Go deeper with athenahealth specialists to discover all that you need to know and some things you may not know about Meaningful Use Stage 2 and the newest government updates.
4. 4
Meaningful Use is designed to create
infrastructure that supports reform
Stage 1:
Data capture
and sharing
Stage 2:
Advanced
processes
Stage 3:
Improved
outcomes
5. Hundreds of thousands of providers
participated in Meaningful Use Stage 1
As of August 2014
490,952
MU-registered
caregivers
Over
$25 billion
in incentive
payments
June 2014 EHR Registration and Payment Report
9. 9
Stage 2 has more core measures, fewer menu
measures, and higher thresholds
Stage 1 Stage 2
5 of 9
Menu
10. Almost all of the Stage 1 measures
appear in Stage 2
10
• CPOE
• Demographics
• Vitals
• Smoking Status
• Structured Labs
• Patient Lists
• Preventive Reminders
• Clinical Summary
• Patient Education
• Medication Reconciliation
• Immunizations
• Syndromic Surveillance
• Security Analysis
Retained Stage 1 Measures Consolidated Stage 1 Measures
• eRx
o eRx, Drug Formulary
• Interventions
o Clinical Decision Support,
Drug/Drug, Drug/Allergy
• Patient Access
o Timely Access, E-Copy of
Health Information
• Summary of Care
o Summary of Care, Problems,
Medications, Medication
Allergies, Exchange Clinical
Information
11. Stage 2 introduces six new measures
11
Imaging
Results
(Menu)
Secure
Messages
(Core)
Family
History
(Menu)
Specialized
Registry
(Menu)
Cancer
Cases
(Menu)
Progress
Notes
(Menu)
13. 13
The MU reporting periods were changed to
allow time for upgrades
*Only for providers who are beyond their first year of MU
Meaningful
Use Start Year
Reporting Period by Stage of Meaningful Use
2011 2012 2013 2014 2015 2016
2011 1 1 1 2 2 2
90 days Full year Full Year Quarter Full Year
2012 1 1 2* 2 2
90 Days Full Year Quarter Full Year
2013 1 1* 2 2
90 Days Quarter Full Year Full Year
2014 1 1 2
Full Year Full Year
16. But beware…
the penalties can really add up
16
Year eRx PQRS Meaningful Use Total
2015 -2.0% -1.5% -1.0% -4.5%
2016 -2.0% -2.0% -2.0% -6%
2017 -2.0% -2.0% -3.0% -7%
2018 -2.0% -2.0% up to -5% up to -9%
2019 -2.0% -2.0% up to -5% up to -9%
Overview of penalties
17. Preparing for Stage 2 MU
1 Upgrade (or replace?) your EHR
2 Perform at Stage 2 thresholds
3 Create a patient engagement strategy
18. Step #1: Upgrade to the 2014 certified version
of your EHR
18
Understand your vendor’s 2014 certification approach
2013 2014
2Q 3Q 4Q 1Q 2Q 3Q 4Q
Upgrade EHR
Practice
Stage 2 MU
Perform
Stage 2 MU
Perform
Stage 2 MU
Perform
Stage 2 MU
Perform
Stage 2 MU
19. Step #1: Upgrade to the 2014 certified version
of your EHR
19
• athenaClinicals certified as a 2014 Edition Complete EHR on
June 21, 2013
• 2014 certified version of athenaClinicals released to all practices
at once
• athenaClinicals physicians will begin practicing Stage 2 MU on
October 1, 2013
2013 2014
2Q 3Q 4Q 1Q 2Q 3Q 4Q
Upgrade EHR
Practice
Stage 2 MU
Perform
Stage 2 MU
Perform
Stage 2 MU
Perform
Stage 2 MU
Perform
Stage 2 MU
20. Ask a few key questions of
your EHR vendor
20
Is your vendor able to deploy the 2014 Certified Edition to all clients at
once?1
Will your vendor certify as a Complete EHR or a Modular EHR?
