The Meaningful Use attestation period for 2013, Stage 1 is complete. Due to a collaborative effort between MPIP, EMR and Clinical Operations we attested for 90 providers. I would like to thank all persons that played a role in this process. Healthcare is in a state of change, and as we all know change is never easy – Kudos!
As we take a minute to congratulate ourselves, and breathe for a minute, I would like to outline the upcoming changes in the Meaningful Use landscape for Stage 2 (MU2).
What is Meaningful Use?
Meaningful use is the set of standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs that governs the use of electronic health records (EHR/EMR) and allows eligible providers and hospitals to earn incentive payments by meeting specific criteria.
The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provides the Department of Health & Human Services (HHS) with the authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT, including electronic health records and private and secure electronic health information exchange.
How is MU2 different from MU1?
Meaningful use has been described as a step-ladder process – each stage of meaningful use lays a groundwork of expectations for the subsequent stage of meaningful use. In this light, much of MU2 is an expansion of objectives already set (and met by most providers) in MU1 (See attached). Examples of this include:
- Electronic prescriptions (ERx): Threshold increases from 40% to 50%.
- Height/Weight/Blood Pressure/Smoking Status: Threshold increases from 50% to 80%.
Much of the rest of MU2 can be defined by:
- Patient Engagement,
- Clinical Quality, and
- Care Coordination.
What is this “Patient Engagement” Thing?
Part of the hope of CMS in designing MU is enabling patients to understand and be in charge of their healthcare. In order to do this part of MU2 involves giving patients their data, and finidng ways to interact with patients outside of the clnic. Examples of this include:
- Provide patients online access to their health information.
- Send patients secure messages
What is Care Coordination?
Care coordination is the “integration of patient care activities between two or more participants involved in a patient’s care to facilitate the appropriate delivery of health care.” In an effort to improve care coordination, MU2 will require that patients moving between systems have a Summary of Care (SOC) document that accompanies them. This SOC should include:
- Patient name.
- Referring or transitioning provider’s name and office contact information (EP only).
- Encounter diagnosis
- Laboratory test results.
- Vital signs (height, weight, blood pressure, BMI).
- Smoking status.
- Functional status, including activities of daily living, cognitive and disability status
- Demographic information (preferred language, sex, race, ethnicity, date of birth).
- Care plan field, including goals and instructions.
- Care team including the primary care provider of record and any additional known care team
- members beyond the referring or transitioning provider and the receiving provider.
- Reason for referral
- Current problem list (EPs may also include historical problems at their discretion)***
- Current medication list***
- Current medication allergy list***
What is Clinical Quality?
One of the key priorities of MU is leveraging electronic health records (EHRs) to improve quality, safety and efficiency of patient care. Meaningful use of EHRs can help providers and hospitals to improve the diagnosis and treatment of acute and chronic conditions, eliminate unnecessary testing, generate reminders, and reduce medical errors. Examples of MU2 requirements for clinical quality include:
- Implement one clinical decision support rule relevant to specialty or high clinical priority.
- Report ambulatory clinical quality measures (CQMs) to CMS.
- Send reminders to patients per patient preference for preventive/ follow up care.
So what’s next?
As you can see there are a multitude of various changes that are in store for 2014. In order to successfully attest to MU2 a major system upgrade of Centricity is ongoing. As time goes on and this upgrade is shown to be stable, myself and the EMR team shall provide updates and training to ensure that the institution continues to remain in compliance with Meaningful Use for 2014.
Again, Healthcare 2014 is filled with changes. I believe that we are well positioned to meet all the challenges in healthcare, this year and beyond. By embracing and leveraging technologies we can continue to improve our clinical processes, engage in care coordination and provide measurable high quality clinical care.
Please feel free to reach out with any questions or concerns you may have.
Ogechika K Alozie, M.D., M.P.H.
Chief Medical Informatics Officer (CMIO)