HEALTH INFORMATION TECHNOLOGY SOLUTIONS

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MEANINGFUL USE / STIMULUS FUNDS

In order to achieve meaningful use eligible providers must satisfy 15 core requirements of their EMR system. These requirements deal with the entry of patient demographics and others such as computer order entry. Additionally, the eligible provider must choose 5 items from a menu list of 10 optional objectives.

Here are the 5 Summary Steps to Receiving Stimulus Funds.

1. Determine eligibility
Once you have ascertained that you are a qualified eligible provider you must next determine which program you wish to participate in. The Medicaid incentive program pays is slated to pay a maximum of $63,750 as opposed to $44,000 for the Medicare program.

2. Implement a certified EMR system
The process of choosing an EMR system which satisfies the needs of your organization is not a quick and easy choice. However, the initial criteria must be that the EMR has been certified by an Authorized Testing and Certification Body (ATCB) that in turn has been authorized by the Office of the National Coordinator for Health Information Technology (ONC). To date, the certification bodies are;
• Certification Commission for Health Information Technology (CCHIT)
• The Drummond Group
• InfoGard Laboratories

Step 3: Demonstrate meaningful use
Once your EMR system is in place, eligible providers have to demonstrate that they are meeting the ONC�s meaningful use criteria, beginning with stage 1requirements. During the organization�s first payment year, meaningful use must be demonstrated for a continuous 90-day period. Meaningful use must be demonstrated for the entire year after the initial payment year. To obtain maximum reimbursement, you should aim for either 2011 or 2012 as your first payment year.

Step 4: Submit reports to HHS
After demonstrating the meaningful use of your EMR for 90 consecutive days you are ready to prove you have done so to the ONC. This is done through an attestation methodology in the form of reports. In 2011, the submission of these reports electronically is not required as the ONC has not implemented the systems necessary to accept and read electronic submissions. In 2012, electronic submissions will be required, provided the ONC has the ability to receive them. If they do not, an announcement will be posted in the Federal Register and paper submissions will again be accepted.

Step 5: Collect meaningful use incentives
The ONC has not given a timeframe for the payment of stimulus funds once your reports have been submitted and analyzed. For Medicaid, the allocation of incentives is contingent on the development of the National Level Repository, which CMS will use to determine who is eligible for that program.

To continue receiving payments, the eligible provider must achieve and demonstrate meaningful use throughout stage 2 and 3 of the program.

Meaningful Use / Stimulus Funds

 

Incentive Payments to Begin in May 2011

On January 3, 2011, registration opened for the incentive program. To participate, hospitals and Medicare physicians must have a national provider identifier and be enrolled in the CMS Provider Enrollment, Chain and Ownership System (PECOS). Most providers also need to have an active user account in the National Plan and Provider Enumeration System (NPPES).

To begin receiving incentive payments eligible providers must verify that they have demonstrated meaningful use of a certified EMR system for a period of 90 days. In order to achieve this 90 day meaningful use threshold no one will be able to attest to meeting the objectives set forth below prior to April.

In accordance with this timeline The Centers for Medicare and Medicaid Services will begin to make meaningful use incentive payments to eligible physicians and hospitals as early as May 2011.

 

Certification Bodies

The Office of the National Coordinator for Health IT (ONC) has chosen its’ third EHR certification organization under the federal governments temporary program. In addition to CCHIT and The Drummond Group, InfoGard Laboratories has been authorized to test and certify electronic health record systems.

 

Summarization of Meaningful Use Objectives

Objective

Core Set

Measure

Record patient demographics (sex, race, ethnicity, date of birth, preferred language, and in the case of hospitals, date and preliminary cause of death in the event of mortality).

More than 50% of patients’ demographic data recorded as structured data.

Record vital signs and chart changes (height, weight, blood pressure, body-mass index, growth charts for children).

More than 50% of patients 2 years of age or older have height, weight, and blood pressure recorded as structured data.

Maintain up-to-date problem list of current and active diagnoses.

More than 80% of patients have at least one entry recorded as structured data.

Maintain active medication list.

More than 80% of patients have at least one entry recorded as structured data.

Maintain active medication allergy list.

More than 80% of patients have at least one entry recorded as structured data.

Record smoking status for patients 13 years of age or older.

More than 50% of patients 13 years of age or older have smoking status recorded as structured data.

For individual professionals, provide patients with clinical summaries for each office visit; for hospitals, provide an

electronic copy of hospital discharge instructions on request.

Clinical summaries provided to patients for more than 50% of all office visits within 3 business days; more than 50% o all patients who are discharged from the inpatient department or emergency department of an eligible hospital or critical access hospital and who request an electronic copy of their discharge instructions are provided with it.

