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Meaningful Use of EMR

TriMed e-Medsys EHR ONC-ATCB Certfied

In an effort to maintain a superior product and provide our clients with all they need to maximize reimbursements while expanding patient care TriMed has taken the necessary steps to achieve ONC-ATCB 2011/12 certification. TriMed’s EHR version 7 meets all the objectives outlined for Meaningful Use as outlined by the Department of Health of Human Services (HHS) in the Final Ruling

What is Meaningful Use?

The Medicare and Medicaid EHR Incentive Programs will provide incentive payments to professionals as they adopt, implement, upgrade, and demonstrate meaningful use of certified EHR technology. There are two main components to receiving incentives through incentive program: (1) Using a certified EHR (2) Demonstrating meaningful use of the EHR.

Using a certified EHR

The Department of Health and Human Services (HHS) outlined certain standards they deemed necessary for EHR products to possess. These standards were announced third quarter of 2010. In an effort to ensure that products meet these standards they required that each EHR vendor certify their product with an Authorized Testing and Certification Body (ATCB) through the Office of the National Coordinator (ONC). These various bodies were accredited and announced in the third and fourth quarters of 2010. Those products receiving this certification are considered ONC-ATCB products for 2011/2012.

TriMed chose to partner with the ONC Authorized Testing and Certification Body SSL Global Solutions to seek its ONC-ATCB certification. This was completed in April 2011 .

Demonstrating meaningful use of the EHR

When considering how to receive the incentive reimbursements through the meaningful use process, it is important to bear in mind the goal of the program. The program is intended to encourage providers to use an Electronic Health Record in a meaningful way. As such, each provider (not practice) must demonstrate his/her meaningful use of the product. This is done by pulling a standard report from the EHR that looks at each “measure” over a 90 day period of time. The report is then uploaded to a CMS EHR Incentive website.

Over the course of the next five years (2011-2015) the criteria for meaningful use will be divided into three stages: Stage 1 (Years 2011-2012), Stage 2 (2013-2014 tentatively), Stage 3 (2015 tentatively). The criteria will grow more stringent in the later stages.

How much money and when?

With the EHR Incentive Programs how much money a provider earns is connected to how soon a provider demonstrates meaningful use. Providers can earn up to $44,000 over a five year period. To earn the maximum amount a provider must demonstrate his/her meaningful use by the end of 2012. As long as a provider is ready to report by the end of 2012 they can still earn the maximum $44,000.

Demonstrating meaningful use in 2011/2012

In stage 1, years 2011 and 2012, providers are required to send in data on 90 consecutive days within the first year they report. They are to send it in for only one 90 day period in that year. So, if a provider reports in 2011 he/she should send in one 90 day period of data for 2011. If a provider chooses to not sign up till 2012 he/she would send in data for one 90 day period for 2012.

What are the various measures?

There are 25 meaningful use objectives. These are divided into two types: Core Objectives and Menu Objectives. There are 15 Core Objectives and 10 Menu Objectives. Each objective has a corresponding measure to determine whether the objective is met. To qualify for an incentive payment an eligible provider must meet all 15 core measures and 5 of the 10 menu measures. Below is a list of each objective with its respective measure and exclusion.

Core Measure 1

Core Measure 1

Objective

Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies), upon request.

Measure

More than 50% of all patients who request an electronic copy of their health information are provided it within 3 business days.

Exclusion

Based on ALL patient records: An EP who has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period would be excluded from this requirement.

Core Measure 2

Core Measure 2

Objective

Implement drug-drug and drug-allergy interaction checks.

Measure

Have you enabled the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period?

Core Measure 3

Core Measure 3

Objective

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

Measure

More than 80% of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data.

Numerator

Number of patients in the denominator who have at least one entry or an indication that no problems are known for the patient recorded as structured data in their problem list.

Core Measure 4

Core Measure 4

Objective

Generate and transmit permissible prescriptions electronically (eRx).

Measure

More than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

Exclusion

Based on ALL patient records: Any EP who writes fewer than 100 prescriptions during the EHR reporting period would be excluded from this requirement.

Core Measure 5

Core Measure 5

Objective

Maintain active medication list.

Measure

More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data.

Core Measure 6

Core Measure 6

Objective

Maintain active medication allergy list.

Measure

More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data.

Core Measure 7

Core Measure 7

Objective

Record all of the following demographics: • Preferred language • Gender • Race • Ethnicity • Date of birth

Measure

More than 50% of all unique patients seen by the EP have demographics recorded as structured data.

Numerator

Number of patients in the denominator who have all the elements of demographics (or a specific exclusion if the patient declined to provide one or more elements or if recording an element is contrary to state law) recorded as structured data.

Core Measure 8

Core Measure 8

Objective

Record and chart changes in vital signs: • Height • Weight • Blood pressure • Calculate and display body mass index (BMI) • Plot and display growth charts for children 2-20 years, including BMI.

Measure

More than 50% of all unique patients age 2 and over seen by the EP, height, weight and blood pressure are recorded as structured data.

Exclusion 1

Based on ALL patient records: An EP who does not see patients 2 years or older would be excluded from this requirement.

Exclusion 2

Based on ALL patient records: An EP who believes that all three vital signs of height, weight, and blood pressure have no relevance to scope of practice would be excluded from this requirement.

