Meaningful Use Measures Series – Session 2 Recording Patient Data in Certified EHR Technology

1. Meaningful Use Measures Series – Session 2Recording Patient Data in Certified EHR Technology

2. MU 3 Session Series Physician Meaningful Use 3 Session Series • Sept. 20 - Session #1  Drug, Medication, eRx related • Oct. 18 - Session #2  Recording Patient Data • Nov. 15 - Session #3  Interoperability, Exchanging Data Outside the Clinic Other Than to Patients TAKEAWAY: Use Your resources – GA-HITREC & HomeTown Health

3. 25 Objectives in 5 Priority Outcomes • Improving quality, safety, efficiency and reducing health disparities • Engage patients and families in their health care • Ensure adequate privacy and security protections for personal health information • Improve care coordination • Improving population and public health

4. 25 Objectives in 5 Priority Outcomes Stage I Meaningful Use for 2011 • – Eligible Professionals must complete: • 15 core objectives (e.g., maintain active medication list, etc.) • 5 objectives out of 10 from menu set (e.g., implement drug formulary checks, etc.) • 6 total Clinical Quality Measures(CQM) (3 core or alternate core, and 3 out of 38 from additional set)

5. Objective Requirements 15 Core Set Objectives • Eligible Professionals must meet all Core Objectives to qualify for incentive payments

6. Objective Requirements 10 Menu Set Objectives • Eligible Professionals will defer 5 Menu Objectives One of the remaining objectives must be from Improving population and public health priority

7. Measures Attestation

8. Exclusions

9. Defining Terms

10. Defining Terms

11. Defining Terms

12. Defining Terms

13. POLL QUESTION POLL QUESTION

14. Core Objective–Record Demographics

15. Attestation Requirements – Demographics The resulting percentage (Numerator ÷Denominator) must be more than 50 percent in order for an EP to meet this measure.

16. Additional Information – Demographics • Race and ethnicity codes should follow current federal standards published by the Office of Mgmt and Budget (http://www.whitehouse.gov/omb/inforeg_statpolicy/#dr). • If a patient declines to provide all or part of the demographic information, or if capturing a patient’s ethnicity or race is prohibited by state law, such a notation entered as structured data would count as an entry for purposes of meeting the measure. In regards to patients who do not know their ethnicity, EPs should treat these patients the same way as patients who decline to provide race or ethnicity—identify in the patient record that the patient declined to provide this information. • EPs are not required to communicate with the patient in his or her preferred language in order to meet the measure of this objective.

17. Core Objective – Record Vital Signs

18. Attestation Requirements – Vital Signs The resulting percentage (Numerator ÷Denominator) must be more than 50 percent in order for an EP to meet this measure.

19. Additional Information – Vital Signs • The provider is permitted, but not required, to limit the measure of this objective to those patients whose records are maintained using certified EHR technology. • The only information required to be inputted by the provider is the height, weight, and blood pressure of the patient. The certified EHR technology will calculate BMI and the growth chart if applicable to patient based on age. • Height, weight, and blood pressure do not have to be updated by the EP at every patient encounter. The EP can make the determination based on the patient’s individual circumstances as to whether height, weight, and blood pressure need to be updated. • Height, weight, and blood pressure can get into the patient’s medical record as structured data in a number of ways. Some examples include entry by the EP, entry by someone on the EP’s staff, transfer of the information electronically or otherwise from another provider.

20. CMS - FAQ– Vital Signs FAQ: In recording height as part of the core Meaningful Use objective “Recording vital signs,” how should providers account for patients who are too sick or otherwise cannot be measured safely? Answer: In cases where taking an actual height measurement is inappropriate, self-reported or estimated height can be used.

21. Core Objective – Record Smoking Status

22. Attestation Requirements – Smoking Status The resulting percentage (Numerator ÷Denominator) must be more than 50 percent in order for an EP to meet this measure.

