ARRA
Meaningful Use Update
Mount Auburn
Hospital
Information
Systems
Update
March 2011
Topics Outline
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ARRA Meaningful Use – A brief history
Overview of Measures
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Core Set
Menu Set
Clinical Quality Measures
Project List
Attestation and Reporting; Timeline and
Structure
ARRA – The American Recovery and
Reinvestment Act
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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
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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
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For Hospitals
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Meet 14 requirements from a core set
Meet 5 requirements from a menu set.
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Establish the infrastructure to report on 15 Core
Quality Measures
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At least one must be a public health reporting
requirement
Quality measures are one of the core requirements
Achieve all of the above using certified functionality
within a certified Electronic Health Record.
Payment Year
1ST Year of
Payment
2011
2012
2013
2014
2015
2011
Stage 1
Stage
1
Stage 2
Stage 2
Stage 3
Stage
1
Stage 1
Stage 2
TBD
Stage 1
Stage 1
TBD
Stage 1
TBD
2012
2013
2014
Stages of Meaningful Use
* 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
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Status update consists of 3 categories of
reporting:
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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
Project
Statu
s
Threshold
1
CPOE for Med Orders
2
Interaction Checking
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
30%
Attestation
Technology
Certificati
on
sMeasurement Tool
MTA Status – Menu Requirements
Measures, Menu Set
Project
Statu
s
Threshold
1
Drug Formulary Check
2
Record Advanced Directives
50%
3
Lab Results into the HER
40%
4
Generate Patient List
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
Attestation
Attestation
Technology
Certificat
ion
Measurement Tool
Meaningful Use Quality Measures
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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
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Electronic specifications for
Quality Measures are
defined in the HITSP
Technical Note (906)
Meaningful Use Quality
Measures for phase one
include:
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ED Throughput
VTE Measures
Stroke Measures
Mount Auburn Project List
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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
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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
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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
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www.cms.gov/EHRIncentivePrograms/
Healthit.hhs.gov
www.hitsp.org
www.meditech.com
www.himss.org