2
Does the vendor provide MU support and training as part of the regular
pricing without additional fees?3
Do they provide the required interfaces for free and without interruption?
How many connections? When will they be available?4
21. How can I switch if 2015
requires full-year
reporting?
22. Check In Intake Exam Sign-Off Checkout Fulfilled Outside of atheanaNet
Security Plan (free self-service
support of intensive consultation for
additional fee)
Fulfilled outside of 5-Stages
Demographics CPOE
E-Copy of
Health Info Patient Lists
Timely Access
(Communicator)
eRx
Clinical
Summaries
Send Care Reminders
Patient Education
Fulfilled by Core
athenahealth Service
Clinical Quality Measures
Summary of Care
Transitions
Immunization Registry Test
Syndromic Surveillance
(HIE department)
Vitals
Up-to-Date
Problems Exchange Clinical Data Test
Drug-Drug InteractionsSmoking
Drug FormularyActive Meds
Clinical Decision Support ToolsActive Allergies
Structured Lab ResultsMed Rec
Step #2: Evaluate your current workflow to
maximize performance…
22
Criteria Integrated within athenahealth’s 5 Stage Patient Workflow
23. …and increase your Stage 1 performance to
meet the Stage 2 thresholds
23
Objective Measure
Thresholds
Stage 1 Final Stage 2 Final
CPOE Use CPOE for medication, lab, and radiology orders 30% meds
60% meds,
30% labs &
radiology
eRx
Generate and transmit permissible prescriptions
electronically
40% 50%
Demographics Record demographics 50% 80%
Vitals Record and chart changes in vital signs 50% 80%
Smoking Status
Record smoking status for patients 13 years
or older
50% 80%
Interventions
Implement CDS interventions at the point
of care; enable drug/drug and drug allergy
interaction checks
One Five
Structured Labs Incorporate lab results as structured data 40% 55%
Patient Lists Generate lists of patients by specific conditions One One
Preventive Reminders Send reminders for preventative/follow-up care
20% patients,
>65 years or
<5 years
10% unique
patients
24. Performance on Meaningful Use Stage 2 Behavioral
measures
Covering period: Q1 2014
24
100% 89%
99%
99%
99%
100%
99%
95%
80%
1. CPOE for Medication, Laboratory, and Radiology Orders
2. E-prescribing (eRx)
3. Record Demographics
4. Record Vital Signs
5. Record Smoking Status
6. Clinical Decision Support Rule
7. Patient Electronic Access
8. Clinical Summaries
9. Protect Electronic Health Information (N/A)
10. Clinical Lab Test Results
11. Patient Lists (N/A)
12. Preventive Care Reminders
13. Patient-Specific Education Resources
14. Medication Reconciliation
15. Summary of Care
16. Immunization Registry Data Submission
17. Use Secure Electronic Messaging
75%
92%
99%
89%
90%
33%
98%
Providers who satisfied required 3 of 6 menu measures:
25. If provider is failing MU Patient Engagement measures,
auto-launch registration upon check-in
Three new
workflows to
register the
patient when
in-office
26. Performance on Meaningful Use Stage 2 Behavioral
measures
As of 12/31/2014
26
100% 100%
100%
100%
100%
99%
99%
1. CPOE for Medication, Laboratory, and Radiology Orders
2. E-prescribing (eRx)
3. Record Demographics
4. Record Vital Signs
5. Record Smoking Status
6. Clinical Decision Support Rule
7. Patient Electronic Access
8. Clinical Summaries
9. Protect Electronic Health Information (N/A)
10. Clinical Lab Test Results
11. Patient Lists (N/A)
12. Preventive Care Reminders
13. Patient-Specific Education Resources
14. Medication Reconciliation
15. Summary of Care
16. Immunization Registry Data Submission
17. Use Secure Electronic Messaging
99%
100%
Providers who satisfied required 3 of 6 menu measures:
100%
100%
100%
100%
100%
100%
100%
29. Our approach to Stage 2 Meaningful Use
29
Software Knowledge Service
• athenaClinicals received 2014
Edition MU certification on
6/21/13
• All athenahealth clients using a
2014 Edition MU certified EHR
today
• Any software changes to
support MU will be pushed to
all clients immediately
• Centrally monitor the
performance of every provider
within your practice to tell
them if they are ahead or
behind in meeting MU criteria
