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1
MEANINGFUL USE
Agenda
2
 What is meaningful use?
 CMS incentive program.
 Benefits.
 Legislation.
 Stages of meaningful use.
 Barriers.
 Penalties
EHR
3
 Electronic health information about patients that
is capable of being shared across different
health care settings.
 EHR can provide many benefits for providers and
their patients, but the benefits depend on how
they're used.
What is meaningful use?
4
 Set of standards by the CMS Incentive
Programs that
 governs the use of electronic health records and
 Allows eligible providers and hospitals to earn
incentive payments by meeting specific criteria.
The Medicare & Medicaid EHR
Incentive Program
5
 Provide incentive payments to eligible
professionals, eligible hospitals and critical
access hospitals (CAHs).
 Can receive up to
 $44,000 (Medicare, 2011 through 2016)
 $63,750 (Medicaid, 2011 through 2021)
 Maximum incentive payment - participation by
2012.
Goal
6
To promote the spread of electronic health records to
improve health care in the United States.
Benefits
7
 Complete and accurate information:
 provide the best possible care.
 Providers will know more about their patients.
 Better access to information:
 diagnose health problems earlier.
 Information can be shared among hospitals.
 Patient empowerment:
 Patients role.
 Records can be shared securely to their families.
Legislation
8
HITECH Act
HHS
Programs to improve
health care quality
Promotion of health IT like
EHR
Authority
To
establish
9
 Incentive Program for EHR: Issued by CMS,
define the minimum requirements that providers
must meet through their use of certified EHR
technology in order to qualify for the payment.
 Standards and Certification Criteria for
EHR: Issued by ONC, defines the technical
capabilities for certified EHR technology.
Stages of meaningful use
10
Stage-1 (2011-2012)
11
 Details the requirements for the use of
requirements for the use of EHR systems by
hospitals and eligible health care professionals.
 MU criteria for eligible professionals
 15 core objectives (mandatory)
 5 out of 10 from menu set objectives(choice)
 MU criteria for eligible hospitals
 14 core objectives (mandatory)
 5 out of 10 from menu set objectives (choice)
Core Requirements
(mandatory)
12
 Use computerized order entry for medication orders.
 Implement drug-drug, drug-allergy checks.
 Generate and transmit permissible prescriptions electronically.
 Record demographics.
 Maintain an up-to-date problem list of current and active diagnoses.
 Maintain active medication list.
 Maintain active medication allergy list.
 Record and chart changes in vital signs.
 Record smoking status for patients 13 years old or older.
 Implement one clinical decision support rule.
 Report ambulatory quality measures to CMS or the States.
 Provide patients with an electronic copy of their health information
upon request.
 Provide clinical summaries to patients for each office visit.
 Capability to exchange key clinical information electronically among
providers and patient authorized entities.
 Protect electronic health information (privacy & security)
Menu Requirements (optional)
13
 Implement drug-formulary checks.
 Incorporate clinical lab-test results into certified EHR as structured data.
 Generate lists of patients by specific conditions to use for quality
improvement, reduction of disparities, research, and outreach.
 Send reminders to patients per patient preference for preventive/ follow-
up care
 Provide patients with timely electronic access to their health information
(including lab results, problem list, medication lists, allergies)
 Use certified EHR to identify patient-specific education resources and
provide to patient if appropriate.
 Perform medication reconciliation as relevant
 Provide summary care record for transitions in care or referrals.
 Capability to submit electronic data to immunization registries and
actual submission.
 Capability to provide electronic syndromic surveillance data to public
health agencies and actual transmission.
Stage-2 (2014)
14
 Released in August 2012.
 Some stage-1 menu list items will move to the
stage 2 core list.
 MU criteria for eligible professionals
 17 core objectives (mandatory)
 3 out of 6 from menu set objectives(choice)
 MU criteria for eligible hospitals
 16 core objectives (mandatory)
 3 out of 6 from menu set objectives (choice)
Stage-3 (2016)
15
 Objectives has not yet defined.
 Likely to follow the same format as its
predecessors.