On request, provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies, and for hospitals, discharge summary and procedures).

More than 50% of requesting patients receive electronic copy within 3 business days.

Generate and transmit permissible prescriptions electronically (does not apply to hospitals).

More than 40% are transmitted electronically using certified EHR technology.

Computer provided order entry (CPOE) for medication orders.

More than 30% of patients with at least one medication in their medication list have at least one medication ordered through CPOE.

Implement drug-drug, drug-allergy interaction checks.

Functionality is enabled for these checks for the entire reporting period.

Implement capability to electronically exchange key clinical information among providers and patient-authorized entities.

Perform at least one test of EHR’s capacity to electronically exchange information.

Implement one clinical decision support rule and ability to track compliance with the rule.

One clinical decision support rule is implemented.

Implement systems to protect privacy and security of patient data in the EHR.

Conduct or review a security risk analysis, implement security updates as necessary, and correct identified security deficiencies.

Report clinical quality measures to CMS or states.

For 2011, provide aggregate numerator and denominator through attestation; for 2012, electronically submit measures.

  

Objective

Menu Set

Measure

Implement drug formulary checks.

Drug formulary check system is implemented and has access to at least one internal or external drug formulary for the entire reporting period.

Incorporate clinical laboratory tests into EHRs as structured data.

More than 40% of clinical laboratory test results whose results are in positive/negative or numerical format are incorporated into EHRs as structured data.

Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.

Generate at least one listing of patients with a specific condition.

Use EHR technology to identify patient-specific education resources and provide those to the patient as appropriate.

More than 10% of patients are provided patient-specific education resources.

Perform medication reconciliation between care settings.

Medication reconciliation is performed for more than 50% of transitions of care.

Provide summary of care record for patients referred or transitioned to another provider or setting.

Summary of care record is provided for more than 50% of patient transitions or referrals.

Submit electronic immunization data to immunization registries or immunization information systems.

Perform at least one test of data submission and follow-up submission (where registries can accept electronic submissions).

Submit electronic syndromic surveillance data to public health agencies.

Perform at least one test of data submission and follow-up submission (where public health agencies can accept electronic data).

Additional choices for hospitals and critical access hospitals

Record advance directives for patients 65 years of age or older.

More than 50% of patients 65 years of age or older have an indication of an advance directive status recorded.

Submit electronic data on reportable laboratory results to public health agencies.

Perform at least one test of data submission and follow-up submission (where public health agencies can accept electronic health data).

Additional choices for eligible health professionals

Send reminders to patients (per patient preference) for preventive and follow-up care.

More than 20% of patients 65 years of age or older of 5 years of age or younger are sent appropriate reminders.

Provide patients with timely electronic access to their health information (including laboratory results, problem lists, medication lists, medication allergies.

More than 10% of patients are provided electronic access to information within 4 days of it being updated in the EMR.

 

The following is an at-a-glance summary of important dates:

  • Oct. 1, 2010 - Reporting year begins for eligible hospitals and CAHs.
  • Jan.1, 2011 - Reporting year begins for eligible professionals.
  • Jan. 3, 2011 - Registration for the Medicare EHR Incentive Program begins.
  • Jan. 3, 2011 - For Medicaid providers, states may launch their programs if they so choose.
  • April 2011 - Attestation for the Medicare EHR Incentive Program begins.
  • May 2011 - EHR Incentive Payments expected to begin.
  • July 3, 2011 - Last day for eligible hospitals to begin their 90-day reporting period to demonstrate meaningful use for the Medicare EHR Incentive Program.
  • September 30, 2011 - Last day of the federal fiscal year. Reporting year ends for eligible hospitals and CAHs.
  • Oct. 1, 2011 - Last day for eligible professionals to begin their 90-day reporting period for calendar year 2011 for the Medicare EHR Incentive Program.
  • Nov. 30, 2011 - Last day for eligible hospitals and critical access hospitals to register and attest to receive an Incentive Payment for Federal fiscal year (FY) 2011.
  • Dec. 31, 2011 - Reporting year ends for eligible professionals.
  • Feb. 29, 2012 - Last day for eligible professionals to register and attest to receive an Incentive Payment for calendar year (CY) 2011.

Rather than having to meet 23 or 25 different objectives (for hospitals and doctors respectively), providers will now have to meet just 14 or 15 “core” requirements dealing with EMR basics, such as being able to enter patient data and use a computer-based system to record medical orders.

Then they can pick an additional five objectives from a menu of ten options. Those include incorporating some lab tests results into records and providing a summary of care record for patients transferring to another facility.

Oncore Associates