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Welcome to the Webinar on
Structured Attestation to
Meaningful Use Stage 2
By Harbinger Systems
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Panellists
Sachin Katariya
Business Development
Harbinger Systems
Pankaj Ojha
Deputy General
Manager – Projects
Harbinger Systems
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Agenda
• Meaningful use program
• Stages of Meaningful Use
• Steps/approach to achieve MU 2
– Prerequisite
– Determine your starting point
– Draw your timeline
– Upgrade your EHR and implement required core and menu
objectives
– Integrate Meaningful Use measures into your workflow
– Create your patient engagement plan
• Q&A
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Meaningful Use Program
• Meaningful Use certification is a program initiated by Centers for Medicare
& Medicaid Services (CMS) to encourage healthcare providers to show
‘meaningful use’ of a Certified EHR technology. Eligible providers who do so
receive incentive payments under CMS Incentive Programs .
• Ultimately it helps in achieving following:
– Promote the widespread adoption of electronic health records systems
– Improve quality, safety, efficiency, and reduce health disparities
– Engage patients and family
– Improve care coordination, and population and public health
– Maintain privacy and security of patient health information
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Stages of Meaningful Use Program
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Source: cms.gov
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Meaningful Use stage 2
• To demonstrate meaningful use under Stage 2 criteria:
– EPs - 17 core objectives & 3 out of 6 menu objectives
– Eligible hospitals and CAHs - 16 core objectives and 3 out of 6 menu
objectives
– In 2014, regardless of MU stage, all providers also need to demonstrate
report on Clinical Quality Measures (CQMs). EPs - 9 out of 64 CQMs and
EHs and CAHs report 16 measures.
– Medicare providers need to demonstrate two years of meaningful use
under the Stage 1 criteria before advancing to the Stage 2 criteria in
their third year.
– In 2014, all providers regardless of their stage of meaningful use are
only required to demonstrate meaningful use for a three-month EHR
reporting period.
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Meaningful Use Stage 2 – Prerequisites
• Determine your eligibility
– http://cms.gov/apps/ehealth-eligibility/ehealth-eligibility-assessment-
tool.aspx
• Prepare for registration – Verify the CMS check-list
• Register at https://ehrincentives.cms.gov
• Check certification of your EHR system at
http://oncchpl.force.com/ehrcert
• Get your CMS EHR certification ID at
http://healthit.hhs.gov/chpl
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Meaningful Use Stage 2 – Approach
Here are the high level steps or approach to successfully
bring your practice through the Meaningful Use
program and beyond:
– Determine your starting point
– Draw your timeline
– Update your EHR system
– Bring Meaningful Use measures into your workflow
– Create your patient engagement plan
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Meaningful Use Stage 2 – Approach (1/5)
• Determine your starting point
– Access your current system or state
– Attested for Stage-1?
– Core and Menu objectives
– It’s never too late
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Meaningful Use Stage 2 – Approach (2/5)
• Draw your timeline
– Timeline Vs Incentive
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Source: cms.gov
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Meaningful Use Stage 2 – Approach (3.1/5)
• Update your EHR system
– Must have a 2014 certified EHR
– Need implementation for modules like Patient Portal, Secure
Patient Messaging, e-Prescribing, Electronic Medication
Administration Record, Electronic Notes, Clinical Quality
Measures
– Stage 2 Quality Reporting – 113 Proposed Measures for Hospitals
and Providers
– Increased Interoperability: Order and Results exchange
electronically, Electronically Transmit a summary of care record
– Exchange requirements - The Direct Project, Discharge
summaries, CCD’s, Referrals , CCDA, Transport protocols
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Meaningful Use Stage 2 – Approach (3.2/5)
• Example: Direct Project Implementation (1/2)
– Direct Project implementation is responsible for packaging
message content, securing it, and transporting it from one
location to another.
– Content is packaged using MIME (Multipurpose Internet Mail
Extensions) protocol.
– Confidentiality and integrity of the content is handled through
S/MIME encryption and signatures.
– Authenticity of the Sender and Receiver is established with X.509
digital certificates.
– Routing of messages is handled through SMTP.
– Supporting 3 XML standard format, those are CCDA, C32 and CCR
– Test your EHR’s alignment with MU 2 compliances using
Transport Testing Tool (TTT)
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Meaningful Use Stage 2 – Approach (3.2/5)
• Example: Direct Project Implementation (2/2)
– Secure patient health information exchange
• Transition of care (ToC) - Two 2014 Edition EHR
certification criteria
– Transitions of care — receive, display, and incorporate
transition of care/referral summaries
– Transitions of care — create and transmit transition of
care/referral summaries.
• Transport
– Direct (required)
– Direct + XDR/XDM (optional, not alternative)
– SOAP + XDR/XDM (optional, not alternative)
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Meaningful Use Stage 2 – Approach (3.3/5)
• Transport Testing Tool (TTT)
– Developed by National Institute of Standards and
Technology (NIST)
– A tool to test the transport and content related standards
– Validation results are rendered to users in XML format. Non
- conformant segments also trigger error and warning
messages (user readable) within the Tool.
– Web and Local interface to access TTT tool.
– Supported only on Linux based operating systems
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Meaningful Use Stage 2 – Approach (3.4/5)
• Example: ePrescribing OR Digitize prescription
management process from hospitals to
pharmacists
• Generate prescribe information by placing an order
• Sign the order using electronic signature
• Store prescribe data in database
• JAXB implementation for generating e-prescribe XML.
• Used JMS queue to push e-prescribe XML
• Sending XML to pharmacy
• Testing tool - http://erx-testing.nist.gov/
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Meaningful Use Stage 2 – Approach (4/5)
• Bring Meaningful Use measures into your
workflow
– To make sure the right person is doing right work, and to
bring the right information to the right provider at the point
of care.
– Provide training or awareness of new workflow to all
stakeholders
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Meaningful Use Stage 2 – Approach (5/5)
• Create your patient engagement plan
– Stage 1 - provide timely access to patient information.
– Stage 2 - patient engagement and empowerment.
– Measurable criteria
• More than 5 % patients should view, download, or transmit to a
third party their health information.
• A secure message must be sent using the electronic messaging
function of Certified EHR Technology by more than 5 percent of
unique patients seen by an EP during the EHR reporting period.
– Leverages technology, such as an online patient portal
– Promote the portal so patients know about it, understand
why it is beneficial, and use it.
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Meaningful Use Stage 2 – What next?
• Attest that you have met the thresholds and all of the
requirements of the Medicare or Medicaid EHR Incentive
Programs.
• Retain proper documentation in case of an audit. You may be
audited prior to receiving payment.
• Continue reporting meaningful use data every year, and avoid
Medicare payment adjustments.
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