MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
• MU 2014 updates; Must know changes!
• MU 2014 support; Do it right, from the start!
• Choose the right EHR… the right way
• The “Must Do!” MU list for 2014
• Success stories, links, and our popular “Ten Tips” for MU Success in 2014
Inside you will find:CLICK ON TITLES TO NAVIGATE
The now tips, the how tools, and the must timing for your MU path in 2014.
Meaningful Use in 2014 - Window of Opportunity
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
Is your window of opportunity closing?
This new eBook will show you how to start Meaningful Use (MU) in 2014... or keep going with it... before the window closes. Learn the important MU Stage 1 and MU Stage 2 changes for this year.?Table of Contents
Introduction Don’t miss your MU window!
Chapter 1 MU 2014 – Updates
Chapter 2 MU 2014 – What
Chapter 3 MU 2014 – How
Chapter 4 MU Success Stories
Chapter 5 MU 2014 Tool Box – Ten Tips!
CLICK ON TITLES TO NAVIGATE
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
Introduction
Don’t miss your MU window in 2014!Your MU window of opportunity is still open. But it’s starting to close. Especially if you’re planning to participate in the Medicare MU program.
The tools and support you use in 2014 to make the changes you need to achieve MU Stage 1, and now Stage 2, should – more than ever – enable you to adapt and thrive in this year of MU expansion, continued ICD-10 transition, HIPAA regulation, and PQRS compliance.
The CMS EHR Incentive Programs help offset costs to acquire or upgrade to the certified EHR technology you need to achieve better workflows, patient outcomes, and financial results in today’s reform-driven healthcare economy.
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
What are the MU Stages?
HITECH envisioned a three-stage process for Meaningful Use. Each stage has a goal and its own final rule—a set of objectives developed by the Department of Health and Human Services (HHS) and published in the Federal Register.
MU Stages
Began in
2011
STAGE
1
Capture data in coded format
Began in
2014
STAGE
2
Expand exchange of information in the most structured
format possible
Begins in
2017
STAGE
3
Focus on clinical decision
support for high-priority conditions, patient self-
management, and access to
comprehensive data
Who is this program for?
Medicare Eligible Professionals (EPs)
• Doctor of medicine or osteopathy
• Doctor of dental surgery or dental medicine
• Doctor of podiatry
• Doctor of optometry
• Chiropractor
Medicaid Eligible Professionals (EPs)
• Physicians (primarily doctors of medicine and doctors of osteopathy)
• Nurse practitioner
• Certified nurse/midwife
• Dentist
• Physician Assistant (PA) who furnishes services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant.
Eligible Hospitals (EHs)
Critical Access Hospitals (CAHs)
Learn more about eligibility here
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
Chapter 1. MU 2014 – Updates
The “must-know updates” for MU in 2014... and beyondDelays and Extensions
Along the way, there have been some changes to the MU timeline. First, as part of the Stage 2 final rule, announced in September 2012, and then in December 2013. Here’s what you must know about these changes.
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
STAGE1
STAGE2
STAGE3
MU Changes – 2014
• You will meet either Stage 1 or Stage 2 MU depending upon the year of your first MU reporting period:*
- Stage 2 if you started in 2011 or 2012
- Stage 1 if you started in 2013 or plan to start in 2014
• You still must attest to 90 days of MU in 2014:
- If you have previously attested to MU, your 2014 MU reporting period must align with a calendar quarter (e.g., January-March, April-June, etc.)
- You may choose any 90 days if 2014 is your first year of MU under Medicare, or if you are participating in the Medicaid MU program
• Penalties begin in 2015 if you have not done the following:
- Completed your 90 days by the end of calendar year 2014 (Continuing meaningful users)
- Attested by October 1, 2014 (First time meaningful users)
• Stage 3 MU has been delayed until 2017: With an additional year of
Stage 2 in 2016 for providers who started Stage 2 in 2014
* Good News: In 2014, regardless of your MU Stage you only report and attest for 90 days.
