History Of Meaningful Use - Miami

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1/21/2014 FCDS Webinar Meaningful Use January 23, 2014 Monique Hernandez Florida Cancer Data System Meaningful Use Coordinator Meaningful Use Goal O The goal of meaningful use is to promote the spread of electronic health records to improve health care in the United States What is Meaningful Use? O Meaningful Use (MU) is a program through the Centers for Medicare and Medicaid Services (CMS) that provides incentives ( ) to healthcare providers who use electronic health record (EHR) technology in a specific and ‘meaningful’ way. Benefits of Meaningful Use O Complete accurate information Equips providers with increased access to patient’s health history O Better information access O To show that the utilization of EHRs are done in a ‘meaningful’ way. The ability to share information among physicians’ offices, hospital and health care systems O Patient Empowerment O Certified Electronic Health Record Technology (CEHRT) History of Meaningful Use O Started with the 2009 American Recovery and Reinvestment Act (ARRA). O ARRA includes measure to modernize our nation’s infrastructure, one of which is the “Health Information Technology for Economic and Clinical Health Act.” This act supports the concept of Electronic Health Records. O Gives Dept. of Health and Human Services authority to establish programs to improve care, safety and efficiency through Health IT. Provides secure electronic copies of medical records for patients to allow them a more active role in care decisions History of Meaningful Use O Under HITECH the Office of the National Coordinator for HIT issued the rules, standards and certification criteria for Electronic Health Record (EHR) technology. O EHR is beneficial depending on how it is used. O Center for Medicare and Medicaid Services (CMS) developed the standards for “Meaningful Use” of Certified Health Information Technology and are providing incentives to providers who practice the standards for MU. http://www.cdc.gov/ehrmeaningfuluse/ 1

1/21/2014 What is a CEHRT? Certified Electronic Health Record Technology O CMS and ONC established standards and criteria for structured data that an EHR must use to qualify for the incentive program. O Covers technological capability, functionality, and security. Who is Eligible for Meaningful Use O Incentives ( ) are available to non-hospital based Eligible Professionals (EP) and to hospitals and critical access hospitals O EPs are physicians (MDs/DOs), dentists, podiatrists, optometrists, and chiropractors who provide Medicare and/or Medicaid services O Each EP in a group practice is eligible for the incentive The Incentive O Under Medicare, up to 44,000 over 5 years for EPs Meaningful Use Stages O The objectives and measures of Meaningful Use are divided in three stages O Under Medicaid, up to 63,750 over 6 years for EPs O Penalties! Beginning 2015, reduced Medicare payments for failure to be meaningful user (3% reduction by 2017) with additional reductions due to sequestration. CMS Timeline Public health reporting Stage I Core Objectives Select examples of objectives include: O Computerized Provider Order Entry (CPOE) for Medication Orders O Active Medication Listing O Medication Allergy List O Demographics O Smoking Status O Clinical Summaries O Protect Electronic Health Information 2

1/21/2014 Stage II Core Objectives Set to begin January 1, 2014 Select Examples of Core Objectives O Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders O Generate and transmit permissible prescriptions electronically (eRx) O Provide clinical summaries for patients at each office visit O Generate lists of patients by specific conditions to use for quality improvement, research or outreach. What if an EP selects the menu option to report to a CCR? What is required to meet this objective? To begin: Complete MU1 2. Have CEHRT – Vendor EHR software 3. Have CEHRT system that is compliant with Cancer Specifications – Using CDA electronic format 1. Stage II Menu Objectives for EPs O Capability to report to syndromic surveillance data to public health agencies O Record electronic notes in patient records O Imaging results are accessible through CEHRT O Record patient family health history as structure data O Identify and report cancer cases to a public health central cancer registry O Capability to identify and report to a specialized registry (non-mandated e.g. ALS registry) What in the world is a CDA? O HL7 Clinical Document Architecture ANSI certified standard developed by the Health Level 7 technical group (HL7.org) for clinical content An XML-based markup standard intended to specify the encoding, structure and semantics of clinical documents for exchange. Contains Text, Structure, Coding Systems Discharge summary, Imaging Report, Path report, admission & physical. http://en.wikipedia.org/wiki/Clinical Document Architecture CDC NPCR CDA O CDC National Program of Cancer Registries developed the CDA reporting standards that ONC adopted for MU Incentives ion Guide for Ambulatory Healthca re Provider Reporting to Central Cancer Registries August 2012.pdf 3

1/21/2014 E-marc Plus How will the CDA be translated into a standard cancer record? O CDC NPCR product used to read in HL7 messages (typically used for pathology reports) O Includes a tool that validates the structure of the MU2 Cancer CDA message O Translates the CDA data elements into a standard NAACCR codes and maps it to a standard record layout– consolidated at the facility/physician level. Reporting to a Public Health Agency The MU2 process for PHAs and EPs 1. Declaration of Readiness FCDS Declaration of Readiness O Public Health Agencies (PHAs) need to declare their readiness to accept data from Providers, register Providers that intend to submit data, establish a testing and validation process to onboard Providers, and acknowledge Providers that successfully submit data .shtml 4

1/21/2014 2. Registration O Eligible Providers must register their intent to meet MU2 public health objectives with the Public Health Agency (PHA) to which they will submit data O Registration captures practice and provider information through the IDEA system 3. Onboarding O Invitation to onboard/request for action After registration, the EP must respond to a PHA’s written request for action within 30 days for testing and validation. O Testing and validation EP provides sample data to ensure correct formatting and required data elements O Ongoing transmission Real and valid data are transmitted continuously What are the benefits and how might this impact the hospital registrar? 4. Acknowledgements O The official communications from PHAs to Providers to affirm successfully submitted data for a MU2 objective O FCDS can provide follow up patient treatment information O Availability of granular data O Requires ongoing submission of valid and real patient data O More comprehensive patient treatment profiles O Evaluation of standards of care O Written communications will be used by providers to document meeting their MU2 objectives O Longitudinal data on patient status O Potential for quality control and data accuracy Resources O http://www.healthit.gov/policy-researchers- implementers/meaningful-use O http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/M eaningful Use.html O www.cdc.gov/cancer/npcr/meaningful use.htm O http://www.phconnect.org/group/ph-reporting- task-force List of Acronyms O O O O O O O O O O O O O O O ARRA – American Recovery and Reinvestment Act of 2009 CAHs- Critical Access Hospitals CCR – Central Cancer Registry CDA – Clinical Document Architecture CDC – Centers for Disease Control CEHRT – Certified Electronic Health Record Technology CMS – Centers for Medicare and Medicaid CPOE – Computerized Provider Order Entry EP – Eligible Professional HHS – Health and Human Services HITECH – Health information Technology and clinical Health Act HL7 – Health Level 7 MU – Meaningful Use ONC – Office of the National Coordinator of Health IT PHA – Public Health Agency 5

1/21/2014 Thank You! QUESTIONS? Contact Info for Monique N. Hernandez Meaningful Use Coordinator mhernandez5@med.miami.edu or MU2FLCancerReporting@med.miami.edu 6

and 'meaningful' way. Meaningful Use Goal O The goal of meaningful use is to promote the spread of electronic health records to improve health care in the United States O To show that the utilization of EHRs are done in a 'meaningful' way. O Certified Electronic Health Record Technology (CEHRT) Benefits of Meaningful Use O Complete .

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