By: Rebecca Cameron Amie Dennis Amy Everson Debborah Stokes

1. Meaningful Use By: Rebecca Cameron Amie Dennis Amy Everson Debborah Stokes

2. What is Meaningful Use? • There are three main components of Meaningful Use in the American Recovery and Reinvestment Act of 2009

3. What is Meaningful Use? • The first component is the use of a certified EHR in a meaningful manner, such as e-prescribing

4. What is Meaningful Use? • The second component is the use of certified EHR technology for electronic exchange of health information to improve the quality of health care QUALITY

5. What is Meaningful Use? • The third component is the use of certified EHR technology to submit clinical quality and other measures

6. The criteria for meaningful use is being implemented in 3 stages. • Stage 1 begins in 2011 and will set the foundation for electronic health records (EHR’s) implementation. • Stage 2 is expected to begin in 2013 and • Stage 3 in 2015, but criteria has not yet been developed.

7. Eligible professionals, hospitals, and critical access hospitals (CAH) can meet incentive payment requirements in one or more of the following ways:

8. Successful use of certified electronic health record technology must be demonstrated in each year of the program.

9. Adopt: Acquire and install certified EHR technology. • Implement: Train staff to begin using EHR technology. • Upgrade: Upgrade current systems to meet definition of certified EHR technology.

10. Clinical Quality Measures “Consist of measures of processes, experience and or outcomes of patient care, observations, or treatment that relate to one or more quality aims for health care, such as effective, safe, efficient, patient-centered, equitable and timely care.”

11. Clinical Quality Measures • The Centers for Medicare and Medicaid Services (CMS) finalized 15 CQMs for eligible hospitals. • Two measures target emergency department processes, seven address the care of patients with ischemic stroke, and six address the care of patients with venous thromboembolism. • Eligible hospitals must report numerators, denominators, and exclusions for all 15 CQMs, even if one or more of the values is zero. • The hospital CQMs for meaningful use are a different set of specifications that enables electronic data capture and analysis using EHR systems.

12. Clinical Quality Measures Example of CQM: NQF #: 0028 Title: Preventive Care and Screening Measure a. Tobacco Use Assessment b. Tobacco Cessation Intervention • In instances where the denominator for one or more of the core measures is zero, the provider must report results for up to three of the alternate core measures. The core measures and alternate core measures. • For the 2011 and 2012 reporting periods, EPs must submit calculated results for a total of six measures: three core measures and three of the 38 additional quality measures.

13. Stage 1 Requirements for Meaningful Use (2011 & 2012) Meaningful use includes both a core set and a menu set of objectives for eligible professionals or eligible hospitals and CAH (Critical Access Hospitals).

14. Eligible Professionals • 25 Meaningful Use Objectives • 20 out of 25 Objectives to meet incentive requirements • 15 Required Core Objectives • 5 out of 10 Chosen Menu Set Objectives

15. Eligible Hospitals & CAH • 24 Meaningful Use Objectives • 19 out of 24 Objectives to meet incentive requirements • 14 Required Core Objectives • 5 out of 10 Chosen Menu Set Objectives

16. Examples of Objectives • Core Objectives • Computerized Provider Order Entry (CPOE) • Electronic Prescriptions(eRx) • Active medication list • Record and chart changes in vital signs • Menu Set Objectives • Patient specific education resources • Medication reconciliation • Clinical Summary transferring a patient • Clinical lab-test results into the EHR