Meaningful Use WebinarMeet the updated requirements successfully with Practice Fusion

2

History

+ Meaningful Use program was created in 2009 from the HITECH Act as part of the American Reinvestment and Recovery Act

+ MU started in 2011, and was designed to have 3 stages

2

Stage 1

Stage 2

Stage 3

Data capture and

sharing

Advanceclinical

processesImprovedoutcomes

3

Background

+ The Center for Medicare and Medicaid Services (CMS) recently finalized Stage 3 requirements

+ CMS decided to also change existing Stage 1 and Stage 2 requirements Didn’t align with Stage 3 Provider feedback and poor Stage 2 performance

3

4

Top 5 Changes to MU

1) Every provider will now be completing a 90-day reporting period for the 2015 reporting year.

2) All providers are now in Stage 2 of Meaningful Use — with a “Modified Stage 2” for providers that were previously in Stage 1.

3) The core and menu measures have been simplified into 10 “Objectives.”

4) The Stage 2 measures that required patient engagement have been greatly reduced.

5) Many data-entry measures have been eliminated.

5

Reporting Periods

+ All providers in 2015 complete a 90 day reporting period+ Full year reporting periods resume in 2016+ Any first year Medicaid participant completes a 90 day reporting period+ A first year Medicare participant will complete a 90 day reporting period

in 2015 and 2016

6

Modified Stages

+ Stage 2 providers remain in Stage 2 for 2015 and 2016

+ Stage 1 providers are in “Modified Stage 2” for 2015 and Stage 2 in 2016

+ All providers can choose to complete Stage 3 in 2017 or remain in Stage 2

+ Stage 3 is mandatory for all in 2018

7

Objective 1: Protect Patient Health Information

Stage 2 Measure “Modified Stage 2” OptionConduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1) and correct identified security deficiencies as part of the provider’s risk management process.

None, must meet Stage 2 measure.

8

Objective 2: Clinical Decision Support

Stage 2 Measure “Modified Stage 2” OptionMeasure 1: Implement 5 clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire reporting period. 

Implement 1 clinical decision support intervention.

Measure 2: Enable functionality for drug-drug and drug-allergy interaction checks for the entire reporting period.

None, must meet Stage 2 measure.

9

Objective 3: Computerized Provider Order Entry (CPOE)

Stage 2 Measure “Modified Stage 2” OptionUse computerized provider order entry (CPOE) to record the following items during your reporting period:Measure 1: More than 60% of medication orders

Use computerized provider order entry (CPOE) to record more than 30% of medication orders during the reporting period.

Measure 2: More than 30% of lab orders

Exclusion because no Stage 1 equivalent.

Measure 3: More than 30% of radiology orders

Exclusion because no Stage 1 equivalent.

10

Objective 4: Electronic Prescribing

Stage 2 Measure “Modified Stage 2” OptionMore than 50% of all permissible prescriptions written are queried for a drug formulary and transmitted electronically.

More than 40% of all permissible prescriptions written are queried for a drug formulary and transmitted electronically.

11

Objective 5: Health Information Exchange

Stage 2 Measure “Modified Stage 2” OptionCreate and provide an electronic summary of care record for more than 10% of transitions to another setting or provider of care.

Exclusion because no Stage 1 equivalent.

12

Objective 6: Patient-Specific Education

Stage 2 Measure “Modified Stage 2” OptionProvide patient-specific education resources identified by the EHR for more than 10% of all unique patients with office visits seen during the reporting period.

Exclusion if provider didn’t intend to report the Stage 1 menu measure.

13

Objective 7: Medication Reconciliation

Stage 2 Measure “Modified Stage 2” OptionPerform medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into your care.

Alternate exclusion if provider didn’t intend to report the Stage 1 menu measure.

14

Objective 8: Patient Electronic Access (VDT)

Stage 2 Measure “Modified Stage 2” OptionMeasure 1: Provide more than 50% of all unique patients seen during the reporting period timely access to view online, download, and transmit to a third party their health information.

None, must meet Stage 2 measure.

Measure 2: At least 1 patient seen by the provider during the reporting period views, downloads or transmits his or her health information to a third party during the reporting period.

Exclusion because no Stage 1 equivalent.

15

Objective 9: Secure Messaging

Stage 2 Measure “Modified Stage 2” OptionEnable the capability for patients to send and receive a secure electronic message with the provider.

Exclusion because no Stage 1 equivalent.

16

Objective 10: Public Health

Stage 2 Measure (Meet 2) “Modified Stage 2” Option (Meet 1)Measure 1: Immunization Registry ReportingThe provider is in active engagement with a immunization registry to submit immunization data.

