Meaningful Use 2015 Measures 22 October 2015

11:00 am

Presented by: Sarah Leake MBA, CPEHR

Co-Host: Susan Clarke HCISPP

1

Thank you for spending your valuable time with us today.

A copy of today’s presentation and the webinar recording will be available on our website. A link to these resources will be emailed to you following the presentation.

We would greatly appreciate your providing us feedback by completing the survey at the end of the webinar today.

2

The goal of this session is to review the 2015 Meaningful Use Requirements focusing on the changes.

It will identify important considerations and actions to take now.

Review of MU measures, but detail in suggested resources.

Answers to submitted questions.

3

Mountain-Pacific holds the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO) contract for the states of Montana, Wyoming, Alaska and Hawaii, providing quality improvement assistance.

HTS, a department of MPQHF, has assisted 1480 providers and 50 Critical Access Hospitals to reach Meaningful Use. We also assist healthcare facilities with utilizing Health Information Technology (HIT) to improve health care, quality, efficiency and outcomes.

4

The presenter is not an attorney and the information provided is the

presenter(s)’ opinion and should not be taken as legal advice. The

information is presented for informational purposes only.

Compliance with regulations can involve legal subject matter with serious

consequences. The information contained in the webinar(s) and related

materials (including, but not limited to, recordings, handouts, and

presentation documents) is not intended to constitute legal advice or the

rendering of legal, consulting or other professional services of any kind.

Users of the webinar(s) and webinar materials should not in any manner

rely upon or construe the information as legal, or other professional advice.

Users should seek the services of a competent legal or other professional

before acting, or failing to act, based upon the information contained in the

webinar(s) in order to ascertain what is may be best for the users individual

needs.

5

Sarah Leake

Sarah Leake, MBA, CPEHR

QR/PR Specialist, MU, PQRS, PM

6

Meaningful Use for 2015 – Overview

Key Considerations

Actions to take now

Questions and Discussion

7

Restructured Stage 1 and Stage 2 Objectives and Measures to align with Stage 3

One set of Required Objectives

EHR Reporting Period Aligns with Calendar Year

2015 – any 90 consecutive days reporting

Modified 2 Patient Engagement objectives that require “patient action”

Removed duplicative, redundant and topped out measures

CQM reporting remains the same

8

CMS Final Rule encompasses EHR Incentive Programs in 2015 through 2017 called “Modified Stage 2” and Stage 3 in 2018

No longer the Stage/Year Concept ◦ 2015-2017 is Modified Stage 2

Alternate Exclusions and Specifications are available for Providers scheduled for Stage 1 in 2015. Optional to use these

Exclusions are available for the Modified Stage 2 measures under certain quotas or circumstances

9

10

(from EHR Incentive program 2015-2017 Tip Sheet)

11

Goal to report to the MODIFIED STAGE 2

Based on Calendar Year ◦ 2015 – continuous 90-day period

◦ 2016 – Full Year (if not first year of attestation)

◦ 2017 – full year (if Modified Stage 2) or

90 day period (if you choose Stage 3)

EHR Technology Used ◦ 2015 use 2014 Certified Edition

◦ 2016 & 2017 – Choose 2014 or 2015 Certified Edition

12

Patient Electronic Access WAS >5%

NOW “at least 1 patient seen by the EP or Hospital” views, downloads or transmits his or her information.”

◦ This must be 1 patient for EACH PROVIDER

Secure Electronic Messaging (EP Only) WAS >5%

NOW “capability for patients to send and receive a secure electronic message with the EP was fully enabled during the EHR reporting period ” Y/N

13

Criteria Provider Hospital/CAH

Objectives 10 9

# Public Health Measures 2 3

CQMs (measures/domains) 9/3 16

Reporting Period continuous

90 day continuous

90 day

14

Finalized!

15

1. Protect Patient Health Information: Protect electronic health information created or maintained by the CEHRT through the implementation of appropriate technical capabilities. Security Risk Analysis each Year

2. Clinical Decision Support (CDS): Use clinical decision support rules to improve performance on high priority health conditions. Measure 1: Implement five clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period. Measure 2: Enabled the functionality of Drug/Drug, Drug/Allergy checks for entire reporting period.

16

3. Computerized Provider Order Entry (CPOE): Use computerized provider order entry for medication, laboratory, and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local, and professional guidelines.

