Tag Archives: meaningful use

Applying a “Best of Breed” Approach to Your Healthcare Practice

With a thriving practice but no online appointment system, Dr. Rogu and his staff were seeking a way to simplify his patients healthcare experience. RBK Pediatrics is multi-provider, multi-location pediatrics practice whom leverage technology solutions for improved efficiency and patient access. “Our patients wanted online scheduling, [and] we had phones,” said Dr. George Rogu of Long Island-based pediatrics practice RBK Pediatrics in a recent interview with ViewPoint Magazine. “With the portal, our systems tap into the schedule, it goes to the portal, they can book their appointment online and we get it in the system.” (more…)

Meaningful Use: A Comprehensive Guide – Part IV: MACRA

MACRA and meaningful useGiven the time sensitive nature of the MACRA program, this article is out dated. Please refer to Bridge’s MACRA 101 article for more current explanation of the MACRA program and how it relates to a patient portal.

As we head into the second half of 2016, it is difficult to talk about Meaningful Use without mentioning the Medicare Access and CHIP Reauthorization Act (MACRA), the new healthcare legislation that is shaping up to begin in January 2017. There has been a lot of buzz that Meaningful Use is ending with the approval of this new legislation, but that is not exactly the case. While the words “meaningful use” may start to fade out of our everyday lexicon, don’t be fooled into thinking that Meaningful Use is going away. Under MACRA, it’s basically just been repackaged and tied up with a bow, as a piece of this larger incentive program. (more…)

Meaningful Use: A Comprehensive Guide – Part III: Frequently Asked Questions

As Meaningful Use Stage 2 was recently finalized, it is imperative that eligible practices and hospitals are ready to attest consequently receive the financial incentives. In Part I and Part II of this Meaningful Use Guide article series, we gave an overview of some important dates and changes, as well as a comprehensive look at the Stage 2 objectives and measures.

The final part of this article series focuses on Frequently Asked Questions to help clarify any lingering questions or concerns about attesting to Meaningful Use.

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Meaningful Use: A Comprehensive Guide – Part II: Final Rule on Stage 2’s Objectives and Measures

Successfully attesting for CMS’s EHR Incentive Program Meaningful Use is essential for eligible providers and hospitals to avoid the financial penalties and instead collect the financial gains. However, it can be difficult to sort through the copious amounts of information in order to find some direction.

Part one of our Meaningful Use Guide article series discussed important deadlines and changes to Stage 2 as directed by the final rule. In the second part of our series, we showcase a user-friendly, yet thorough summary of finalized Stage 2 objectives and measures for both eligible professionals and hospitals. Updated Stage 2 Objectives and Measures for Meaningful Use.

 

Updated Stage 2 Objectives and Measures:

Below is a summary of the objectives for Eligible Professionals and Eligible Hospitals and Critical Access Hospitals (CAH).

 

Updated Stage 2 Objective Eligible Professionals Eligible Hospitals and Critical Access Hospitals
Protect Patient Health Information

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

Conduct or review a security risk analysis aligned with the requirements in 45 CFR 164.308(a)(1), implement security updates as necessary, and correct identified security deficiencies as part of your risk management process.
Conduct or review a security risk analysis aligned with the requirements in 45 CFR 164.308(a)(1), implement security updates as necessary, and correct identified security deficiencies as part of your risk management process.
Clinical Decision Support

Use clinical decision support to improve
performance on high priority health conditions.

Measure 1: Implement 5 CDS interventions related to 4 or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period. If 4 clinical quality measures do not relate to your scope of practice or patient population, the CDS interventions must be related to high-priority health conditions.
Measure 2: Enable and implement the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period.
Measure 1: Implement 5 CDS interventions related to 4 or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period. If 4 clinical quality measures do not relate to your scope of practice or patient population, the CDS interventions must be related to high-priority health conditions.
Measure 2: Enable and implement the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period.
CPOE (Computerized Physician Order Entry)

Use a CPOE to enter medication, lab, and radiology orders into the medical record per state, local, and professional guidelines.

