steps to obtaining CMS EHR
Certification ID Number (Cont.)
• Add product(s) to the cart to determine if your product(s) meet 100% of the required criteria.
Steps to obtaining CMS EHR
Certification ID Number (Cont.)
• Request a CMS EHR Certification ID for CMS registration or attestation from your cart page
Attestation Process with OneView
SQL Server Agent Job Disabled
Hospital Settings Updated
Attestation Locked
Alerts & Subscription Disabled
Audit Preparation with Supporting Documentation
SQL Server Agent Job Disabled
Disable job once Medical Records has completed coding and abstracting for the reporting period and hospital is ready to attest.
Hospital Settings
Hospital settings should be updated to include information for current reporting period
Attestation Locked
Start an Attestation under the Attestation section
Select appropriate reporting period
Everything should have green checks
Lock it when hospital is ready to attest
Attestation Locked
View Attestation Data Report
Alerts & Subscription Disabled
Delete all alerts and subscriptions
Audit Preparation with Supporting
Documentation
Relevant supporting documentation associated with a CQM, CM, or MSM Measure
MEDITECH screenshots
Payment calculations
ONC EHR licensing documentation
OneView Invoices
Meaningful Use 2014 Edition -
Stage 1 and Stage 2
Other Resources
Glen’s MUSE International 2013 a presentation EHR
Meaningful Use 2014 (Stage 2)
http://www.acmeware.com/downloads/EHR%20Meaningful%20Use%202014%20(Stage%202)%20DR%20Reporting%20Strategies.pdf
Meaningful Use 2014 Edition -
Stage 1 and Stage 2
EP, EH, CAH - What do they mean?
EP - Eligible Provider
Ambulatory/Clinic Typically Office Visit
Using Systems like AthenaHealth, eClinicalWorks, LSS
EH/CAH - Eligible Hospital/Critical Access Hospital
Inpatient and ED depending on method
2 Methods for ED
Observation Services method
All ED Visits method
https://questions.cms.gov/faq.php?id=5005&faqId=2843
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/critaccesshospfctsht.pdf
Stages of Meaningful Use
Editions not Stages
Do not confuse 2014 Edition with Stage 2
http://www.healthit.gov/policy-researchers-implementers/meaningful-use-stage-2
Stages of Meaningful Use
Stages of Meaningful Use
Stages of Meaningful Use
2014 Edition Stage 1 & Stage 2
All EH/CAH’s need to upgrade to 2014 Edition certified EHR technology in 2014
Regardless of the meaningful use stage
Requirements that update the baselines for interoperability, health information exchange (HIE), and patient engagement.
IMPORTANT! 2011 Edition will no longer be acceptable as
"Certified EHR Technology” and regulatory officials perspective 2011 Edition certifications will expire the start of 2014 MU reporting period.
2014 Edition Stage 1 & Stage 2
2014 Meaningful Use reporting period If first year was 2013 Stage 1 90 days, then 2014 will be
Stage 1 90 days.
The 2014 MU reporting period for both Stage 1 and Stage 2 is set to one calendar quarter during a Medicare EH/CAH reporting year. (e.g., April 1, 2014 through June 30, 2014 would be a
Medicare EH/CAH 3rd quarter)
2014 Edition Stage 1
Meaningful Use 2014 Edition starts a beginning of a reorganized Stage 1
• Some Core and Menu removed/combined
• No Longer Count Measure Exclusions
• Stage 1 Thresholds Increases
• View, Download, Transmit to 3rd Party more then 50% of unique patients
2014 Edition Stage 1
Changes between 2011 Stage 1 and 2013 Stage 1 Stage 1 Changes Tip sheet
http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage1ChangesTipsheet.pdf
2014 Edition Stage 2
• New Objectives & Measures
• Core Measures
• eMAR
• View Online, Download and Transmit
• Menu Set Measures
• Record electronic notes in patient records
• Imaging results accessible
• Record patient family health history
• Generate and transmit permissible discharge prescriptions electronically (eRx)
• Provide structured electronic lab results to ambulatory providers
2014 Edition Stage 2
Clinical Quality Measures for 2014
Select CQMs from 3 of these 6 domain
16 out of 29 total CQMs
CQM's must be submitted electronically to CMS
HL7 QRDA (Quality Reporting Document Architecture) has been approved as a standard for clinical data exchange for Quality Measures
CMS approved standardized Nomenclature
Clinical Quality Measures for 2014
• Introduction of universal identifier, eMeasure ID NQF# (VTE-1 = 0371)
• How will standardized nomenclature based code system work?
