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Dr Berger’s Entrance. Dr Berger Introduction. Hello … I’m Dr. John Berger. I would like to share with you a recent Meaningful Use experience that gave me a little heartburn …. Dr Berger comments 1. We have a small clinic … only 10 physicians. - PowerPoint PPT Presentation

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Page 1: Dr Berger’s Entrance

Dr Berger’s Entrance

Page 2: Dr Berger’s Entrance

Hello … I’m Dr. John Berger.

I would like to share with you a recent Meaningful Use experience that gave me a little heartburn …

Page 3: Dr Berger’s Entrance

We have a small clinic … only 10 physicians.

About a month ago, we received notice that one of our physicians

would be audited by CMS regarding their 2011 Meaningful

Use Attestation.

Page 4: Dr Berger’s Entrance

No worries.

We use a certified EHR product. Our vendor took

care of us.

Page 5: Dr Berger’s Entrance

Dr Berger Comments 3

What we found out was ….

… all was not so simple as we thought.

Page 6: Dr Berger’s Entrance

Dr Berger Comments 3

Let me share with you the

conversations we had along the way.

Page 7: Dr Berger’s Entrance

Dr Berger animation

Page 8: Dr Berger’s Entrance

Here’s the call from the auditor

Page 9: Dr Berger’s Entrance

Hello, Dr. Berger. We’ll be auditing your 2011

Meaningful Use attestation, for which you received

$18,000.

Page 10: Dr Berger’s Entrance

Please provide documentation proving that you fulfilled all criteria, were using Certified EHR Technology, and were an eligible, non-hospital-based

Medicare provider during the 2011 reporting period.

Page 11: Dr Berger’s Entrance

So I called our Office manager to start the process.

Page 12: Dr Berger’s Entrance

Jackie, please arrange

everything the auditor

needs.

Introduction – Jackie Ford, Requirements Manager

Page 13: Dr Berger’s Entrance

I’ll start running the reports right away.

We have upgraded our EHR since 2011, so we

should be in good shape.

Page 14: Dr Berger’s Entrance

That’s when the trouble began

Page 15: Dr Berger’s Entrance

I got a call from our EHR vendor,

after Jackie asked them to help out.

Page 16: Dr Berger’s Entrance

Hello, Dr. Berger.

You realize that we can’t really re-run 2011 reports, right?

Page 17: Dr Berger’s Entrance

For one thing, you are now on the 2013 version of our software, and

those reports have changed.

Page 18: Dr Berger’s Entrance

… and even if we could do exactly the same reports, the patient data

has changed, too.

For example, there’s no way we could identify whether “smoking

status” was updated for any patient in 2011 … if you’ve seen that

patient since then and updated their records. We only have current

values.

Page 19: Dr Berger’s Entrance

That was a shock. But it got worse.

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It seems our EHR creates reports against 16 percentage based

measures. But …

Page 21: Dr Berger’s Entrance

There are another nine items the auditors want to

see and there are no reports at all from the EHR

on those.

Page 22: Dr Berger’s Entrance

They want proof that we followed a clinical decision

support rule, integrated with the hospital and tested the

EHR’s ability to do electronic syndromic surveillance. We don’t have reports for those.

Page 23: Dr Berger’s Entrance

Next, I got a call from our

IT consultant.

Page 24: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

Uhhh … Dr. Berger?

The auditors want a copy of a HIPAA privacy and security

review.

But the EHR vendor told us that if we were using their Certified Product, we were

covered for HIPAA

Page 25: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

Now the auditor says that is not enough. We need a copy of the “Privacy and Security

Review” from 2011.

… and we didn’t do anything like that.

Page 26: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

I’m really sorry.

And, one more thing …

Page 27: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

Remember how we were trying to save some money in 2011?

And we decided not to by the extra Lab module? Well … we found out that the Lab module

had to be part of the EHR in order for us to really be

“Certified”

Page 28: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

So, even though we bought it in 2012, we were not certified in 2011, even though we thought

we were.

Page 29: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

We thought we were good. We bought the Certified product after all … just not all of it.

And the auditor says that’s not good enough.

I’m really sorry. It is a great EHR, though.

So why didn’t

someone tell us???

Page 30: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

Thing is … he’s right.

It is a great EHR. But I counted on them for Meaningful Use, and that just didn’t work

out.

Page 31: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

In the end, the auditors identified seven

deficiencies , any one of which would have disallowed our 2011

attestation.

Page 32: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

So I had to write a check to CMS to repay the $18k

stimulus money I received in 2011.

Talk about disappointment. I was hopping mad.

Page 33: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

These regulations are complicated.

Someone should have told me.

Page 34: Dr Berger’s Entrance

Introduction – Ron Holmes, Quality Manager

Since then, we’ve taken some corrective actions so our other providers don’t

get hurt.

Take a look at these “Lessons Learned”

Page 35: Dr Berger’s Entrance

Lesson 1: You can’t change the past!

Meaningful Use Audits are against a prior year, and you can’t create documentation you didn’t save in

the first place.

Page 36: Dr Berger’s Entrance

Lesson 2: Your EHR Vendor cannot do it all

You have to document a number of actions, decisions and tests that don’t come from your

EHR’s reporting tools.

Page 37: Dr Berger’s Entrance

Lesson 3: The regulations are not simple

Find some good expertise, and ask questions frequently. Get some formal training.

Page 38: Dr Berger’s Entrance

Lesson 4: Attestation and payment are not the “End Game”

Audits can occur for several years after you’ve received your money, and you need to retain

documentation of each single year. Just like income taxes.

Page 39: Dr Berger’s Entrance

Dr Berger’s Wrap up 3

So that’s the story of our CMS Audit, and what we learned.

Page 40: Dr Berger’s Entrance

Dr Berger’s Wrap up 3

Since then, our EHR vendor has made some really positive changes.

They now provide us something called the

Meaningful Use Monitor

And it gives us the formal expertise and tools to withstand an audit.

I highly recommend you take a look at it, so you don’t have the bad experience we

did.

Page 41: Dr Berger’s Entrance

Dr Berger’s Wrap up 3

Be sure to check out

Meaningful Use

Monitor!

Page 42: Dr Berger’s Entrance

Jay Fisher414-640-2817

[email protected]

Chris Coleman414-640-2817

[email protected]

Contacts

http://MeaningfulUseMonitor.com