6. Meaningful Use: The American Recovery and Reinvestment Act of 2009 specifies three main components of Meaningful Use: 1. The use of a certified EHR in a meaningful manner, such as e-prescribing. 2. The use of certified EHR technology for electronic exchange of health information to improve quality of health care. 3. The use of certified EHR technology to submit clinical quality and other measures.
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8. * Hospital-based professionals excluded from incentives Eligible Providers - Medicare Eligible Providers - Medicaid Eligible Professionals (EPs)* Eligible Professionals (EPs) Doctor of Medicine or Osteopathy Physicians (Pediatricians have special eligibility & payment rules) Doctor of Dental Surgery or Dental Medicine Nurse Practitioners (NPs) Doctor of Podiatric Medicine Certified Nurse-Midwives (CNMs) Doctor of Optometry Dentists Chiropractor Physician Assistants (PAs) who lead a FQHC)or rural health clinic Eligible Hospitals* Eligible Hospitals Acute Care Hospitals Acute Care Hospitals, Critical Access Hospitals Critical Access Hospitals (CAHs) Children’s Hospitals
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13. Summary of Stage 1 Meaningful Use Objectives and Measures for Eligible Professionals (July 13, 2010) Core Objectives (All must be satisfied) Functional Requirements Objective / Condition 1. Computerized Physician Order Entry (CPOE) • At least one medication ordered via CPOE for >30 percent of unique patients seen with at least one medication on current medication list 2. Drug-drug, Drug-Allergy Checking • CPOE drug-drug and drug-allergy checking features are enabled 3. Generate and Transmit Electronic Prescriptions • >40 percent of all permissible medication orders (excluding controlled substance orders) are electronically prescribed 4. Maintain up-to-date Problem/Diagnosis List • For >80 percent of unique patients seen (at least one structured entry, ICD-9-CM or SNOMED CT) 5. Maintain Active Medication List • For >80 percent of unique patients seen (at least one structured entry) 6. Maintain Active Medication Allergy List • For >80 percent of unique patients seen (at least one structured entry) 7. Record Vital Signs • For >50 percent of unique patients ≥ 2 years old seen, record and chart changes in vital signs (as structured data): – Height, weight, blood pressure – Calculate and display BMI – Plot and display growth chart, including BMI (patients 2-20 years old) 8. Record Demographics • For >50 percent of unique patients seen, record demographics (as structured data): – Gender – Ethnicity, race (federal guidelines), preferred language – Date of birth 9. Record Smoking Status • For >50 percent of unique patients seen ≥ 13 years old 10.Report Quality Measures to CMS and the States • Report ambulatory quality measures — per data captured and calculated by the EHR — to CMS or the states for specified core and specialty measures – For 2011: attest to accuracy and completeness of aggregate numerator and denominator – For 2012 (and beyond): submit (at least one measure) electronically 11. Implement Clinical Decision Support • Implement one rule (with high clinical priority for or relevant to the specialty of the EP) and track compliance Health Information Exchange (HIE) Requirements Objective / Condition 12. Provide Patients with Clinical Summary of Office Visits • Satisfy more than 50 percent of requests for a clinical summary of an office visit (via Personal Health Record (PHR), portal, other electronic media, or printed output) within 3 business days 13. Provide Patient with Electronic Copies of Health Information • Provide >50 percent of patients who request copies with electronic copies of their health information (lab test results, problem, medication, allergy lists) within 3 business days 14. Implement Capability to Exchange Key Clinical Information • Perform at least one test of the capability of the certified EHR system used by the EP to electronically exchange key clinical information (for example, problem list, med list, allergies, test results) with another EHR (not shared) HITECH Privacy And Security Objective / Condition 15. Implement Systems to Protect Patient Data • Conduct or update a security risk assessment per 45 CFR 164.308 (a)(1) and implement security updates as necessary
14. Summary of Stage 1 Meaningful Use Objectives and Measures for Eligible Professionals (July 13, 2010) Menu Set Objectives (5 Must Be Satisfied) Functional Requirements Objective / Condition 1. Incorporate Test Results into EHR • Incorporate clinical laboratory test results into EHR as structured data for >40 percent of all clinical lab tests ordered with positive/negative or numeric results 2. Medication Reconciliation • Performed at >50 percent of relevant encounters and transitions of care 3. Drug Formulary Checking • Drug-formulary check functionality is enabled (with access to at least one internal or external formulary for entire period) 4. Generate Patient Lists • Generate at least one list of the EP’s patients with a specific condition to use for quality improvement, reduction of disparities, and/or outreach Health Information Exchange (HIE) Requirements Objective / Condition 5. HIE: Patients • Provide >10 percent of unique patients seen with electronic access (available on-demand at any time) to their health information (lab test results, problem, medication, allergy lists) within 4 business days of the information’s availability to the EP 6. Patient Follow-up/Preventive Care Reminders • Send reminders for preventive/follow-up care (per patient preference) to >20 percent of patients who are ≥65 or <5 years old 7. HIE: External Providers • Provide summary care record (via electronic exchange, secure portal, secure e-mail, CD, USB drive or printed copy) for >50 percent of patient transitions of care and referrals 8. HIE: Immunization Registries • Perform at least one test of the capability to submit electronic data to immunization registries • Actual submission where required and accepted 9. HIE: Syndromic Surveillance Data • Perform at least one test of the capability to provide electronic surveillance data to public health agencies • Actual transmission according to applicable law and practice 10. Identify Patient-Specific Educational Resources • Use EHR technology to identify and provide >10 percent of unique patients seen with patient-specific educational resources
27. Service Offering EHR / OPD Portal RIM Web Development C#, ASP.NET, .NET Framework 3.0/3.5, PHP Java, Servlets, Web Services User Experience : AJAX, JavaScript, CSS, HTML, XML, Flash, Action Script, JSON, JQuery Windows & Linux, Nagios, Microsoft Exchange, IIS, SMTP, Netorking, Appache, Tomcat, etc. Databases / Data Migration SQL Server 2005/2008, Oracle 10g/ 11g, MySQL Other Technologies HL7 2.x/3.0, CDA SCRUM Agile Project Management
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Hinweis der Redaktion
CoArtha TechnoSolutions , is an end-to-end Healthcare IT, Product Development company. We provide healthcare solutions to Providers/Payers to Automate Practice & Clinical Management, Interoperability HIE and Clinical Labs, Portals & User Experience for customers, Outsourced Product Development for Healthcare ISVs, Remote Infrastructure Management and Revenue Cycle Management solutions for Providers. We offer one of the most cost effective and comprehensive outsourcing solutions to healthcare professionals available. Keywords: EHR, HIT, HIE, ARRA, HL7, Interoperability, OPD, Healthcare, RCM, Revenue Cycle Management
Takeaways from the slide:
How to Use this Flow Chart: A Medicaid eligible professional may also be eligible for the Medicare incentive and should follow the path of answering no to the question of Medicaid patient volume to determine Medicare eligibility. An eligible professional who qualifies for both programs may only participate in one program. Eligible Professionals eligible to receive EHR incentive payments under Medicare or Medicaid will maximize their payments by choosing the Medicaid EHR Incentive Program.