• Using Quality Data Model (QDM) with HL7 QRDA (Quality Reporting Document Architecture)
Venous Thromboembolism
Prophylaxis NQF#: 0371
Description:
This measure assesses the number of patients who received VTE prophylaxis or have documentation why no VTE
prophylaxis was given the day of or the day after hospital admission or surgery end date for surgeries that start the day
of or the day after hospital admission.
Data criteria (QDM Data Elements):
"Medication, Administered: Warfarin" using "Warfarin RxNorm Value Set (2.16.840.1.113883.3.117.1.7.1.232)“
"Medication, Administered: Direct Thrombin Inhibitor" using "Direct Thrombin Inhibitor RxNorm Value Set
(2.16.840.1.113883.3.117.1.7.1.205)"
"Medication, Administered: Injectable Factor Xa Inhibitor" using "Injectable Factor Xa Inhibitor RxNorm Value Set
(2.16.840.1.113883.3.117.1.7.1.211)"
"Medication, Administered: Low Molecular Weight Heparin" using "Low Molecular Weight Heparin RxNorm Value Set
(2.16.840.1.113883.3.117.1.7.1.219)"
"Medication, Administered: Oral Factor Xa Inhibitor" using "Oral Factor Xa Inhibitor RxNorm Value Set
(2.16.840.1.113883.3.117.1.7.1.134)"
"Medication, Administered: Unfractionated Heparin" using "Unfractionated Heparin RxNorm Value Set
(2.16.840.1.113883.3.117.1.7.1.218)"
Venous Thromboembolism
Prophylaxis - NQF#: 0371 Data criteria (QDM Data Elements):
"Medication, Administered: Warfarin" using "Warfarin RxNorm Value Set (2.16.840.1.113883.3.117.1.7.1.232)“
Value Set Table:
Venous Thromboembolism
Prophylaxis - NQF#: 0371 Data criteria (QDM Data Elements):
"Medication, Administered: Warfarin" using "Warfarin RxNorm Value Set (2.16.840.1.113883.3.117.1.7.1.232)“
"Medication, Administered: Direct Thrombin Inhibitor" using "Direct Thrombin Inhibitor RxNorm Value Set
(2.16.840.1.113883.3.117.1.7.1.205)"
"Medication, Administered: Injectable Factor Xa Inhibitor" using "Injectable Factor Xa Inhibitor RxNorm Value Set
(2.16.840.1.113883.3.117.1.7.1.211)"
"Medication, Administered: Low Molecular Weight Heparin" using "Low Molecular Weight Heparin RxNorm Value Set
(2.16.840.1.113883.3.117.1.7.1.219)"
"Medication, Administered: Oral Factor Xa Inhibitor" using "Oral Factor Xa Inhibitor RxNorm Value Set
(2.16.840.1.113883.3.117.1.7.1.134)"
"Medication, Administered: Unfractionated Heparin" using "Unfractionated Heparin RxNorm Value Set
(2.16.840.1.113883.3.117.1.7.1.218)"
Venous Thromboembolism
Prophylaxis - NQF#: 0371 Data criteria (QDM Data Elements):
"Medication, Administered: Warfarin" using "Warfarin RxNorm Value Set (2.16.840.1.113883.3.117.1.7.1.232)“
Value Set Table:
This shows a value set for a class of medications (Warfarin)
Venous Thromboembolism
Prophylaxis - NQF#: 0371 HL7 QRDA (XML File) Snippet for Patient Visit that meets NQF#: 0371
Electronic Transmission to CMS for
Quality Measures Reporting
Meaningful Use 2014 Edition
Why does 2014 Edition matter?
Don't get caught up in the incentive payments
• 2014 MU determines Medicare payment adjustments. http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/PaymentAdj_HardshipExcepTipsheetforHospitals.pdf
Discussion, Questions & Answers
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