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Meaningful Use Rule Changes - What You Need to Know!

As most of you are aware, we’ve long been waiting for an announcement on upcoming changes to Meaningful Use. CMS has recently released the final rule specifying the criteria that eligible providers must meet. To help you understand the impact of these changes, we’re breaking it down for you. We’ve highlighted some of the key changes, broken down CMS’s outline and gathered additional resources to ensure you are up to speed! We know there is a lot to cover when it comes to Meaningful Use. If you’re interested in the full ruling and comments, click here. Otherwise, keep reading for the FoxFire shortened version.

If you are just here for the quick 101, here’s what you NEED to know:

Key Changes to Meaningful Use

1. One of the most prominent changes to Meaningful Use will be the exclusion of Stage 1, being replaced instead by Modified Stage 2. Moving forward, Meaningful Use will encompass Modified Stage 2, Stage 2 and Stage 3 which will begin in 2018. The final rule’s provisions encompass 2015 through 2017 (Modified Stage 2) as well as Stage 3 in 2018 and beyond.

2. In 2015 only, the EHR reporting period for all providers will be any continuous 90-day period selected from January 1, 2015 through December 31, 2015.

3. For an EHR reporting period in 2015, all Medicare providers must attest by February 29, 2016. Despite the change to a 90-day period in 2015, providers will not be able to attest for a reporting period in 2015 prior to January 4, 2016.

4. Stage 2 Patient Electronic Access – Instead of the 5% threshold, the measure requires that at least 1 patient seen by the eligible provider (EP) during the reporting period views, downloads or transmits to a third party his or her health information during the EHR reporting period.

5. Stage 2 Secure Electronic Messaging – The 5% threshold has been changed to the capability for patients to send and receive a secure electronic message with the EP was fully enabled during the EHR reporting period (yes/no).

Now for those of you interested in a little more detail, let’s break it down. We’ve utilized the 2015 Tip Sheet provided by CMS (click here for full version) to outline the specific measures and objectives for Modified Stage 2. (This does not include information for eligible hospitals/CAHs.)

Protect Patient Health Information

Objective: Protect electronic health information created or maintained by the CEHRT through the implementation of appropriate technical capabilities.

Measure: Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI created or maintained by CEHRT in accordance with requirements under 45 CFR 164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the EP’s risk management process.

Clinical Decision Support

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

Measure 1: Implement five clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period. Absent four clinical quality measures related to an EP’s scope of practice or patient population, the clinical decision support interventions must be related to high-priority health conditions.

Measure 2: The EP has enabled and implemented the functionality for drug-drug and drug allergy interaction checks for the entire EHR reporting period.

There is an exclusion as well as an alternate objective and measure for Stage 1 providers in 2015.

Computerized Provider Order Entry (CPOE)

Objective: Use CPOE for medication, laboratory, and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local, and professional guidelines.

Measure 1: More than 60 percent of medication orders created by the EP during the EHR reporting period are recorded using computerized provider order entry.

Measure 2: More than 30 percent of laboratory orders created by the EP during the EHR reporting period are recorded using computerized provider order entry.

Measure 3: More than 30 percent of radiology orders created by the EP during the EHR reporting period are recorded using computerized provider order entry.

There are exclusions as well as two alternate exclusions for Stage 1 providers scheduled to demonstrate in 2015 and 2016, and an alternate measure for Stage 1 providers in 2015 only.

Electronic Prescribing (eRx)

EP Objective: Generate and transmit permissible prescriptions electronically (eRx).

EP Measure: More than 50 percent of permissible prescriptions written by the EP are queried for a drug formulary and transmitted electronically using CEHRT.

There are exclusions for EPs as well as an alternate measure for EPs scheduled to demonstrate Stage 1 in 2015.

Health Information Exchange

Objective: The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care provides a summary care record for each transition of care or referral.

Measure: The EP that transitions or refers their patient to another setting of care or provider of care must–(1) use CEHRT to create a summary of care record; and (2) electronically transmit such summary to a receiving provider for more than 10 percent of transitions of care and referrals.

There is an exclusion as well as an alternate exclusion for Stage 1 providers in 2015.

Patient Specific Education

Objective: Use clinically relevant information from CEHRT to identify patient-specific education resources and provide those resources to the patient.

EP Measure: Patient-specific education resources identified by CEHRT are provided to patients for more than 10 percent of all unique patients with office visits seen by the EP during the EHR reporting period.

There is an exclusion as well as an alternate exclusions for Stage 1 providers.

Medication Reconciliation

Objective: The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant performs medication reconciliation.

Measure: The EP performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP.

There is an exclusion as well as an alternate exclusion for Stage 1 providers in 2015.

Patient Electronic Access (for EPs)

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

EP Measure 1: More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timely access to view online, download, and transmit to a third party their health information subject to the EP’s discretion to withhold certain information.

EP Measure 2: For an EHR reporting period in 2015 and 2016, at least one patient seen by the EP during the EHR reporting period (or patient-authorized representative) views, downloads or transmits his or her health information to a third party during the EHR reporting period. For an EHR reporting period in 2017, more than 5 percent of unique patients seen by the EP during the EHR reporting period (or his or her authorized representatives) view, download or transmit health information to a third party during the EHR reporting period.

There are exclusions plus an alternate exclusion for Measure 2 for Stage 1 providers in 2015.

Secure Messaging (EPs only)

Objective: Use secure electronic messaging to communicate with patients on 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 during the EHR reporting period. For an EHR reporting period in 2016, for at least 1 patient seen by the EP during the EHR reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative). For an EHR reporting period in 2017, for more than 5 percent of unique patients seen by the EP during the EHR reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative).

There is an exclusion as well as an alternate exclusion for Measure 2 for Stage 1 providers in 2015.

Public Health Reporting

Objective: 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.

EPs must meet 2 of 3 measures:

Measure 1:Immunization Registry Reporting: The EP is in active engagement with a public health agency to submit immunization data.

Measure 2: Syndromic Surveillance Reporting: The EP is in active engagement with a public health agency to submit syndromic surveillance data.

Measure 3: Specialized Registry Reporting -The EP is in active engagement to submit data to a specialized registry.

*Alternate Specification: An EP scheduled to be in Stage 1 in 2015 may meet 1 measure.

Multiple exclusions apply.

To see the full presentation of information provided by CMS, click here.

With Stage 3 requirements still in the commenting phase, the final criteria for Stage 3 have not yet been released. We will share this information with you as it is released.

If you are feeling a little lost or overwhelmed, let FoxFire Systems Group be your guide. We offer Meaningful Use Consulting to help simplify the process. Speak to a representative today to see how we can help your practice.

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