Use a CPOE to record the following orders for the reporting period:
Measure 1: At least 60% of medication orders
Measure 2: At least 30% of lab orders
Measure 2: At least 30% of radiology orders
Use a CPOE to record the following orders for the reporting period:
Measure 1: At least 60% of medication orders
Measure 2: At least 30% of lab orders
Measure 2: At least 30% of radiology orders
Electronic Prescribing (eRx)

Generate and transmit permissible prescriptions electronically (eRx).

Measure: More than 50% of permissible prescriptions written are queried for a drug formulary and transmitted electronically using CEHRT.
Measure: More than 10% of hospital discharge medication orders for permissible prescriptions (for new and changed prescriptions) are queried for a drug formulary and transmitted electronically using CEHRT.
Health Information Exchange

Provide a summary of care record for each transition or care or referral.

Measure: Use CEHRT to create a summary of care record and electronically transmit such summary to a receiving provider for more than 10% of transitions of care and referrals.
Measure:

Use CEHRT to create a summary of care record and electronically transmit such summary to a receiving provider for more than 10% of transitions of care and referrals.

Patient Specific Education

Use CEHRT to provide patients with clinically relevant patient-specific education resources.

Measure: Provide education resources for more than 10% of all unique patients with office visits seen during reporting period.
Measure: Provide education resources to more than 10% of all unique patients admitted to the inpatient or emergency department (POS 21 or 23).
Medication Reconciliation

Perform medication reconciliation for patients received from another setting or provider.

Measure: Perform medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the provider’s care. Measure: Perform medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the inpatient or emergency department (POS 21 or 23).
Patient Electronic Access

Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available.

Measure 1: Provide more than 50% of all unique patients seen during the reporting period timely access to view online, download, and transmit their health information to a third party.
Measure 2: At least 1 patient seen by the provider during the reporting period views, downloads or transmits his or her health info to a third party during the reporting period.
Measure 1: Provide more than 50% of all patients who are discharged from the inpatient or emergency department (POS 21 or 23) timely access to view online, download, and transmit their health information to a third party.
Measure 2: At least 1 patient who is discharged from the inpatient or emergency department (POS 21 or 23) views, downloads, or transmits his or her information to a third party.
Secure Electronic Messaging

Use secure electronic messaging to communicate with patients about relevant health information.

Measure:

For an EHR reporting period in:
2015: The capability for patients to send and receive a secure electronic message with the EP was fully enabled.
2016: Send a secure message using the electronic health messaging function of the CEHRT to the patient (or patient-authorized representative) or respond to a message sent by a patient (or patient-authorized representative) during the EHR reporting period.
2017: For more than 5% of unique patients during the EHR reporting period, send a secure message using the electronic health messaging function of the CEHRT to the patient (or patient-authorized representative) or respond to a message sent by a patient (or patient-authorized representative) during the EHR reporting period.

N/A
Public Health Reporting

The EP is in active engagement with a public health agency to submit electronic public health data from CEHRT except where prohibited and in accordance with applicable law and practice.

Measure 1: Immunization Registry Reporting – The provider is in active engagement with a public health agency to submit immunization data.
Measure 2: Syndromic Surveillance Reporting – The provider is in active engagement with a public health agency to submit syndromic surveillance data.
Measure 3: Specialized Registry Reporting – The provider is in active engagement to submit data to a specialized registry.
Measure 1: Immunization Registry Reporting – The hospital or CAH is in active engagement with a public health agency to submit immunization data.
Measure 2: Syndromic Surveillance Reporting –The hospital or CAH is in active engagement with a public health agency to submit syndromic surveillance data.
Measure 3: Specialized Registry Reporting – The hospital or CAH is in active engagement to submit data to a specialized registry.
Measure 4: Electronic Reportable Laboratory Result Reporting – The hospital or CAH is in active engagement with a public health agency to submit electronic reportable laboratory (ELR) results.

