Meaningful Use Stage 3 Brett Paepke, OD Why talk about Stage 3 now? - - PowerPoint PPT Presentation

Meaningful Use Stage 3

Brett Paepke, OD

• Why talk about Stage 3 now?
• Introduce the objectives to assist in connecting what

we’re doing now to the future

• RevYou attendees get first look

• Notice of proposed rule making released on March 20, 2015
• Proposes more flexibility and simplifies requirements for

providers by focusing on advanced use of electronic health records and eliminating requirements that are no longer relevant.

• Eliminates “topped out” objectives such as Patient

Demographics

Stages of MU

First Year of Meaningful Use

Stage of Meaningful Use

2015 2016 2017 2018 2011

Modified Stage 2 Modified Stage 2 Modified Stage 2 or Stage 3 Stage 3

2012

Modified Stage 2 Modified Stage 2 Modified Stage 2 or Stage 3 Stage 3

2013

Modified Stage 2 Modified Stage 2 Modified Stage 2 or Stage 3 Stage 3

2014

Modified Stage 2 Modified Stage 2 Modified Stage 2 or Stage 3 Stage 3

2015

Modified Stage 2 Modified Stage 2 Modified Stage 2 or Stage 3 Stage 3

2016

n/a Modified Stage 2 Modified Stage 2 or Stage 3 Stage 3

Reporting Periods

2015

• any 90 consecutive days for all EPs
• attestation cannot be completed until 2016 (1/1/16 - 2/29/16)

2016

• any 90 consecutive days for new EPs
• full calendar year for all others

2017+

• full calendar year for all EPs in Medicare arm
• 90 consecutive days for EPs in 1st year of Medicaid arm

Stage 3 objectives

• Protect Electronic Health Information
• E-Prescribing
• Clinical Decision Support
• CPOE
• Patient Electronic Access to Health Information
• Coordination of Care through Patient Engagement
• Health Information Exchange
• Public Health and Clinical Data Registry Reporting

Protect Electronic Health Information

Proposed Objective

Protect electronic health information created or maintained by the CEHRT through the implementation of appropriate technical capabilities.

Proposed Measure

Conduct or review a security risk analysis in accordance with
 the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of data stored in Certified EHR Technology in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the EP’s risk management process

Exclusions

None

Electronic Prescribing

Proposed Objective

Generate and transmit permissible prescriptions electronically (eRx)

Proposed Measure

More than 80 percent of all permissible prescriptions written by the EP are queried for a drug formulary and transmitted electronically using Certified EHR Technology

Exclusions

• 1. Any EP who writes fewer than 100 permissible prescriptions during the

EHR reporting period

• 2. An EP who does not have a pharmacy within his or her organization

and does not have a pharmacy that accepts electronic prescriptions within 10 miles of the EP's practice location at the start of his or her EHR reporting period


Clinical Decision Support

Proposed Objective

Use clinical decision support to improve performance on high-priority health conditions

Proposed Measures

• 1. Implement five clinical decision support interventions related to four or

more clinical quality measures at a relevant point in patient care for the entire EHR reporting period

• 2. The EP has enabled and implemented the functionality for drug-drug and

drug allergy interaction checks for the entire EHR reporting period

Exclusions

Any EP who writes fewer than 100 medication orders during the EHR reporting period can exclude from measure 2

Computerized Provider Order Entry

Proposed Objective

Use computerized provider order entry (CPOE) for medication, laboratory, and diagnostic imaging orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local, and professional guidelines

Proposed Measures

• 1. More than 80 percent of medication orders created by the EP during the EHR

reporting period are recorded using computerized provider order entry

• 2. More than 60 percent of laboratory orders created by the EP during the EHR

reporting period are recorded using computerized provider order entry

• 3. More than 60 percent of diagnostic imaging orders created by the EP during the

EHR reporting period are recorded using computerized provider order entry

Exclusions

Any EP who writes fewer than 100 medication, laboratory, or diagnostic imaging

• rders during the EHR reporting period can exclude from that measure

Objectives 5 & 6

A number of Stage 1 and 2 objectives focused on access to health information and communication:

• V/D/T access
• Patient-specific education resources
• Secure messaging
• V/D/T use

Objective 5: Patient Electronic Access to Health Information Objective 6: Coordination of Care through Patient Engagement

Patient Electronic Access to Health Information

Proposed Objective

The EP provides access for patients to view online, download, and transmit their health information, or retrieve their health information through an API, within 24 hours of its availability.