Measures: More than 60% medication, 30% laboratory and 30% radiology created using CPOE

4. Electronic Prescribing: (EPs) Generate and transmit permissible prescriptions electronically (eRx); (Eligible hospitals/CAHs) Generate and transmit permissible discharge prescriptions electronically (eRx).

Measure: EPs >50%, Hospitals and CAHs >10%

17

5. Health Information Exchange: The EP, eligible hospital or CAH who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care provides a summary care record for each transition of care or referral.

Measure: 1) use CEHRT to create a summary of care record; and (2) electronically transmit such summary to a receiving provider for more than 10 percent of transitions of care and referrals

18

6. Patient Specific Education: Use clinically relevant information from CEHRT to identify patient specific education resources and provide those resources to the patient.

Measure: >10 percent of all unique patients with office visits seen by the EP, or admitted to the EH, IP or ER are provided education

7. Medication Reconciliation: The EP, eligible hospital, or CAH who receives a patient from another setting of care or provider of care or believes an encounter is relevant performs medication reconciliation.

Measure: Medication reconciliation is performed for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP or admitted to the eligible hospital's or CAH's inpatient or emergency department (POS 21 or 23).

19

8. Patient Electronic Access: (EPs) Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP. (Eligible hospitals/CAHs) Provide patients the ability to view online, download, and transmit their health information within 36 hours of hospital discharge.

Measure 1: 50% of unique patients must have access to online health information.

Measure 2: at least one patient seen by the provider or discharged from IP or ER during the reporting period views, downloads or transmits health information.

**2017 will be >5% of unique patients seen by EP

20

9. Secure Electronic Messaging (EPs only): Use secure electronic messaging to communicate with patients on relevant health information. Measure:

2015 – capability is fully enabled during the entire reporting period)

2016 – a secure message was sent by provider for at least 1 patient

2017 - a secure message was sent for >5% patients seen

10. Public Health and Clinical Data Reporting: The EP, eligible hospital or CAH is in active engagement with a public health agency to submit electronic public health data from CEHRT, except where prohibited and in accordance with applicable law and practice. (more explanation on next page)

21

Providers choose 2 of 3 measures, Hospitals need 3 of 4 measures

Registries to choose from: 1. Immunization registry

2. Syndromic surveillance reporting

3. Specialty registry reporting

4. Electronic reportable lab (hospital only)

Active Engagement with Public Health reporting

22

2015 MU requirement is to report CQMs for 90 Days, No Threshold

23

Reporting Options Provider Hospital/CAH

Reporting Measure Requirements 9 measures/ 3 domains

16 Measures

Continuous 90 day period when you attest

MU MU

Full year through PQRS electronically MU, PQRS NA

1Q, 2Q, 3Q Electronically QualityNet NA MU, IQR, OQR

For an EHR reporting period in 2015, an eligible hospital or CAH must attest by February 29, 2016 .

Despite the change to a 90-day EHR reporting period in 2015, providers will not be able to attest to meaningful use for an EHR reporting period in 2015 prior to January 4, 2016.

24

25

Confirm Providers that are Eligible for MU ◦ Confirm Program

Can no Longer switch between programs

Medicare, (if first year) has no incentive but can receive penalty in 2016 and 2017 if not reporting in 2015

◦ Confirm Practice Location(s)

Must combine num/den

Y/N must be met at each location

Ensure Providers are Registered and Active in CMS EHR Registration Site (NLR) and State Level Registries (SLR) for Medicaid ◦ May need to activate in Pecos (this can take time!)

26

Verify your EHR technology is Certified to 2014 Edition ◦ Certified Health IT Product List (CHPL) website here

Make sure these are Configured and ON ◦ CPOE

◦ Drug/Drug, Drug/Allergy Interaction checks **

◦ FIVE Clinical Decision Support Rules **

◦ Health Information Exchange for Summary of Care Transition

◦ Patient Portal **

◦ Direct Messaging (EP) **

** DOCUMENT these are Configured

from Day 1 or Now. 27

Coordinate and complete a Security Risk Analysis - within the 90 Day reporting period

Must begin active engagement with a Public Health Agency no later than 60 days from the start date of the reporting period ◦ If 90 Day start is Oct 1, 2015 need to contact the State

Registries by Nov 29, 2015

◦ “Registration of Intent” with DPHHS

◦ Active engagement can be completing registration to start conversation, then receiving and retaining the acknowledgment of your registration

