This document summarizes a presentation on preparing for meaningful use audits. It provides an overview of recent CMS updates to stage 2 meaningful use requirements, common stumbling blocks providers face, how to conduct a gap analysis, lessons from customer audit experiences, the benefits of mock audits, how intelligent medical objects can help with requirements, and an outlook on future stage 3 goals. Contact information is provided for attendees to ask questions or provide feedback through a post-webcast survey for a chance to win a gift card.

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Welcome!
Preparation is the Key
to Meaningful Use
Success
Presented by:
Kay Jackson
(978) 805-3104
Kay.Jackson@iatric.com
Cindy Paul
(978) 674-5927
Cindy.Paul@iatric.com

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•Email amanda.howell@iatric.com
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3. Our Presenters
Kay Jackson
Manager, Software Certification,
Compliance Application Software
Iatric Systems, Inc.
Kay.Jackson@iatric.com
Cindy Paul
Consultant
Professional Services
Iatric Systems, Inc.
Cindy.Paul@iatric.com
Mike Elvin
Consultant
Professional Services
Iatric Systems, Inc.
Mike.Elvin@iatric.com

4. Agenda
 Recent updates from CMS and what they mean to you
 Stumbling Blocks for Stage 2
 Meaningful Use Gap Analysis – do you know where you
stand?
 Audits: Customer Examples and How to Prepare
 Mock Audits and Beyond
 Intelligent Medical Objects (IMO) – what you need to
know for Meaningful Use
 A look ahead at MU3

5. Recent Updates from CMS
Stage 2
NPRM- Meaningful Use proposed change for 2014
http://1.usa.gov/1pndpQQ

6. Recent Updates from CMS
Stage 2
• 5/27/14 - CMS published a new proposed rule
that would let providers use 2011 Edition
CEHRT or a combination of 2011 and 2014
CEHRT for the reporting period in 2014
• Beginning 2015 all would be required to
report using 2014 CEHRT
• 60 Day comment period before final rule is
determined – comments due by July 21
• You have the opportunity to comment – 636
comments received (as of 7/17/14)
• Expected to announce the final rule Sept 1
• To Comment, go here: http://1.usa.gov/1pndpQQ

7. Where does the NPRM Stand?
http://1.usa.gov/1pndpQQ

8. CEHRT NPRM Tool
Stage 2 Proposed Rule
http://go.cms.gov/1jRHwcgf

9. What should your team do?
Stage 2 Proposed Rule
1. Review the changes and make comments by 7/21
2. Review the chart and consider a Plan B
3. Move forward with Plan A, but make sure Plan B is ready
4. Use the CEHRT NPRM tool to validate your Plan B

10. CQM 2014
Questions and Answers
• Are we required to submit eCQM data if we reported by the
aggregate method via the CMS attestation tool?
Answer: No, it’s not required
• What is QRDA Cat 3 vs. QRDA Cat 1?
• When are the 2015 rules going to be out?
Answer: 2015 rules are expected to be published in August 2014
• What final advice do you have for 2014 CQMs?
Answer: Be prepared — all coding ready

11. Stumbling Blocks
• Patient Portal- what does CMS really want you to track for
providing access to the portal?
The CMS definition of “access” for this
measure explicitly states that a patient has
access when they possess “all of the
necessary information needed to view,
download, or transmit their
information.” If the patient does not have
“access,” the information cannot be
considered “available” to the patient.
Having a data feed to a portal without
telling patients how to access the portal
doesn’t count.
Response from:
Erica Galvez, MA
Stage 2

12. For Patient Portal
View before discharge

13. Must have VDT to count patient
Stage 2

14. Stage 2 Core 12
Keys to Success
• Core 12.1 — can be both paper and
electronic
• Core 12.1 and Core 12.2 — can limit by
discharge disposition code
• Is your HIE or HITSP ready?
• Direct Mailbox
• Message Delivery Notification

15. Why there are Meaningful
Use “Gaps”
• Meaningful Use “takes a village”
• Most hospitals have limited resources in
one area or another
• Project management is often difficult and
costly to the hospital
• MU requires C-level buy-in

16. Conducting a Meaningful
Use Gap Analysis
• Offers guidance and suggestions for best
practices in MU objectives and data
capture
• Provides “Gap Analysis Report” to identify
specific areas of improvement to meet
CMS regulations

17. Audits: Customer Experiences
• Audits becoming more frequent and Congress requests more
than 1 in 20 providers
• I am seeing more and more the person who did the attestation
is no longer at the hospital — email audit notification
• Remember the 5 Stage 1 MUST haves — retain for 6 years:
• Letter from all providers of software used in the CHPL
process
• Letter to explain your Method
• Supporting documentation for Cores 1,3,4,5,6,7,8, 11
and 12-report from your EHR system that ties to the
attestation numbers
• Proof of the security risk analysis- see CMS document for
expectations — remediation plan is key
• Supporting documentation for Menu 2,3,5,6 and 7 that
were used to attest as well supporting documentation for
Menu 4,8,9,or 10
Lessons Learned

18. Audits: Customer Experiences
• Are you prepared to respond to a audit? If you fail what
happens?
• Security Risk Analysis:
Resource: CMS Guide to Privacy and Security of Health Information
Lessons Learned

19. Audits: How to Prepare
• Plan “when we are audited, not if”
• Have at least three team members that know where
everything to support the audit is located
• When you attest — have an Attestation Team
• Watch for Notice:

20. Audit Concerns
• Many hospitals believe they are ready…
• Need to be certain all objectives are well
documented
• Often hospitals have holes that are
uncovered during actual audit
• Audit places strain on staff during process

21. Mock Audits
Benefits of a Mock Audit from a third party:
•Team of experts have prior experience
•Ensures proper documentation is provided
•Experts are able to view entire MU reporting
similar to actual audit
•Offer tips on how to best handle audit to
maintain staff efficiencies

22. Going Beyond Mock Audits
Reach beyond MU with patient experience:
•Are patients using their portal or HIE?
•Are they satisfied with physician/provider
communication after their stay?
•Were their discharge instructions adequate?
Did they receive a callback?
•Are they supplied with specific,
comprehensive educational resources?
•Is there room for improvement with
available HIT applications?

23. Intelligent Medical Objects
• Intelligent Medical Objects (IMO):
partnership with EHR vendors to
standardize medical terminology
• IMO integration is essential to populate
accurate:
• Problem Lists
• CQM reporting
• Data fields for CCD, Public health
reporting, Patient Portal and correct
abstract/billing

24. Help for IMO
• Working with IMO can take up to 6
months
• 3rd
Party Vendor can cut this time to 2-3
months
• Familiarity with IMO implementation steps
and procedures
• Additional benefits:
• First-time accuracy reconciling terms
• ROI by reduced internal resources
required for IMO
• External experts have IMO experience

25. Stage 3 EH Delayed
until 10/1/16
Stage 3 Goal is to improve outcomes:
• Hospitals must receive provider-requested, electronically
submitted patient-generated health information through either
structured questionnaires or input from patients
• Hospitals to send electronic notifications of significant healthcare
events to a patient’s care team—such as their primary care
provider, referring provider, or care coordinator — within four
hours of the event. Significant events that would trigger a
notification include:
• Arrival to ED
• Admission to hospital
• Discharge from ED or hospital
• Death
http://bit.ly/1sz1e4Y

26. Q & A

27. Meaningful Use
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