What you need to know about Meaningful Use 2 & interoperability
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Does this describe you? ·You are constantly challenged to stay abreast of the latest information on EHR integration and HIE interoperability, Meaningful Use stages, the Direct Project, clinician and patient portals, just to name a few. ·You walk a fine line between adopting health information technology for the good it can bring patient outcomes…….and for the good incentive dollars it can mean to your organization. ·You play a key role in ensuring your organization can attest for meaningful use. Join Andy Nieto, Health IT Strategist at DataMotion where he’ll explain the key role that interoperability plays in Meaningful Use Stage 2 attestation including: - What does interoperability really mean - Why you can’t ignore interoperability - How to achieve interoperability and make it meaningful - What you need in order to attest
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What you need to know about Meaningful Use 2 & interoperability
- 1. Compliancy Group 1 Please ask questions Todays Slides http://compliancy-group.com/ slides023 Upcoming & Past webinars go to: http://compliancy-group.com/webinar/ Get Involved #cgwebinar Industry leading Education
- 2. What You Need to Know About Meaningful Use 2 and Interoperability Andy Nieto, Health IT Strategist, DataMotion
- 3. “There are risks and costs to a program of action, but they are far less than the long-range risks and costs of comfortable inaction” - President John F. Kennedy
- 4. Agenda ■ A little history ■ Meaningful Use (MU) ■ Stage 2 and interoperability ■ Going beyond core measures 4
- 5. Evolution of healthcare IT 5 1972 First EHR Introduced 1996 HIPAA 2001 EHR system usage at 18% 2003 HIPAA Security Rule Feb 2009 HITECH - ARRA 2013 Meaningful Use 2 Rules included Direct 2011 Meaningful Use Stage 1 attestation begins Jan 2013 Final HIPAA Omnibus ruling 2014 attestation for Meaningful Use 2 begins 1971 first email sent
- 6. What is interoperability “In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged.” - 2013 HIMSS Board 6
- 7. HITECH - the approach Stage 1 20132011 2015 Stage 2 Stage 3 Stage 1 Data capture and sharing Stage 2 Advanced clinical processes Stage 3 Improved outcomes
- 8. The college analogy ■ Application = pick an EHR ■ First year = MU1 » 1 down, I’m broke ■ Second year / pick a major = MU2 » Where am I going? ■ Graduate = MU3 » Ok, this works… I think » Yeah, I’m in my career; on my way » I have a degree in WHAT???? How do I make money 8
- 9. Show me the money Starting Year ($$ $) 2011 2012 2013 2014 2015 2016 2011 ($43,720) 1 1 1 2 2 3 2012 ($43,480) 1 1 2 2 3 2013 ($38,220) 1 1 2 2 2014 ($23,520) 1 1 2 9 For eligible providers
- 10. Meaningful Use Stage 1 ■ Install and use an EHR ■ Collect discrete data ■ 13 Core Measures ■ 5 Menu Measures 10
- 11. Meaningful Use 1 Discreet data 11
- 12. Meaningful Use Stage 2 ■ Collect discrete data – even more ■ Exchange more data ■ Engage others ■ 17 Core Measures ■ 3 Menu Measures 12
- 13. Meaningful Use 2 Integrate, interoperate, engage 13
- 14. Advancing clinical process ■ More rigorous information exchange ■ More “e” » e-prescribe » Integration of labs » Transition of Care events ■ Engage patients 14
- 15. Do I have to upgrade my EHR? ■ Yes! Must be 2014 ONC certified. 15
- 16. 17 Core Measures 1. Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders 2. Generate and transmit permissible prescriptions electronically (eRx) 3. Record demographic information 4. Record and chart changes in vital signs 5. Record smoking status for patients 13 years old or older 6. Use clinical decision support to improve performance on high-priority health conditions 7. Provide patients the ability to view online, download and transmit their health information 8. Provide clinical summaries for patients for each office visit 9. Protect electronic health information created or maintained by Certified EHR Technology 10. Incorporate clinical lab-test results into Certified EHR Technology 11. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach 12. Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care 13. Use Certified EHR Technology to identify patient-specific education resources 14. Perform medication reconciliation 15. Provide summary of care record for each transition of care or referral 16. Submit electronic data to immunization registries 17. Use secure electronic messaging to communicate with patients on relevant health information 16