Did you know? EPs participate in MU in calendar years while EHs and CAHs participate according to the federal fiscal year.
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
Chapter 2. MU 2014 – What
The “must-dos” for MU in 2014Whether you are switching to a new EHR or implementing for the first time, you’ll need to go live in time to meet MU in 2014.
• To achieve MU, you’ll need to successfully meet an entire set of Core objectives and also select from a of set Menu objectives
• Core and Menu objectives are designed to measure your use of certified electronic health record technology (CEHRT) for things such as e-prescribing, clinical decision support, and reporting clinical quality measures (CQMs) to CMS
MU
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
National Quality Strategy (NQS) domains
1. Patient and Family Engagement
2. Patient Safety
3. Care Coordination
4. Population/Public Health
5. Efficient Use of Healthcare Resources
6. Clinical Process/Effectiveness
NQS domains represent the Department of Health and
Human Services’ (HHS) NQS priorities for a coordinated
national health care quality improvement platform.
Stage 1 and Stage 2 MU Objectives in 2014 and Beyond
Clinical Quality Measures (CQMs) in 2014 and Beyond
Meaningful Use Stage 2 is “live” right now! And the “final rule” for Stage 2 includes some changes to Stage 1. Keep going with your MU program and note these points:
• Most objectives have numerator/denominator measures
• Some are basic Yes/No responses
• All are reported through the CMS MU Incentive Program attestation
website or through your state’s Medicaid agency
• You’ll also need to choose from a new list of clinical quality measures
(CQMs) to report to CMS
• Beginning in 2014, you have two options for reporting CQMs:
Option 1: Report manually (as in prior years) as part of your MU
attestation using the EHR Registration & Attestation System
Option 2: Report electronically to CMS using the Physician
Quality Reporting System (PQRS) Portal
2014 AND BEYOND
Eligible Professionals
9 out of 64
- At least 3 in 6 NQS domains
Eligible Hospitals & CAHs
16 out of 29
- At least 3 in 6 NQS domains
STAGE 2
Eligible Professionals
17 core objectives
3 of 6 menu objectives
20 total objectives
Eligible Hospitals & CAHs
16 core objectives
3 of 6 menu objectives
19 total objectives
STAGE 1
Eligible Professionals
13 core objectives
5 of 9 menu objectives
18 total objectives
Eligible Hospitals & CAHs
14 core objectives
5 of 10 menu objectives
19 total objectives
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
But what’s in it for me?
Centers for Medicare and Medicaid Services (CMS) created two separate EHR Incentive Programs. Providers must choose one.• The Medicare EHR Incentive Program is run by CMS. Under the
Medicare incentive program providers can receive up to $44,000 over five years… that’s big bucks (a little less if you’re starting MU Stage 1 for the first time this year).
• The Medicaid EHR Incentive Program is administered by each state. If you qualify for the Medicaid incentives you can receive up to $63,750 over six years… that’s bigger bucks.
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
Chapter 3. MU 2014 – How
The “how to” for MU success in 2014Earning MU incentive revenue, and leveraging improved workflows to improve care and reduce costs, requires collaboration and partnership.
Partner with an EHR vendor that demonstrates, on several fronts, that their integrated suite of solutions is ready for MU Stage 2 and the transition to ICD-10.
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
Choose carefully.
• Picking the right EHR for your specialty and your individual practice is important. Finding the vendor that meets your most important needs is a lot like finding the right builder for your home. You check references, assess capabilities, and verify licenses or certifications before making a commitment.
• Selecting and implementing an EHR is a big commitment. Lofty expectations, broken promises, sub-standard products, lack of training, and lack of vendor resources are the main reasons some EHR vendor relationships just don’t work out.
• Making sure your vendor is a good fit, a good partner, and in it for the long haul is a critical success factor. And, by the way… partnership is a two-way street. You’ll need to commit time, effort, and resources, as well.
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
Chapter 4. MU Success Stories
Now You’re Talking!You’re probably feeling a little overwhelmed. Don’t worry…you aren’t alone. Every provider who has achieved and attested for Meaningful Use has been where you are right now.