Milestone Timeline
16
Barriers to adoption
17
 Start-up costs
 Maintenance costs
 Training costs
Penalties
18
 Medicare:
 No payments after 2014.
 1% to 5% penalty of Medicare reimbursement after
2015.
 Medicaid:
 There are no penalties.
THANK YOU
19

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Meaningful use: Medicare EHR Incentive Program

  • 2. Agenda 2  What is meaningful use?  CMS incentive program.  Benefits.  Legislation.  Stages of meaningful use.  Barriers.  Penalties
  • 3. EHR 3  Electronic health information about patients that is capable of being shared across different health care settings.  EHR can provide many benefits for providers and their patients, but the benefits depend on how they're used.
  • 4. What is meaningful use? 4  Set of standards by the CMS Incentive Programs that  governs the use of electronic health records and  Allows eligible providers and hospitals to earn incentive payments by meeting specific criteria.
  • 5. The Medicare & Medicaid EHR Incentive Program 5  Provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs).  Can receive up to  $44,000 (Medicare, 2011 through 2016)  $63,750 (Medicaid, 2011 through 2021)  Maximum incentive payment - participation by 2012.
  • 6. Goal 6 To promote the spread of electronic health records to improve health care in the United States.
  • 7. Benefits 7  Complete and accurate information:  provide the best possible care.  Providers will know more about their patients.  Better access to information:  diagnose health problems earlier.  Information can be shared among hospitals.  Patient empowerment:  Patients role.  Records can be shared securely to their families.
  • 8. Legislation 8 HITECH Act HHS Programs to improve health care quality Promotion of health IT like EHR Authority To establish
  • 9. 9  Incentive Program for EHR: Issued by CMS, define the minimum requirements that providers must meet through their use of certified EHR technology in order to qualify for the payment.  Standards and Certification Criteria for EHR: Issued by ONC, defines the technical capabilities for certified EHR technology.
  • 11. Stage-1 (2011-2012) 11  Details the requirements for the use of requirements for the use of EHR systems by hospitals and eligible health care professionals.  MU criteria for eligible professionals  15 core objectives (mandatory)  5 out of 10 from menu set objectives(choice)  MU criteria for eligible hospitals  14 core objectives (mandatory)  5 out of 10 from menu set objectives (choice)
  • 12. Core Requirements (mandatory) 12  Use computerized order entry for medication orders.  Implement drug-drug, drug-allergy checks.  Generate and transmit permissible prescriptions electronically.  Record demographics.  Maintain an up-to-date problem list of current and active diagnoses.  Maintain active medication list.  Maintain active medication allergy list.  Record and chart changes in vital signs.  Record smoking status for patients 13 years old or older.  Implement one clinical decision support rule.  Report ambulatory quality measures to CMS or the States.  Provide patients with an electronic copy of their health information upon request.  Provide clinical summaries to patients for each office visit.  Capability to exchange key clinical information electronically among providers and patient authorized entities.  Protect electronic health information (privacy & security)
  • 13. Menu Requirements (optional) 13  Implement drug-formulary checks.  Incorporate clinical lab-test results into certified EHR as structured data.  Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach.  Send reminders to patients per patient preference for preventive/ follow- up care  Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies)  Use certified EHR to identify patient-specific education resources and provide to patient if appropriate.  Perform medication reconciliation as relevant  Provide summary care record for transitions in care or referrals.  Capability to submit electronic data to immunization registries and actual submission.  Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission.
  • 14. Stage-2 (2014) 14  Released in August 2012.  Some stage-1 menu list items will move to the stage 2 core list.  MU criteria for eligible professionals  17 core objectives (mandatory)  3 out of 6 from menu set objectives(choice)  MU criteria for eligible hospitals  16 core objectives (mandatory)  3 out of 6 from menu set objectives (choice)
  • 15. Stage-3 (2016) 15  Objectives has not yet defined.  Likely to follow the same format as its predecessors.
  • 17. Barriers to adoption 17  Start-up costs  Maintenance costs  Training costs
  • 18. Penalties 18  Medicare:  No payments after 2014.  1% to 5% penalty of Medicare reimbursement after 2015.  Medicaid:  There are no penalties.