28

http://dphhs.mt.gov/publichealth/meaningfuluse.aspx

http://wyomingincentive.wyo.gov/registration-intent

Identify >30% Medicaid patient volume for 90-365 days in qualifying period ◦ Document

Note: ◦ First year still can be AIU but,

◦ if provider is dual eligible, Medicare payment adjustment will apply

29

Run your MU and CQM reports for the “Modified Stage 2” and CQMs from 2014 Certified EHR ◦ For all locations a provider practices in (they need

to be combined)

Monitor and Verify accuracy of MU reports/data

Determine the MU Gap for each provider Identify Measures not met, investigate reason and

modify workflows

30

With the new rules do you still pick either OBS, IP and swing bed or ER for your patient population? I don’t see anything specific and I do see that several of the objectives state “discharged from the Inpatient and ER. “ - We have found no change in the method for selecting your patient population. The objectives state IP or ED for every measure.

How could you prove that Secure Messaging was turned on during the entire reporting period? - Gather documentation/ screenshots that you may have regarding Go-Live prior to or on Oct 1

What are requirements for successfully attesting to Public Health Measures? Please see slide 27

31

If an EP, eligible hospital or Critical Access Hospital (CAH) is unable to effectively plan for a reporting period in 2015 due to the timing of the publication of the 2015 through 2017 Modifications final rule, can they apply for a hardship exception? Yes, if a provider is unable to meet the requirements of meaningful use for an EHR reporting period in 2015 for reasons related to the timing of the publication of the final rule, a provider may apply for a hardship exception under the "extreme and uncontrollable" circumstances category. Each hardship exception application will be reviewed on a case-by-case basis, as required by law.

In the past, CMS has considered these applications seriously and, in fact, has approved over 85% of hardship exemptions. Hardship applications will be available in early 2016 on https://www.cms.gov/EHRIncentivePrograms

32

Determine if providers practice in more than one location

Calculate and document Medicaid Eligibility

Confirm EHR version is 2014

Determine Stage of MU for each provider

Verify EP registration info in PECOS, NLR and SLR if Medicaid

Verify EHR configurations and functionality

“Actively Engage” for the Public Health Measures (2 for EPs or 3 for Hospital/CAH)

33

Determine MU Gap

Monitor MU performance and adjust workflows

Choose MU reporting period

Take screenshots needed for CMS Audit

Perform or Update Security Risk Assessment

Meet MU

Attest

Finalize CMS MU Audit folder documentation

34

Register for our upcoming webinars and check out the resources used today: www.healthtechnologyservice.com HTS HOSTED PUBLIC WEBINARS:

Wednesday, Nov 4 1-2pm MDT *MU 2015 Step by Step to Attestation

Wednesday, Dec 16 2-3pm MDT *Patient Engagement

OTHERS WEBINARS OF INTEREST:

Tuesday, Nov 3, 1-2pm MDT *Unleashing the Power of Data (QualityNet eUniversity))

Thursday, Nov 19, 11:30am-12:30pm MDT *2015 PQRS Reporting Requirements (QualityNet eUniversity))

35

Quality Reporting Program Assistance

*PQRS & Value-Based Modifier for Providers, HIQR for Hospitals

Meaningful Use *Avoiding payment adjustments *Stage 1 and Stage 2 assistance for EH or EPs

*2015 Meaningful Use Requirements

Security Risk Assessments *Basic or Comprehensive SRAs

HIT Consulting and Project Management

*Assistance with interfaces, HIE, etc.

Combined Services

*Year long assistance with Meaningful Use, PQRS/IQR and ICD-10

HTS services and pricing can be found on our website:

36

www.healthtechnologyservice.com

2015 EHR CMS Link https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/2015ProgramRequirements.html

CMS 10/8/2015 Webinar: EHR Incentive Programs Final Rule Overview and What You Need to Know for 2015

◦ PDF Presentation

◦ Webinar Recording

EHR for Eligible Professionals: What You Need to Know for 2015 Tip sheet

EHR for Eligible Hospitals and CAHs: What You Need to Know for 2015 Tipsheet

EHR Incentive Programs in 2015-2017 Overview Fact Sheet

FAQ Page Top Questions https://questions.cms.gov/

37

38

Please complete our survey

after the webinar!

What further Topics or Areas you would like to explore or have interactive sessions regarding MU, QRUR, PQRS, VBM ?