Note: It is possible that your practice may be exempt from reporting specific criteria during attestation as previous core and measures were streamlined into fewer objectives. Visit the CMS website to see if you qualify for any of these exclusions.

 

Thoroughly understanding Meaningful Use is essential for every provider and hospital. In the next part of our Meaningful Use Guide article series, Frequently Asked Questions are highlighted.

View the complete Meaningful Use series here:

Bridge Patient Portal is an enterprise platform that provides a superior user experience for healthcare organizations and patients. Bridge’s patient portal truly entices users to access health data, which improves patient-physician collaboration, care outcomes and caregiver profitability. To learn more about how our robust, HIPAA-compliant system can help you meet Meaningful Use requirements visit our website or call (866) 838-9455.

Meaningful Use: A Comprehensive Guide – Part I: Stage 1 and 2 Overview, Stage 2 Final Rule Major Changes, and Important Dates

UPDATED 6/6/2016: Per recently proposed MACRA rules, this article was updated and a Part 4: Meaningful Use and MACRA was added. While modified Stage 2 Meaningful Use remains unchanged, we think it’s important to take MACRA into consideration.

Last week, the financial importance of successfully attesting to Meaningful Use was discussed. The first part of our Meaningful Use article series will include an overview of Stage 1 and Stage 2, seven of the biggest changes to Stage 2 as stated by the Final Rule, and some important dates to keep in mind when attesting. (more…)

What Providers Need to Know About Meaningful Use and Patient Portals

Guest post by Zach Watson, marketing operations analyst at TechnologyAdvice.

patient portalAfter much ado, the Centers for Medicare and Medicaid Services (CMS) released the proposal for the final rules of Meaningful Use Stage 3 earlier this month. Unsurprisingly, the healthcare industry has spent the subsequent weeks sifting through the document to get a better understanding of what the government’s end game is for the program.

After the final rules were released, CMS announced there would be a 60-day period for public feedback on the proposal, so calling it the “final rules” is a bit misleading.

Regardless, there are numerous initiatives to prepare for in Stage 3, as well as significant changes to the criteria for Stage 1 and Stage 2.

The Stage 3 rules are a mixed bag for the application of patient portal software — most of the objectives and their accompanying measures seem quite attainable, but one patient engagement measure in particular could prove a significant challenge for providers.

Here’s what you need to know.

Stage 2 Attestation is Much More Manageable

Much of the analysis regarding Stage 3 has focused on streamlining the program. CMS narrowed the core objective list to 10, and the requirements to attest for Stage 2 have been significantly lightened.

In fact, if a provider hasn’t attested for Stage 1 yet, they can automatically begin participating in Meaningful Use at a modified version of Stage 2 this year. This only requires a 90-day attestation period for 2015, though the following years require that providers attest for a full year.

Additionally, the patient engagement requirements for Stage 2 have been radically altered. The much maligned “View-Download-Transmit” measure requiring five percent of patients to actively engage with their health record has been all but eliminated.

The new rule simply says, “at least one patient during the reporting period” must actively engage with their health information during the reporting period. Similarly, the Stage 2 requirement for secure messaging has essentially been reduced to a yes or no scenario.

All of these changes to Stage 2 indicate that CMS understands the need to move the needle forward in terms of where the majority of providers are in the Meaningful Use program before Stage 3 begins to take full effect in 2017.

It’s intriguing that two of the major changes in the final rule proposal deal with Stage 2 measures that directly relate to patient portal usage. In no uncertain terms, this is a win for eligible providers.

Stage 3 Brings Back Tough Patient Engagement Requirements

The proposed rules for Stage 3 attempt to follow the theme of simplification applied to modifying the Stage 2 rules. But just because something is easily understood doesn’t mean that it’s easily performed.

In terms of patient portals and patient engagement, the most important objective for physicians to examine is the Coordination of Care Through Patient Engagement. As the name implies, this objective focuses on patient engagement, which has nearly always been manifested as a view, transmit, or download threshold in the context of Meaningful Use.

