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Meaningful Use of Health information Exchange
- 3. What is Meaningful Use? • Meaningful Use is using certified EHR technology to – Improve quality, safety, efficiency, and reduce health disparities – Engage patients and families in their health care – Improve care coordination – Improve population and public health – All the while maintaining privacy and security • Meaningful Use is required to receive incentives and avoid penalties
- 6. CEHRT & MU Relationship Meaningful Use Stage 2 (MU2) CMS: Medicare and Medicaid EHR Incentive Programs Stage 2 • outlines incentive payments (+$$$) for early adoption • outlines payment adjustments(‐$$$) for late adoption/non‐compliance Reference: CMS Medicare and Medicaid Programs; Electronic Health Record Incentive Program – Stage 2 Final Rule 495.6 ONC: Standards, Implementation Specifications & Certification Criteria (SI&CC) 2014 Edition • Specifies the data and standards requirements for certified electronic health record (EHR) technology (CEHRT) needed to achieve “meaningful use” Reference: ONC Health Information Technology : Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology 170.314(b)(1)&(2)
- 7. CEHRT & MU Relationship Care Coordination / Transitions Meaningful Use Stage 2 (MU2) – Care Coordination CMS: Medicare and Medicaid EHR Incentive Programs Stage 2 • Measure #2 : Provide an electronic ‘‘summary of care record for more than 10 percent of such transitions and referrals” using one of the accepted transport mechanisms specified in the rule. Reference: CMS Medicare and Medicaid Programs; Electronic Health Record Incentive Program – Stage 2 Final Rule 495.6 ONC: Standards, Implementation Specifications & Certification Criteria (SI&CC) 2014 Edition • Electronically receive and incorporate a transition of care/referral summary Electronically create and transmit a transition of care/referral summary Reference: ONC Health Information Technology : Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology 170.314(b)(1)&(2)
- 10. Transitions of Care Measure 1 Measure 1 The EP, EH, or CAH that transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals.
- 11. Transitions of Care Measure 1 Transitions of Care Measure 2 Measure 2 The EP, EH, or CAH that transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 10 percent of such transitions and referrals either: • Electronically transmitted using CEHRT to a recipient OR • Where the recipient receives the summary of care record via exchange facilitated by an organization that is a Nationwide Health Information Network (NwHIN) Exchange participant or in a manner that is consistent with the governance mechanism ONC establishes
- 12. Transitions of Care Measure 1 Transitions of Care Measure 2 Transitions of Care Measure 3 Measure 3 An EP, EH, or CAH must satisfy one of the following: • Conducts one or more successful electronic exchanges of a summary of care record meeting the measure specified in Requirement 2 of this section with a recipient using technology to receive the summary of care record that was designed by a different EHR developer than the sender's CEHRT certified OR • Conducts one or more successful tests with the CMS designated test EHR during the EHR reporting period
- 13. Transitions of Care – EPs Transitions of Care – EH/CAHs Patient name Patient name Sex Sex Date of birth Date of birth Race (OMB Race and Ethnicity) Race (OMB Race and Ethnicity) Ethnicity (OMB Race and Ethnicity) Ethnicity (OMB Race and Ethnicity) Preferred language Preferred language Smoking status (SNOMED‐CT value set) Smoking status (SNOMED‐CT value set) Problems (SNOMED‐CT value set) Problems (SNOMED‐CT value set) Medications (RxNorm) Medications (RxNorm) Medication allergies (RxNorm) Medication allergies (RxNorm) Laboratory test(s) (LOINC) Laboratory test(s) (LOINC) Laboratory value(s)/result(s) Laboratory value(s)/result(s) Vital signs (height, weight, blood pressure, BMI) Vital signs (height, weight, blood pressure, BMI) Care plan field(s), including goals and instructions Care plan field(s), including goals and instructions Procedures (SNOMED‐CT or HCPCS/CPT‐4), optional CDT, optional ICD‐10‐PCS Procedures (SNOMED‐CT or HCPCS/CPT‐4), optional CDT, optional ICD‐10‐PCS Care Team Member(s), including the primary care provider of record and any additional known care team members beyond the referring or transitioning provider and the receiving provider Care Team Member(s), including the primary care provider of record and any additional known care team members beyond the referring or transitioning provide and the receiving provider Encounter diagnosis (ICD‐10‐CM or SNOMED‐CT) Encounter diagnosis (ICD‐10‐CM or SNOMED‐CT) Immunizations (HL7 Standard Code Set CVX) Immunizations (HL7 Standard Code Set CVX) Functional status, including activities of daily living and cognitive and disability status Functional status, including activities of daily living and cognitive and disability status The following are Elements that are different between EP and EH/CAH Reason for referral Discharge instructions Referring or transitioning provider's name and office contact information Common MU Data Set Data Elements in Common Between EP and EH/CAH in Addition to Common MU Data Set Elements that are different between EP and EH/CAH All summary of care documents must include these data elements
- 14. MU Stage 2 Medication Reconciliation Core Objective Objective: • The EP, EH, or CAH who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation. Measures: • The EP who performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP. • The eligible hospital or CAH performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP or admitted to the eligible hospital's or CAH's inpatient or emergency department.
- 16. Federal Government Initiatives Graphic: The Value Proposition for Exchange; Doug Fridsma, July 2011 • Federal Advisory Committees (FACAs) – HIT Policy Committee, Standards • Nationwide Health Information Network (NwHIN) – Services, standards, policies, trust fabric This image cannot currently be displayed.
- 17. Direct Project Facilitates Meaningful Use • Other Providers/Authorized Entities: – Clinical information – Labs – test results – Referrals – summary of care record • Patients: – Health information – Discharge instructions – Clinical Summaries – Reminders • Public Health: – Immunization registries – Syndromic surveillance b.wells@direct.mclinic.org Direct Project facilitates the communication of many different kinds of content necessary to fulfill meaningful use requirements. Examples of Meaningful Use ContentExamples of Meaningful Use Content D I R E C T
- 18. CCSNPC Technology Partner 1993 1999 2006 20 Years 14 Years 7 Years • Standards‐based Solutions for Health Information Exchange • Commercial Software and Support • Open Architecture • User Extensible • Application and Data Integration Experts Software Development Software Development Healthcare Focus Healthcare Focus Mirth Products
- 20. Mirth at ChathamHealthLink • Healthcare Data Repository • Provider Portal • Available XDS.b Plugin • CCD and Consolidated CDA • Agents – Data Detectors and Subject Groups • Scheduled Reports • Central and Federated Deployment • Standards‐based Integration with NextGate MatchMetrix EMPI and GeorgiaDirect HISP Mirth Appliance Ready‐to‐Run Platform for Mirth Applications HL7, DICOM, X12, CCD, C‐CDA, and EHR Integration Mirth Connect Mirth Results eHealth and IHE Exchange
- 21. The Value of Mirth • Talks Documents, Stores Data • Standards‐based HIE and EHR Integration • Improve Physician Alignment and Patient Engagement • Enable ED/IP Notification and Summary of Care Delivery CCD EDI CDA HL7
- 22. Value Proposition for HIE • Provide better, safer and more efficient patient care • Distribute hospital information to doctors • Savings on uncompensated care related to unnecessary or avoidable services • Provides outreach to community partners • Helps maintain referral patterns • Improved care coordination • Aligns with shifting reimbursement models
- 28. Capacity Building Funding • $492,500.00 funding award • Opportunity to connect • Move beyond the pilot • Next Steps: – Strong policy development – Build sustainability model – Security assessment