Meaningful Use Workgroup

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Meaningful Use Workgroup. Stage 3 Draft Recommendations Paul Tang, Chair George Hripcsak, Co-Chair. March 11, 2014. Meaningful Use Workgroup Members. Chairs Paul Tang, Chair, Palo Alto Medical Center George Hripcsak, Co-Chair, Columbia University Members - PowerPoint PPT Presentation

Text of Meaningful Use Workgroup

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Stage 3 Draft Recommendations

Paul Tang, ChairGeorge Hripcsak, Co-Chair

Meaningful Use WorkgroupMarch 11, 2014Meaningful Use Workgroup MembersChairsPaul Tang, Chair, Palo Alto Medical CenterGeorge Hripcsak, Co-Chair, Columbia UniversityMembersDavid Bates, Brigham & Womens Hospital*Christine Bechtel, National Partnership for Women & Families *Neil Calman, The Institute for Family HealthArt Davidson , Denver Public Health Department *Paul Egerman , Software EntrepreneurMarty Fattig, Nemaha County Hospital (NCHNET)Leslie Kelly Hall, HealthwiseDavid Lansky, Pacific Business Group on HealthDeven McGraw, Center for Democracy & TechnologyMarc Overhage, Siemens HealthcarePatricia Sengstack, Bon Secours Health SystemsCharlene Underwood, Siemens *Michael H. Zaroukian, Sparrow Health SystemAmy Zimmerman, Rhode Island Department of Health and Human ServicesFederal Ex-OfficiosJoe Francis, MD, Veterans AdministrationMarty Rice, HRSAGreg Pace, Social Security AdministrationRobert Tagalicod, CMS/HHS1* Subgroup LeadsAgendaIncorporation of HITPC feedback

Reconsideration of draft recommendations

Revised stage 3 MU recommendations2Summary of HITPC FeedbackInteroperability is a top priorityFocus on 4 emphasis areasClinical decision supportPatient engagementCare coordinationPopulation managementWeigh impact on provider workflow FlexibilityConsider the needs of specialistsConsider dropping certification-only requirementsAvoid requirements where standards are not matureConsuming external knowledge broadly is not matureUsability3Work Group ProcessCharge: Revise MUWGs draft recommendations to reduce number, tighten focus, reduce burden on providers, and rely on more mature standardsTighten focusClinical decision supportRepresents most evidence for improving outcomes associated with EHRsPatient engagementImportant to achieve improved outcomesCare coordinationRequirement for advanced care modelsPopulation managementRequirement for advanced payment models4Process to Revise MUWG RecommendationsMU workgroup members were asked to revise MUWG draft recommendations to identify objectives that could be removed. Based upon guidance from HITPC, the following criteria was used to re-evaluate draft recommendations:Reduce the overall number of objectivesEnsure relevant to a focus areaWeight of physician burden of useValue to performance improvement and enabling new models of careFlexibilityNeeds of specialistsAvoid requirements where standards are not maturePromote usabilityFull Work Group discussion5Revision: Reduced Number of Objectives from the MUWG RecommendationsObjectives Removed from the draft MUWG RecommendationsReminders Amendments eMAR Case Reports Medication Adherence Syndromic Surveillance for EPsImaging Family History6Recommended ObjectivesImproving Quality of Care and Safety Clinical decision supportOrder trackingDemographics/patient informationCare planning advance directiveElectronic notesHospital labsUnique device identifiersEngaging Patients and Families in their Care View, download, transmitPatient generated health dataSecure messagingVisit Summary/clinical summaryPatient education

Improving Care Coordination Summary of Care at TransitionsNotificationsMedication ReconciliationImproving Population and Public Health Immunization historyRegistriesElectronic lab reportingSyndromic surveillance7Improving Quality of Care and SafetyClinical decision supportOrder trackingDemographics/patient informationCare planning advance directiveElectronic notesHospital labsUnique device identifiers8Orange text - High provider use effort, standards not mature, or high development effortImproving quality of care and safety:Clinical decision support (CDS)9Use of CDS to Improve Quality of Care and SafetyCore: EP/EH/CAH use of multiple CDS interventions that apply to CQMs in at least 4 of the 6 NQS prioritiesRecommended intervention areas:Preventive careChronic disease condition management Appropriateness of lab/rad orders Advanced medication-related decision supportImproving problem, meds, allergy listsDrug-drug /drug-allergy interaction checksRed: Changes from stage 2 Blue: Newly introduced Bright Red: edits for clarityCertification criteria:Ability to track CDSinterventions and user responses Perform age-appropriate maximum daily-dose weight based calculation Focus AreaTypeProvider use effortStandards MaturityDevelopmentCDSPopulation managementCare coordinationPrimary careSpecialty (selectively) Medium EmergingHigh9Improving quality of care and safety:Order tracking10Tracking Orders to Improve Quality of Care and SafetyNEW Menu: EPsAssist with follow-up on orders to improve the management of results. Results of specialty consult requests are returned to the ordering provider [pertains to specialists]Threshold: LowCertification criteria:Display EHR should display the abnormal flags for test results if it is indicated in the lab-result messageDate completeNotify when available or not completed Blue: Newly introducedBright Red: edits for clarityRecord date and time results reviewed and by whomMatch results with the order to accurately result each order or detect when not been completedFocus AreaTypeProvider use effortStandards MaturityDevelopmentPatient engagementCare coordinationPrimary CareSpecialtyMedium