Measure 1: Immunization Registry ReportingThe provider is in active engagement with a public health agency to submit data.

Measure 2: Syndromic Surveillance ReportingThe provider is in active engagement with a public health agency to submit syndromic surveillance data.

Measure 2: Syndromic Surveillance ReportingThe provider is in active engagement with a public health agency to submit syndromic surveillance data.

Measure 3: Specialized Registry ReportingThe provider is in active engagement to submit data to a specialized registry.

Measure 3: Specialized Registry ReportingThe provider is in active engagement to submit data to a specialized registry.

17

Objective 10 Public Health Exclusions

+ Immunization Registry Reporting Providers who administer immunizations should use Practice Fusion’s immunization

registry integration feature See the Knowledge Base article for more details

+ Syndromic Surveillance Reporting Exclusion: Is not in a category of providers from which ambulatory syndromic

surveillance data is collected by their jurisdiction's syndromic surveillance system Alternate Exclusion: If provider didn’t intend to attest to the menu measure

+ Specialized Registry Reporting Practice Fusion does not support (optional for certification) Providers may use electronic submission methods beyond the functions of CEHRT

to meet the requirements Alternate Exclusion: If provider didn’t intend to attest to the menu measure

+ Source: CMS FAQ

18

Removed Measures

+ Record Demographics+ Record Vital Signs+ Record Smoking Status+ Clinical Summaries + Structured Lab Results + Patient List + Patient Reminders 

+ Summary of Care  Measure 1 – Any

Method  Measure 3 – Test 

+ Electronic Notes + Imaging Results + Family Health History

19

Lab/Imaging Clarifications

+ Lab and Imaging Results Requirements Removed from MU

+ CPOE requirement retained as objective 30% of lab and imaging orders must be entered in EHR Orders do not need to be transmitted to count, just recorded Avoid duplicate entry by connecting to lab and imaging centers

for ordering

+ Patient Electronic Access Objective requires lab test results to be available to patients with 4 business days of the information being available to the provider

CQM Requirements in 2015

+ Requirement: Report at least 9 CQMs that relate to at least 3 National Quality Strategy (NQS) domains:

+ CMS selected 9 recommended CQMs for adult and pediatric populations Practice Fusion supports 9 recommended adult CQMs and

CQMs that cover all 6 NQS domains

Patient and Family Engagement Patient SafetyCare Coordination Population and Public HealthEfficient Use of Healthcare Resources Clinical Processes/Effectiveness

CQM Reporting Methods

+ Medicare EPs will submit CQMs to CMS electronically or via attestation

+ Medicaid EPs must submit CQM data to their State Medicaid Agency+ Reporting period: Entire calendar year if electronically, 90 days if via

attestation + Electronic submission for 2015: January 1, 2016 – February 29,

2016 Medicare EPs have the option to submit a full year of data electronically to

receive credit for the EHR Incentive Program and the Physician Quality Reporting System (PQRS) if using the PQRS EHR reporting mechanism.

22

Is Meaningful Use based on all patients?

+ You must record all patients you see, regardless of their insurance, in the outpatient setting for Meaningful Use.

+ If you see patients in the hospital, you do not need to include them in Practice Fusion for Meaningful Use.

+ At minimum, you must maintain more than 80% of your patients in the certified EHR for Meaningful Use.

23

Choosing an encounter type for Meaningful Use

+ In order to receive credit for Meaningful Use measures based on unique patients seen during the reporting period, you must sign a note with an encounter type of “Office visit,” “Home visit,” “Nursing Home visit,” or “Telemedicine visit.”

+ Only the provider who signs the note receives denominator credit.

24

Deadlines

+ October 3, 2015 The last possible start date for a 90 day reporting period in 2015

+ January 4, 2016 Providers can begin attesting

+ February 29, 2016 Attestation deadline

25

Reasons to Start Today and Use Practice Fusion

Medicaid eligible providers can still earn up to $63,750

Medicare eligible providers can avoid a 3% penalty in 2017

Practice Fusion is the only EHR that can quickly adapt to program changes

Resources Being Updated

Practice Fusion Blog• Practicefusion.com/blog

Meaningful Use Center• Practicefusion.com/meaningfuluse

Knowledge Base• knowledgebase.practicefusion.com

Meaningful Use Dashboard

27

Next Steps for Success

Sign up for e-Prescribing and

Labs

Chart all patients that

come into the office

Review Meaningful Use Dashboard to see progress

28

Thanks for your attention and engagementQuestions?