- 17. 17 Core Measures - interoperability 1. Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders 2. Generate and transmit permissible prescriptions electronically (eRx) 3. Record demographic information 4. Record and chart changes in vital signs 5. Record smoking status for patients 13 years old or older 6. Use clinical decision support to improve performance on high-priority health conditions 7. Provide patients the ability to view online, download and transmit their health information 8. Provide clinical summaries for patients for each office visit 9. Protect electronic health information created or maintained by Certified EHR Technology 10. Incorporate clinical lab-test results into Certified EHR Technology 11. Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach 12. Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care 13. Use Certified EHR Technology to identify patient-specific education resources 14. Perform medication reconciliation 15. Provide summary of care record for each transition of care or referral 16. Submit electronic data to immunization registries 17. Use secure electronic messaging to communicate with patients on relevant health information 17
- 18. 6 Menu Objectives 1. Submit electronic syndromic surveillance data to public health agencies 2. Record electronic notes in patient records 3. Imaging results accessible through CEHRT 4. Record patient family health history 5. Report cancer cases to a public health central cancer registry 6. Report specific cases to a specialized registry Important Note: While there are exclusions provided for some of these menu objectives, you cannot select a menu objective and claim the exclusion if there are other menu objectives that you could report on instead. 18
- 19. 6 Menu Objectives - interoperability 1. Submit electronic syndromic surveillance data to public health agencies 2. Record electronic notes in patient records 3. Imaging results accessible through CEHRT 4. Record patient family health history 5. Report cancer cases to a public health central cancer registry 6. Report specific cases to a specialized registry Important Note: While there are exclusions provided for some of these menu objectives, you cannot select a menu objective and claim the exclusion if there are other menu objectives that you could report on instead. 19
- 20. CQM – Clinical Quality Measures Must pick 9 of the 64 approved CQMs There are 6 domains for CQS based upon the National Quality Strategy » Patient and Family Engagement » Patient Safety » Care Coordination » Population and Public Health » Efficient Use of Health Care Resources » Clinical Processes/Effectiveness 20
- 21. Interoperability 21 Meaningful Use: EHR to EHR Goal: ü Measureable exchange of health data Clinician: Referral Consult Orders and results Goal: ü Greater awareness of patient status ü Improved care Patient: “My doctors talk to each other and know what is going on.” Goal: ü Feel better with simpler care
- 22. The building blocks of interoperability ■ Information exchange is not “one size fits all” The components: 22 Data Structure (content) Delivery Tool (DSM, XDR, Interface) Delivery Structure (envelope or form)
- 23. Data Structure (content) ■ Health Language 7 ■ Code Sets » LOINC » ICD » CPT » SNOMED » DRG » HCPDP » RxNorm » DSM 23
- 24. Delivery Structure (envelope or form) ■ CCDA ■ HL7 ■ HCFA 24
- 25. Delivery Tool (DSM, XDR, Interface) 25
- 26. What needs to be standardized? » Vocabulary » Structure (HL7) » Transport with secure email protocols » Adoption of NIST security encryption » Services using open application programing interfaces (APIs) 26
- 27. HIPAA Implications ■ Privacy rule » Who gets access to the data? ■ Security rule » How is the data protected? ■ Breach notification ■ Business associates 27
- 28. Becoming a Meaningful User ■ Re-engineer office processes » When do you fax and why? Can this be automated? » What is the “busy work” in the office? ■ Integrate external connections » Labs, CPOE, Immunization registry, Public Health registry, HIE, RHIE ■ Set “patient care” goals that align with the Meaningful Use criteria 28
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