AdoptedHigh (matching results)1011Reducing health disparities:Demographics/patient informationPatient Information Captured and Used to Reduce Health DisparitiesCertification criteria to achieve goals: Ability to capture patient preferred method of communicationAbility to capture occupation and industry codesAbility to capture sexual orientation, gender identity Ability to capture disability status Communication preferences will be applied to visit summary, reminders, and patient educationFocus AreaTypeProvider use effortStandards MaturityDevelopmentCDSPatient engagementPrimary CareSpecialty (selectively)MediumEmergingHighRed: Changes from stage 2 Blue: Newly introduced11Improving Quality of Care and SafetyCare planning advance directiveRecord whether a patient 65 years old or older has an advance directiveCertification criteria: ability to include more information about the document, if available (e.g., links to document or storing a copy of the document)Electronic notesCore from menu, higher threshold, [eliminated revision or track changes example]Hospital labsProvide structured electronic lab results using LOINC to ordering providersUnique device identifiers (UDI)New: Record the FDA UDI when patients have devices implanted for each newly implanted device12Engaging Patients and Families in their Care View, download, transmitPatient generated health dataSecure messagingVisit Summary/clinical summaryPatient education13Orange text - High provider use effort, standards not mature, or high development effortEngaging patients and families in their care:View, download, transmit14Access to health Information to Engage Patients and Families in their CareEPs/EHs provide patients with the ability to view online, download, and transmit (VDT) their health information within 24 hours if generated during the course of a visit Threshold for availability: High Threshold for use: lowLabs or other types of information not generated within the course of the visit available to patients within four (4) business days of availabilityAdd family history to data available through VDT Focus AreaTypeProvider use effortStandards MaturityDevelopmentPatient engagementCare coordinationPrimary CareSpecialtyHighEmergingMediumRed: Changes from stage 2 Blue: Newly introduced14Engaging patients and families in their care:Patient Generated Health Data (PGHD)15Use of PGHD to Engage Patients and Families in their CareNewMenu: Eligible Professionals and Eligible Hospitals receive provider-requested, electronically submitted patient-generated health information through either (at the discretion of the provider):structured or semi-structured questionnaires (e.g., screening questionnaires, medication adherence surveys, intake forms, risk assessment, functional status)or secure messagingThreshold: LowFocus AreaTypeProvider use effortStandards MaturityDevelopmentPatient engagementCare coordinationPrimary CareSpecialtyHighImmature (devices)Mature (secure messaging)HighRed: Changes from stage 2 Blue: Newly introduced Bright Red: edits for clarity15Engaging patients and families in their care:Secure messaging16Functionality Needed to Achieve GoalsNo Change in objectiveCore: Eligible Professionals Patients use secure electronic messaging to communicate with EPs on clinical matters. Threshold: Low (e.g. 5% of patients send secure messages)Certification criteria:Capability to indicate whether the patient is expecting a response to a message they initiateCapability to track the response to a patient-generated message (e.g., no response, secure message reply, telephone reply) Focus AreaTypeProvider use effortStandards MaturityDevelopmentPatient engagementPrimary CareSpecialtyMediumApprovedHigh (tracking)Red: Changes from stage 2 Blue: Newly introducedEngaging Patients and Families in their Care Visit Summary/clinical summaryContinue stage 2 objectiveCertified functionality to allow provider organizations to configure the summary reportsPatient educationContinue stage 2 objectiveNew: Provide patient-specific educational material in non-English speaking patient's preferred language17Improving Care Coordination Summary of Care at TransitionsNotificationsMedication Reconciliation No change from stage 218Orange text - High provider use effort, standards not mature, or high development effortSummary of care may (at the discretion of the provider organization) include, as relevant:A narrative (synopsis, expectations, results of a consult) [required for all transitions]Overarching patient goals and/or problem-specific goalsPatient instructions (interventions for care)Information about