What are Clinical Quality Measures? Essentially, the measure of the care you’re providing to your patients based on administrative or medical record data Once benchmark data is gathered, analyzing this data will allows government and the industry to identify patterns in diagnosis & treatment related to geography, insurance coverage, race, language and other segmentation Effective, Safe, Timely Care, Patient-Centered Can attest that almost any of the metrics are irrelevant to your practice to remove it from the list and reduce the number of metrics you must report on Can be dummy data but cannot be simulated tests
Include approximate timelines Project plan to come up with the people involvement at different stages of implementation Step 1: Build the Case for Change Rapidly builds motivation for EHR adoption in even the most skeptical staff member Addresses the major concerns staff members have about EHR adoption so these concerns don’t derail your project later Overcomes complacency and gets staff members to willingly contribute the extra time, effort and energy needed for a smooth and rapid transition Builds urgency for EHR adoption in practice leaders — partners, physicians, practice managers who may not all appreciate the need for an EHR Step 2: Identify the Guiding Team Identifies the right staff members to take the lead in the practice’s transition to Meaningful Use Effectively delegates project responsibilities, so you can focus on patient care Defines communication and decision-making strategies to avoid the miscommunications and misunderstandings that often delay EHR projects and lead to costly mistakes Step 3: Motivate with Inspiring Goals Defines Meaningful Use objectives for the practice & target dates by which to achieve them Sets specific goals for: Improved practice bottom-line performance Enhanced patient care & satisfaction Reduced administrative burdens and improved quality of practice life Step 4: Promote Staff Collaboration Gets staff members involved in implementation & Meaningful Use. By fully engaging staff members in EHR adoption, you can significantly reduce the costs of your implementation Identifies bottlenecks, inefficiencies and sources of productivity slowdowns that can be reduced or eliminated through effective EHR use Delineates the system configuration, peripherals, interfaces (incoming & outgoing), and EHR components your practice needs to achieve the Meaningful Use objectives defined in Step 3 Identifies potential implementation problems before they can cause real damage Ensures successful workflow design Step 5: Translate Plans into Action Identifies the strategies your practice will use for: Migrating patient data into the EHR Data entry Clinical documentation Managing incoming documents that cannot be directly imported into the EHR Provides a system for maintaining accountability, so staff members and vendor implementation teams do what they need to do, when they need to do it, to keep your EHR transition on track Identifies the specific training each staff member should have to build the proficiency needed for Meaningful Use — saving time and money on unnecessary and repetitive training Step 6: Build Confidence Identifies intermediate objectives that build momentum toward Meaningful Use Provides a tracking mechanism, so all staff members can see the progress of the transition Step 7: Achieve & Sustain Meaningful Use Provides a mechanism to track your practice’s progress to meeting Meaningful Use goals in the areas of: core objectives menu objectives clinical quality measures Assists you and your practice staff with registering and attesting for the incentive payments you are eligible to receive Provides you with updates on Meaningful Use guidelines and requirements, so you don’t have to worry about missing changes in deadlines and reporting requirements
- Web-based systems. - ASP with local thin-client: central data center serving multiple hospitals; a combination of onsite and vendor- hosted storage; corporate data centers; local data exported daily to a larger [storage] site; and a remote storage owned by the organization. But for many physicians in small offices, the cost advantages are not enough to overcome concerns regarding the security of their patients’ personal health data when stored off-site. Indeed, this group shows a higher percentage of records stored onsite when compared to hospitals.
The Meaningful Use cost has been segregated into the three categories and the above slide depicts the costs for single provider and the benefits to understand the ROI Year-over-Year and Five year total. Product cost Implementation cost Provider cost Salient points: Provider has choice to take Meaningful use either this year by June or next year by June (to provide necessary time to get the process approved) Overall implementation would take about 2 months and following to it there will be 90 day attestation process (no breaks) Provider can bet for break even ROI in a single year of implementation if he/she plans right Scenarios: Doctors with EMR (for & not for MU), Doctors with no EMR – HIE integration, Integrations with Labs Factors affect timelines Solution: Configuration of EHR, EHR finalization, Which HIE to use? Integration Remote / Onsite, Differentiators slide
Shivaji Mukthavaram, Technology, Business Expert & PMP Haricharan Juvvadi – Healthcare Expert
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