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 Stage of Meaningful Use Meaningful Use 2015 2016 2017 2018 Modified Stage 2 or 2011 Modified Stage 2 Modified Stage 2 Stage 3 Stage 3 Modified Stage 2 or 2012 Modified Stage 2 Modified Stage 2 Stage 3 Stage 3 Modified Stage 2 or 2013 Modified Stage 2 Modified Stage 2 Stage 3 Stage 3 Modified Stage 2 or 2014 Modified Stage 2 Modified Stage 2 Stage 3 Stage 3 Modified Stage 2 or 2015 Modified Stage 2 Modified Stage 2 Stage 3 Stage 3 Modified Stage 2 or 2016 n/a Modified Stage 2 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 Protect electronic health information created or maintained by the Proposed Objective CEHRT through the implementation of appropriate technical capabilities. 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) Proposed Measure 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 None Exclusions

Electronic Prescribing Proposed Objective Generate and transmit permissible prescriptions electronically (eRx) More than 80 percent of all permissible prescriptions written by the EP Proposed Measure are queried for a drug formulary and transmitted electronically using Certified EHR Technology 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 Exclusions 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 Use clinical decision support to improve performance on high-priority health Proposed Objective conditions 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 Proposed Measures 2. The EP has enabled and implemented the functionality for drug-drug and drug allergy interaction checks for the entire EHR reporting period Any EP who writes fewer than 100 medication orders during the EHR reporting Exclusions period can exclude from measure 2

Computerized Provider Order Entry Use computerized provider order entry (CPOE) for medication, laboratory, and diagnostic imaging orders directly entered by any licensed healthcare professional Proposed Objective who can enter orders into the medical record per state, local, and professional guidelines 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 Proposed Measures 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 Any EP who writes fewer than 100 medication, laboratory, or diagnostic imaging Exclusions orders 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 Objective 5: Patient Electronic Access to Health Information • Patient-specific education resources Objective 6: Coordination of • Secure messaging Care through Patient • V/D/T use Engagement

Patient Electronic Access to Health Information 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 Proposed Objective hours of its availability. 1. More than 80 percent of unique patients are provided PHR or API-based access within 24 hours. Proposed Measures 2. Provide electronic access to patient-specific educational resources for more than 35 percent of unique patients 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 Exclusions (www.broadbandmap.gov) 2. EP has no o ffi ce visits during the reporting period

Coordination of Care through Patient Engagement Use communications functions of certified EHR technology to engage with patients Proposed Objective or their authorized representatives about the patient’s care. 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 Proposed Measures 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 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 Exclusions (www.broadbandmap.gov) 2. EP has no o ffi ce visits during the reporting period

Health Information Exchange 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 Proposed Objective 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. 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 Proposed Measures 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. 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 Exclusions 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 The EP is in active engagement with a PHA or CDR to submit electronic public Proposed Objective health data in a meaningful way using certified EHR technology, except where prohibited, and in accordance with applicable law and practice 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 Proposed Measures 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 of 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