But there’s hope! Read on to see how providers just like you have successfully achieved Meaningful Use.
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
…and client success stories…
In 2014, MU Stage 2 success requires making progress on key healthcare reform drivers like patient engagement, collaborative care and care transition, direct exchange of PHI, CPOE for orders, and using clinical decision support to improve patient safety and treatment outcomes.
Achieving Meaningful Use and Getting Paid
“It’s a real team effort with a greater purpose, though the incentive is nice, too. I gave my staff a bonus for all the hard work and I bought myself a new EKG!”
Dr. Steven DavisHealthCare Partners
Achieving Meaningful Use as a gateway to Collaborative Care
“NextGen provided the pathway to move us from PCMH to MU and now on to ACO, while ensuring continuity between the inpatient and outpatient experience.”
Kimberly Haspert, COO
New Pueblo Medicine
… and more MU Success!
See how these practices did it…
• New Jersey Health System Puts Docs On Path
To Meaningful Use
• Center for Family Medicine Earns Maximum
MU Incentive
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
MU ToolboxEssential links and information to help you on the path to MU.
CMS EHR Incentives Homepage
Certified Health IT Product List (CHPL)
NextGen Healthcare Updated MU FAQ
EHR Incentive Program Registration and Attestation
MU Stage 1 Objectives
MU Stage 2 Objectives
CMS Educational Resources for EHR
Every practice needs the tools and tips to help guide them on the path to Meaningful Use.
Chapter 5.
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
Register today!
• Register early, don’t wait… get this administrative task
out of the way
• You don’t need to have an EHR or EHR certification
number to register
• Go here: https://ehrincentives.cms.gov/hitech/login.action
Select the right certified product for your medical specialty and manner of practice
• 2014 is a mandatory software upgrade year for all EHR users to
an ONC 2014 Edition certified system or module. Partner with
a top-five vendor offering proven ONC 2014 Edition certified
solutions, training, and support, including extensive MU Stage 2
and ICD-10 transition assistance and information
• More than 50 percent of attestation made using top five vendors
• Consider workflow and clinical content for your specialty
• Choose a vendor for your specialty and practice that
addresses more than just MU and being ICD-10 ready; is their
ONC 2014 Edition certified solution also SNOMED-ready?
• Ensure vendor is stable, established, and proven, with a
solid strategy for the future
Build a Meaningful Use SWAT Team
• Build a cross-functional, dedicated MU team, consisting of physicians, other clinicians, administrative, and technical stakeholders
• Include an in-house MU subject matter expert, or consider a consultant
Become MU smart!
• Take advantage of learning opportunities
• Partner with your vendor; do they provide learning opportunities?
• Visit Medicare and Medicaid Incentive Program websites
• Attend local, regional, national, or virtual training
MU Toolbox
10 Tips
for Meaningful Use
1
2
3
4
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
Implement a Patient Portal
• Stage 1 and Stage 2 required, starting in 2014
• Integrate with EHR and practice management system
• Must be an ONC 2014 Edition certified solution
• Include a friendly but highly visible in-office (and Internet) patient portal “micro marketing” presence with patients to encourage sign-in and use
Deploy interfaces early
• Lab results must be entered or imported as structured data, a core requirement in Stage 2
• Must choose Immunization or Syndromic reporting in Stage 1
• Immunization reporting is a core requirement in Stage 2
• Syndromic, cancer, and specialty registries are Menu options in Stage 2.
• Interfaces to support exchange of health information (Stage 2 includes tougher interoperability requirements)
Perform GAP analysis, THEN ATTEST!
• Identify missing thresholds and corrective steps
• Perform attestation once you hit thresholds
• Document your results, protect against audit
Build an MU action plan
• Create a plan that’s understood and supported by providers, executives, administrators, and staff; get early buy-in from all physicians and staff
• Create and maintain a formal training schedule
• Include practice time prior to go-live
• Select a go-live period where patient volumes are less
Have an “MU ramp-up period”
• Implement and use your EHR for several weeks (prior to 90-day reporting)
• Focus on proper use of your EHR (not MU) but you’ll find you’re doing both just by using your EHR!