23. Additional Information – Smoking Status • The provider is permitted, but not required, to limit the measure of this objective to those patients whose records are maintained using certified EHR technology. • This is a check of the medical record for patients 13 years old or older. If this information is already in the medical record available through certified EHR technology, an inquiry does not need to be made every time a provider sees a patient 13 years old or older. • The frequency of updating this information is left to the provider and guidance is provided already from several sources in the medical community..

24. Menu Objective – Clinical Lab Test Results

25. Attestation Requirements – Lab Tests The resulting percentage (Numerator ÷Denominator) must be more than 40 percent in order for an EP to meet this measure.

26. Additional Information – Lab Tests • The provider is permitted, but not required, to limit the measure of this objective to labs ordered for those patients whose records are maintained using certified EHR technology. • Structured data does not need to be electronically exchanged in order to qualify for the measure of this objective. The EP is not limited to only counting structured data received via electronic exchange, but may count in the numerator all structured data entered through manual entry through typing, option selecting, scanning, or other means. • Lab results are not limited to any specific type of laboratory or to any specific type of lab test. • The Incentive Programs do not specify the use of code set standards in meeting the measure for this objective. The ONC has adopted LOINC® v2.27, when such codes were received within an electronic transaction from a lab, for the entry of structured data for this measure and made this a requirement for EHR technology to be certified.

27. CMS - FAQ FAQ: In a group practice, will each provider need to demonstrate meaningful use in order to get Medicare and Medicaid electronic health record (EHR) incentive payments or can meaningful use be calculated or averaged at the group level? Answer: Yes. Medicare and Medicaid incentive payments are made on a per EP basis, not by practice. Each EP will need to demonstrate the full requirements of meaningful use in order to qualify for the EHR incentive payments. We made this clear in the preamble to the final rule when we declined to adopt alternative means for demonstrating meaningful use on a group-practice level (75 FR 44437). Published 08/16/2010 01:58 PM | Updated 03/24/2011 11:10 AM | Answer ID 10076

28. CMS - FAQ FAQ: How are the reporting periods for Medicaid patient volume and for demonstrating meaningful use affected if an EP skips a year or takes longer than 12 mo. between attestations? Answer: For the Medicaid EHR Incentive Program, how are the reporting periods for Medicaid patient volume and for demonstrating meaningful use affected if an eligible professional (EP) skips a year or takes longer than 12 months between attestations? Regardless of when the previous incentive payment was made, the following reporting periods apply for the Medicaid EHR Incentive Program: • For patient volume, an eligible professional (EP) should use any continuous, representative 90-day period in the prior calendar year. • For demonstrating they are a meaningful users of Electronic Health Records (EHRs), EPs should use the EHR reporting period associated with that payment year (for the first payment year that an EP is demonstrating meaningful use, the reporting period is a continuous 90-day period within the calendar year; for subsequent years the period is the full calendar year). Published 08/23/2010 01:09 PM | Updated 03/24/2011 11:11 AM | Answer ID 10100

29. 2015 Payment Adjustments Begin Reduction in reimbursement if meaningful use of certified EHR technology is NOT successfully demonstrated • 2015 – 99% of Medicare FFS covered amount • 2016 – 98% of Medicare FFS covered amount • 2017 – 97% of Medicare FFS covered amount • 2018 – if determined, payment adjustment can occur by 1% point each year until payment adjustment reaches 95%

30. Resources • CMS Web Site for the Medicare and Medicaid EHR Incentive Program www.cms.gov/EHRIncentivePrograms • Meaningful Use Measures Links http://www.cms.gov/EHRIncentivePrograms/Downloads/EP-MU-TOC.pdf • Georgia HITREC • http://www.ga-hitrec.org/gahitrec/

31. Q&A The patient should be on the forefront of every decision you make

32. Regional Extension Center Your Meaningful Use Expert Resource. Contact us today! For More information go to: www.ga-hitrec.org This presentation is compliments of www.IowaHITREC.org In Partnership with: The Office of the National Coordinator for Health Information Technology (ONC) U.S. Department of Health and Human Services grant 90RC0004/01. IA-HITREC-03/11-219