ARRAMeaningful Use Update

Mount Auburn Hospital Information Systems Update March 2011

Topics Outline

ARRA Meaningful Use – A brief history Overview of Measures

– Core Set – Menu Set– Clinical Quality Measures

Project List Attestation and Reporting; Timeline and

Structure

ARRA – The American Recovery and Reinvestment Act

Effective February 19th, 2009 HITECH is the health IT section Created the Office of the National Coordinator (ONC), Health

Information Technology (HIT) Policy and HIT Standards Committee

Provided approximately $20 billion in incentive payments for Eligible Providers and Hospitals under Medicare and Medicaid “for adoption and meaningful use of certified EHR technology”

Meaningful Use Final Rule specifying requirements became available July, 2010

Established measures to meet 5 core goals

Improve quality, safety, efficiency and reduce health disparities

Engage patients and families in their care Improve care coordination Ensure privacy and security for Personal Health

Information Improve public health and interact with public

health programs

Meeting MU Requirements

For Hospitals– Meet 14 requirements from a core set– Meet 5 requirements from a menu set.

At least one must be a public health reporting requirement

– Establish the infrastructure to report on 15 Core Quality Measures

Quality measures are one of the core requirements– Achieve all of the above using certified functionality

within a certified Electronic Health Record.

Stages of Meaningful Use

Payment Year

1ST Year of Payment

2011 2012 2013 2014 2015

2011 Stage 1 Stage 1

Stage 2 Stage 2 Stage 3

2012 Stage 1

Stage 1 Stage 2 TBD

2013 Stage 1 Stage 1 TBD

2014 Stage 1 TBD

* Note that Year 1 of Stage 1 reporting period is 90 days. Remainder of reporting requirements are for full fiscal year.

Mount Auburn Hospital Status – Core Requirements

Status update consists of 3 categories of reporting:– Project Status: Denotes the status of the project

work required to complete the measure– Technology Status: Denotes the status of the

technology used to complete the measure; ie – certification status

– Measurement Tool: Is the measurement tool completed and functional for attestation

MTA Status – Core Requirements

  Measures, Core Set Threshold

Project Status

Technology Certification sMeasurement Tool

           

1 CPOE for Med Orders 30%      

2 Interaction Checking Attestation      

3 Demographics 50%      

4 Problem List 80%      

5 Maintain active medication list 80%      

6 Medication Allergy List 80%      

7 Record Vital Signs 50%      

8 Smoking Status 50%      

9 Clinical Decision Support Attestation      

10 Clinical Quality Measures Numerator/Denominator      

11 E Copy of Health Record 50%      

12 E Copy of Discharge Instructions 50%      

13 Exchange Key Clinical Information Attestation      

14 Privacy and Security Attestation      

MTA Status – Menu Requirements

  Measures, Menu Set Threshold

Project Status

Technology Certification Measurement Tool

           

1 Drug Formulary Check Attestation      

2 Record Advanced Directives 50%      

3 Lab Results into the HER 40%      

4 Generate Patient List Attestation      

5 Patient Specific Education N/A      

6 Summary of Care N/A      

7 Medication Reconciliation N/A      

8 Immunization Registries Attestation      

9 Lab Results to Public Health Attestation      

10 Syndromic Surveillance Data Attestation      

Meaningful Use Quality Measures

MU Reporting users new “e-Definitions” promoting the use of coded terminology

MU requires reporting on all patients, regardless of payer status

For Year 1 reporting period, 90 days of data will be reported.

The first year, attestation inclusive of measure numerator and denominators are required.

Subsequent stages will require electronic submission of data files.

Health Information Technology Standards Panel

Electronic specifications for Quality Measures are defined in the HITSP Technical Note (906)

Meaningful Use Quality Measures for phase one include:

– ED Throughput – VTE Measures– Stroke Measures

Mount Auburn Project List

MEDITECH Allergy Conversion Upgrade of Patient Discharge Instructions Creation of secure electronic downloads of Electronic Health Records and

Discharge Instructions Upgrading infrastructure and enabling encryption Installation of Data Repository Completion of Demographic Requirements Begin Testing and building Continuity of Care and Public Health interfaces Start codifying in required nomenclature (Laboratory Data, Medications,

Immunizations) Implement Problem List functionality Upgrade all systems to certified versions of vendor software

Attesting and Reporting

Registration for the program is now open. The Medicare Attestation page will be ready

for use in April, 2011 Select a reporting period – Goal is May 15th,

2011 – August 13, 2011 Final date to begin reporting period for 2011

payment is July 3, 2011

Next Steps in Meaningful Use

Stage 2 requirements build on Stage 1. Menu set items become required and thresholds increase.

Preliminary Stage 2 requirements have been posted for comment in 4 out of 5 areas.

In 2015, penalties for not being a Meaningful User begin

Resources

www.cms.gov/EHRIncentivePrograms/ Healthit.hhs.gov www.hitsp.org www.meditech.com www.himss.org