Choose your Clinical Quality Measures (CQMs) wisely
• Pick the CQMs most relevant and helpful to your practice
• MU Stage 2 requires nine out of 64 measures
• Three of six domains based on NQS six priorities:
1) Patient and Family Engagement; 2) Patient Safety; 3) Care Coordination; 4) Population and Public Health; 5) Efficient Use of Healthcare Resources; 6) Clinical Process/Effectiveness
6
7
8
9
5
10
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
MU Stage 2 went live this January and carries higher thresholds (than Stage 1) for demonstrating MU and introduces some new core and menu objectives. Changes to Stage 1 also took effect in January.
A new Stage 1 Core Objective, that replaces earlier patient engagement objectives (Core and Menu), requires you to provide a way for patients to view online, download, and transmit their own health data [… you’ll find this in Stage 2 as well, but with an additional measure for patient participation].
CMS also eliminated a Stage 1 interoperability requirement and dropped a core objective concerning Clinical Quality Measures (CQMs). You still have to report CQMs but there’s no core objective stating so, leaving 13 out of the original 15 Stage 1 core measures.
Core and Menu ObjectivesMU Stage 1 – 2014
Core
1. Use CPOE for medication orders
2. Implement drug-drug and drug-allergy interaction checks
3. Maintain a problem list
4. Use eRX
5. Maintain a medication list
6. Maintain a medication allergy list
7. Record demographics
8. Record vitals
9. Implement clinical decision support
10. Provide patients ability to view online, download, and transmit their health information
11. Record smoking status
12. Provide patients with clinical summaries
13. Protect health information
Menu
1. Implement drug formulary checks
2. Incorporate lab test results
3. Generate a list of patients by condition
4. Send patient reminders
5. Identify patient education
6. Perform medication reconciliation
7. Provide a summary of care record
8. Submit data to an immunization registry
9. Submit syndromic surveillance data to a public health agency
MU STAGES
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
Core and Menu ObjectivesMU Stage 2 – 2014
Core
1. Use CPOE for medication, laboratory and radiology orders
2. Use eRX
3. Record demographics
4. Record vitals
5. Record smoking status
6. Implement clinical decision support
7. Provide patients ability to view online, download, and transmit their health information
8. Provide patients with clinical summaries
9. Protect health information in the EHR
10. Incorporate lab test results
11. Generate a list of patients by condition
12. Send patient reminders
13. Identify patient education
14. Perform medication reconciliation
15. Provide a summary of care record
16. Submit data to an immunization registry
17. Use secure electronic messaging
Menu
1. Submit syndromic surveillance data to a public health agency
2. Record electronic notes
3. Access imaging results
4. Record family health history
5. Identify and report cancer cases
6. Identify and report specific cases to a specialized registry [non-cancer]
As of January 2014, more than 22,000 providers have already successfully attested for approximately $550 million in MU incentives using certified solutions from NextGen Healthcare*
* Based on ONC Medicare attestation data by vendor and an estimate of NextGen Healthcare Medicaid attestations as a percentage of overall Medicaid attestations as reported by CMS
MU UPDATES | MU WHAT | MU HOW | MU SUCCESS STORIES | MU TOOLBOX
NextGen Healthcare Information Systems, LLC 795 Horsham Road, Horsham, PA 19044
Copyright© 2014 NextGen Healthcare Information Systems, LLC All rights reserved. NextGen is a registered trademark of QSI Management, LLC, an affiliate of NextGen Healthcare Information Systems, LLC. All other names and marks are the property of their respective owners.
Take the next step.
Contact us at 855-510-6398 Or visit nextgen.com
EDU6-4/14
MU Bonus Tip!Think Big Picture
• Embrace the journey
• Health reform is driving automation and change
• Pay for Performance replacing Fee-for-Service
• Keep things in perspective; keep things positive
• Prepare for change…and change