Stage 3 is no different, and this objective comes with three accompanying measures, of which eligible professionals must meet two.

Let’s start with most difficult. Though its teeth were pulled for Stage 2, View-Download-Transmit is back for Stage 3, and this time it’s going to take a whopping 25 percent of patients actively engaging with their health information to meet the threshold. However, there’s also the option of using an API to automatically push this information to another platform in order to meet this goal.

Secondly, the Patient Engagement objective requires 35 percent of patients to receive a secure message during the reporting period. In the past, this would mean that patients had to send the message, but CMS has mercifully included messages sent first from a provider in this measure.

Lastly, patient-generated health data or data from a non-clinical setting must be incorporated into the EHR record for more than 15 percent of patients during the reporting period. An API can also be used to meet this measure instead of tasking patients and providers with manually entering the data.

The addition of APIs is very interesting in the proposal by CMS, but the practicality of this approach — at least in the short term — is questionable.

Developing APIs will be out of reach for many smaller practices because they simply don’t have the resources. This puts the onus clearly on vendors, with an advantage going to standalone patient portals that aren’t tethered to a particular EHR.

These platforms likely have more open architecture and may be in a better position to integrate with multiple EHRs and serve as an all access point for patient records from multiple providers.

Additionally, APIs could significantly reduce the administrative workload of incorporating patient-generated health data — Apple’s HealthKit is a prime example of this technology in action.

The silver lining is that providers can choose two of the three measures in the Patient Engagement objective, skirting the difficult undertaking of driving one out of every four patients to engage with their health records online.

All in all, Stage 3 isn’t overwhelming from a patient portal view, though providers must choose which difficult measure to tackle: View-Download-Transmit, or integrating patient-generated health data.

About the Author: Zach Watson is a marketing operations analyst at TechnologyAdvice. He covers marketing automation, healthcare IT, business intelligence, HR, and other emerging technology. Connect with him on LinkedIn.

CMS and ONC Adjust Requirements for Meaningful Use Stage 3 Reporting

doctor using ehrGiven the time sensitive nature of the MACRA program, this article is out dated. Please refer to Bridge’s MACRA 101 article for more current explanation of the MACRA program and how it relates to a patient portal.

CMS and the ONC have recently released a range of adjustments intended to help reduce reporting burdens on health providers and simplify meaningful use reporting requirements.

The changes, which demonstrate its aim for greater meaningful use flexibility and simplicity, have been received positively by major healthcare organizations and Health IT groups who had voiced their concerns to CMS. In recognition and response to over 2,500 comments from physicians and providers, CMS has stated that it’s time to focus on information technology systems that improve the quality and safety of patient care.

The final rules aim to continue to progress the healthcare industry from a paper-based system to an electronic system, where a doctor’s handwriting had to be interpreted and patient files could be misplaced.

The major adjustments include:

  • Shift the focus of health IT and the adoption of information technology systems so that they become a tool for improvement in the quality and safety of patient care, not an end in itself.
  • Allow providers to choose the measures that are most meaningful for their practices in their reporting.
  • Allow providers and state Medicaid agencies more time – until January 1, 2018 – to comply with the new requirements.
  • Give developers more time to create new technology appropriate to new models of care and to give consumers easier access to data.
  • Support a more useful infrastructure that allows exchange of information between providers and patients.
  • Address health information blocking and work towards greater interoperability between providers and patients.

In addition, the adjustments adopt more flexible reporting periods and will move from a fiscal calendar year to a calendar year beginning in 2015. All providers will have a 90-day reporting period in 2015 as well as new participants in 2016 and 2017, and for any provider moving to Stage 3 in 2017.

CMS has also considered the objectives and measures of the EHR incentive programs in 2015 to 2017 and restructured these to align with Stage 3.