• Identify insights based on high
and low performers nationwide
and roll out to network
• Coach on Meaningful Use
program performance with
intervention for poor
performance
• Take on the technical work
required to satisfy health
information exchange
measures
• Management of registration and
attestation with CMS
• Incentive payment tracking and
processing
US Patent
# 7,720,701
30. Our approach to Stage 2 Meaningful Use
30
Software Knowledge Service
• athenaClinicals received 2014
Edition MU certification on
6/21/13
• All athenahealth clients using a
2014 Edition MU certified EHR
today
• Any software changes to
support MU will be pushed to
all clients immediately
• Centrally monitor the
performance of every provider
within your practice to tell
them if they are ahead or
behind in meeting MU criteria
• Identify insights based on high
and low performers nationwide
and roll out to network
• Coach on Meaningful Use
program performance with
intervention for poor
performance
• Take on the technical work
required to satisfy health
information exchange
measures
• Management of registration and
attestation with CMS
• Incentive payment tracking and
processing
US Patent
# 7,720,701
31. Our approach to Stage 2 Meaningful Use
31
Software Knowledge Service
• athenaClinicals received 2014
Edition MU certification on
6/21/13
• All athenahealth clients using a
2014 Edition MU certified EHR
today
• Any software changes to
support MU will be pushed to
all clients immediately
• Centrally monitor the
performance of every provider
within your practice to tell
them if they are ahead or
behind in meeting MU criteria
• Identify insights based on high
and low performers nationwide
and roll out to network
• Coach on Meaningful Use
program performance with
intervention for poor
performance
• Take on the technical work
required to satisfy health
information exchange
measures
• Management of registration and
attestation with CMS
• Incentive payment tracking and
processing
US Patent
# 7,720,701
75.7%
of our providers attested to MU Stage 2
(through December 2014)
Note: you can’t talk about everything and all the buckets but you might want to pick out a few so as they appear so you can narrate along as they pop up: “PCMH, ACO, Self-Pay, ICD-10, Meaningful Use….”
It’s already difficult enough with all the changes to payers, hospitals, patients and government.
Patients are more involved today and payers are coming up with new strategies like ACOs, hospitals are acquiring practices, etc, etc.
So it can feel like trying to run your practice is like walking a tightrope, trying to balance all this change while you keep getting handed more to juggle, more things that can upset your balance
And of course the long arm of government reaching ever further into your practices:
Meaningful Use Stages leading to eventual penalty in 2017 for failure to adopt
Shift to ANSI 5010 (Jan 2012)
Conversion from ICD-9 to ICD-10 (Oct 2013)
14 million new beneficiaries in Medicaid
What is Meaningful Use?
It’s the buzzword everyone’s talking about today, based on the HITECH Act, focused specifically on stimulating the adoption of EMR technology
It’s not about buying it, it’s about adopting the technology and Meaningfully Using an EMR
So let me take a step back…
Question:
Raise of hands: Medicare vs. Medicaid. Started MU in 2011? Started this year? Starting next year? Not doing MU at all?
Talk about the date. Only 16 months away. Is it going to be pushed again? We don’t think so… Farzad, etc etc.
Sending secure messages between providers. “Direct” address and channel. HSP will intervene and send the message in a secure way.
Sending secure messages between providers. “Direct” address and channel. HSP will intervene and send the message in a secure way.
MU is an all-hands-on-deck program
We have built out the Perform section of the MURC to include demos, measure details, and stage checklists
The Menu and Core measures will be mixed throughout the workflow and athenahealth-fulfilled measures
There are measures that you must satisfy outside of the 5 stage visit