Core Measure 9

Core Measure 9

Objective

Record smoking status for patients 13 years old or older.

Measure

More than 50% of all unique patients 13 years or older seen by the EP have smoking status recorded as structured data.

Exclusion

Based on ALL patient records: An EP who did not see patients 13 years or older would be excluded from this requirement.

Core Measure 10

Core Measure 10

Objective

Report ambulatory clinical quality measures to CMS.

Measure

Although clinical quality measures are not included in this tool, EPs will be required to submit numerator, denominator, and exclusion information for clinical quality measures during the online attestation process. If you plan to submit clinical quality measure information during attestation, answer yes to the following question: Will you submit Clinical Quality Measures?

Core Measure 11

Core Measure 11

Objective

Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance to that rule.

Measure

Have you implemented one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance to that rule?

Core Measure 12

Core Measure 12

Objective

Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, medication allergies), upon request.

Measure

More than 50% of all patients who request an electronic copy of their health information are provided it within 3 business days.

Exclusion

Based on ALL patient records: An EP who has no requests from patients or their agents for an electronic copy of patient health information during the EHR reporting period would be excluded from this requirement.

Core Measure 13

Core Measure 13

Objective

Provide clinical summaries for patients for each office visit.

Measure

Clinical summaries provided to patients for more than 50% of all office visits within 3 business days.

Exclusion

Based on ALL patient records: Any EP who has no office visits during the EHR reporting period would be excluded from this requirement.

Core Measure 14

Core Measure 14

Objective

Capability to exchange key clinical information (for example, problem list, medication list, allergies, diagnostic test results), among providers of care and patient authorized entities electronically

Measure

Have you performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information?

Core Measure 15

Core Measure 15

Objective

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

Measure

Have you conducted or reviewed a security risk analysis per 45 CFR 164.308 (a)(1) and implemented security updates as necessary and corrected identified security deficiencies as part of your risk management process?

Menu Measure 1

Menu Measure 1

You must choose at least one of Menu Measure 1 or Menu Measure 2.

Objective

Capability to submit electronic data to immunization registries or immunization information systems and actual submission in accordance with applicable law and practice.

Measure

Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP submits such information have the capacity to receive the information electronically).

Exclusion 1

Based on ALL patient records: An EP who does not perform immunizations during the EHR reporting period would be excluded from this requirement.

Exclusion 2

Based on ALL patient records: If there is no immunization registry that has the capacity to receive the information electronically, an EP would be excluded from this requirement.

Menu Measure 2

Menu Measure 2

You must choose at least one of Menu Measure 1 or Menu Measure 2.

Objective

Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice

Measure

Performed at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP submits such information have the capacity receive the information electronically).

Exclusion 1

Based on ALL patient records: If an EP does not collect any reportable syndromic information on their patients during the EHR reporting period, then the EP is excluded from this requirement.

Exclusion 2

Based on ALL patient records: If there is no public health agency that has the capability to receive the information electronically, then the EP is excluded from this requirement.

Menu Measure 3

Menu Measure 3

If you met both Menu Measures 1 and 2, you need to meet three of Menu Measures 3-10. If you only met one of Menu Measure 1 and 2, you need to meet four of Menu Measures 3-10.

Objective

Implement drug formulary checks.

Measure

The EP has enabled this functionality and has access to at least one internal or external drug

Exclusion

Based on ALL patient records: Any EP who writes fewer than 100 prescriptions during the EHR reporting period would be excluded from this requirement

Menu Measure 4

Menu Measure 4

Objective

Implement drug formulary checks .

Measure

The EP has enabled this functionality and has access to at least one internal or external drug formulary for the entire EHR reporting period.

Exclusion

Based on ALL patient records: Any EP who writes fewer than 100 prescriptions during the EHR reporting period would be excluded from this requirement.

Menu Measure 5

Menu Measure 5

Objective

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

Measure

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

Menu Measure 6

Menu Measure 6

Objective

Send reminders to patients per patient preference for preventive/follow up care.

Measure

More than 20% of all unique patients 65 years or older or 5 years or younger were sent an appropriate reminder during the EHR reporting period.

Exclusion

Based on ALL patient records: Any EP who has no patients 65 years or older or 5 years old or younger with records maintained using certified EHR technology is excluded from this requirement.

Menu Measure 7

Menu Measure 7

Objective

Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists and allergies) within 4 business days of the information being available to the EP.

Measure

At least 10% of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP’s discretion to withhold certain information.

Exclusion

Based on ALL patient records: Any EP who neither orders nor creates lab tests or information that would be contained in the problem list, medication list, or medication allergy list during the EHR reporting period would be excluded from this requirement.

Menu Measure 8

Menu Measure 8

Objective

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

Measure

More than 10% of all unique patients seen by the EP during the EHR reporting period are provided patient-specific education resources.

Menu Measure 9

Menu Measure 9

Objective

The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.

Measure

The EP performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP.

Exclusion

Based on ALL patient records: An EP who was not on the receiving end of any transition of care during the EHR reporting period would be excluded from this requirement.

Menu Measure 10

Menu Measure 10

Objective

The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary of care record for each transition of care or referral.

Measure

The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50% of transitions of care and referrals.

Exclusion

Based on ALL patient records: An EP who does not transfer a patient to another setting or refer a patient to another provider during the EHR reporting period would be excluded from this requirement.
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