The major provisions for Stage 3 starting in 2017 include:

  • Eight objectives for eligible professionals and eligible hospitals. In stage 3, more than 60% of the proposed measures require interoperability, up from 33% in stage 2.
  • Public health reporting with flexible options for measure selection.
  • Align CQM reporting with the CMS quality reporting programs.
  • Extend the access that patients have to their own health records through application program interfaces (API’s) and empower individuals to make key health decisions.

The simplified stage 3 measures were in response to complaints from many providers that the reporting rules were inflexible. Furthermore, according to ONC, the stage 3 requirements are optional in 2017. Providers who choose to begin stage 3 in 2017 will have a 90-day reporting period. All providers will be required to comply with stage 3 requirements beginning in 2018 using EHR technology certified to the 2015 Edition.

CMS is also encouraging providers to apply for exemptions if they had difficulty with their EHR vendor or experienced challenges with implementation due to the timing of the rules. Additionally, the new rules aim to give individuals greater access to their information through the development of user-friendly technology so they can be engaged and empowered in their care.

The Benefits of Outsourcing Healthcare Software Development


Nearshore Americas’ whitepaper “
Healthcare Software: The Argentine Advantage” highlights many benefits that Argentina has for outsourcing healthcare software development over its offshore rivals. Here are the key reasons for partnering with a nearshore developer in Argentina: (more…)

Helpful Tips for a Smooth ICD-10 Transition

ICD-10 checklistAccording to the World Health Organization, the change to the new ICD-10 system will make it easier for physicians to identify known diseases, and classify symptoms and procedures. However, many physicians and health practitioners aren’t sure if the benefits of the new system will outweigh all the trouble it will take to implement. But one thing is for certain: it won’t be an easy change, and it’s a requirement.

The new classification system includes more than 68,000 diagnostic codes, dwarfing the 13,000 included in ICD-9. It also contains twice as many coding categories. A smooth transition to ICD-10 isn’t impossible, but providers need to take very calculated steps to prepare for the change, scheduled for Oct. 1, 2015.

Update Your Software and Documents

In anticipation of the new ICD-10 rollout, it’s important to update all the necessary software that will be affected by the new coding system. Medical billing, EMR, and claims processing systems will all be affected by the change in code, so be sure that you don’t need to update these manually. Search for the latest downloads for all the software your office is using to make sure they’re compatible with ICD-10. You can also use robotic process automation to update the codes when necessary, rather than doing it manually.  

It’s also important to make sure all the forms your office uses on a regular basis reflect the new changes in the coding system. Every form you use, from patient intake forms to payment paperwork, will be affected by the change, so updating them appropriately is essential. These are things your office can be doing now to ensure its prepared when the change takes place. Keep in mind that any paperwork errors due to the new ICD-10 could be extremely complicated to remedy after they’re already filed.

Educate Your Staff

One of the most important ways you can ensure a smooth transition to ICD-10 is by making sure your staff is working together as a team. The point of the system update is to allow for enhanced patient care, but in order for this to happen, your staff needs to minimize human error. Set aside some time for you and your employees to practice the new coding system, and attend some seminars on best practices for its implementation.

Another helpful way to prepare for the switch is to develop a cheat sheet of the most common codes from ICD-9, and identify what those are in the ICD-10 system. For the first few weeks after the transition, it’s OK to allow your staff to carry such a sheet around with them. The goal is to eventually memorize all the necessary changes needed to increase efficiency and patient care, but at the beginning, cheating a little will help you and your staff feel more comfortable.

Give Your Office Some Time

Another great way to ensure a smooth switch to ICD-10 is to allow your office a little time to prepare for the changes, and adapt to them after Oct. 1. It might not be a bad idea to keep a light schedule the week prior to the change, and the week following the change. Doing so will help prevent costly mistakes due to stress or common clerical errors.

The change in October to the new ICD-10 system won’t be an easy one, but it’s long overdue. It will allow physicians to streamline the intake process, as well as make quicker, more accurate diagnoses. The tips above are by no means exhaustive, but they’re a great start to help your office make a smooth transition. To learn more about the switch to ICD-10, visit the Centers for Medicare and Medicaid Services’ website.  

 

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