Proposed Measures

• 1. More than 80 percent of unique patients are provided PHR or API-based access

within 24 hours.

• 2. Provide electronic access to patient-specific educational resources for more

than 35 percent of unique patients

Exclusions

• 1. EP conducts >50% of their encounters in a county where <50% of households

have access to >4 Mbps broadband speed at the start of the reporting period (www.broadbandmap.gov)

• 2. EP has no office visits during the reporting period

Coordination of Care through Patient Engagement

Proposed Objective

Use communications functions of certified EHR technology to engage with patients

• r their authorized representatives about the patient’s care.

Proposed Measures

• 1. More than 25 percent of unique patients actively engage with EHR data made

available by the EP (i.e. V/D/T Actual Use, API)

• 2. A secure message is sent to more than 35 percent of unique patients
• 3. Patient-generated health data or data from a non-clinical setting is incorporated

into the certified EHR technology for more than 15 percent of unique patients

Exclusions

• 1. EP conducts >50% of their encounters in a county where <50% of households

have access to >4 Mbps broadband speed at the start of the reporting period (www.broadbandmap.gov)

• 2. EP has no office visits during the reporting period

Health Information Exchange

Proposed Objective

The EP provides a summary of care record when transitioning or referring their patient to another setting of care, retrieves a summary of care record upon the first patient encounter with a new patient, and incorporates summary of care information from other providers into their EHR using the functions of certified EHR technology.

Proposed Measures

• 1. for more than 50 percent of outbound TOCs and referrals, the EP: (1) creates a

summary of care record using CEHRT and (2) electronically exchanges it with the recipient

• 2. for more than 40 percent of inbound TOCs, referrals and encounter with patients

the EP has never seen before, the EP incorporates an electronic summary of care document from a source other than the EP’s EHR.

• 3. for more than 80 percent of inbound TOCs, referrals and encounter with patients

the EP has never seen before, the EP performs clinical information reconciliation.

Exclusions

• 1. EP neither transfers a patient to another setting nor refers a patient to another

provider during the reporting period (applies to measure 1)

• 2. Any EP for whom the total of transitions or referrals received and patient

encounters in which the provider has never before encountered the patient, is fewer than 100 during the EHR reporting period is excluded from this measure (applies to measures 2 and 3)

• 3. EP conducts >50% of their encounters in a county where <50% of households

have access to >4 Mbps broadband speed at the start of the reporting period (www.broadbandmap.gov) (applies to all 3 measures)

Public Health and Clinical Data Registry Reporting

Proposed Objective

The EP is in active engagement with a PHA or CDR to submit electronic public health data in a meaningful way using certified EHR technology, except where prohibited, and in accordance with applicable law and practice

Proposed Measures

There are a total of six possible measures for this objective. EPs would be required to choose from measures 1 through 5, and would be required to successfully attest to any combination of three measures

Exclusions

3 available for each measure

Public Health and Clinical Data Registry Reporting

What is “Active Engagement”?

The EP is moving toward the submission of real patient data. This can be demonstrated 1 of 3 ways:

• 1. Completed registration with a PHA or CDR within 60 days after the start
• f reporting period
• 2. Testing of data submission process initiated
• 3. Actively submitting patient data

Public Health and Clinical Data Registry Reporting

Exclusions:

• Do not count as satisfying a measure
• i.e. EP cannot exclude from Immunization Registry Reporting on grounds

that they didn’t perform any immunizations during reporting period and have that count as 1 of the 2 measures they need to meet.

• In the event that 3 measures don’t apply, EP can report on whatever

is applicable and claim an exclusion for the non-relevant measures

• AOA’s MORE is a clinical data

registry available to ODs

Summary

• Stage 3 is the only definition of MU in 2018 and beyond
• Full year reporting periods for all EPs in 2017 and beyond
• Stage 3 increases V/D/T Use to 25%
• Only secure electronic delivery of health info will be counted
• Patient Education
• Summary of Care
• “Active engagement” with Clinical Data Registries will be expected

Next – 10:45AM to 12:30 PM

• Closing General Session

– RevYou 2015 recap & the future of RevolutionEHR!