gloStream and Meaningful Use August, 2010 Table of Contents • • • • • Final rule from the ONC and CMS The gloStream path to truly meaningful use Medicare payment schedule Path to certified EMR technology and MU reporting Review of the Core and Menu requirements – Objective for each requirement – How we’ll measure EMR usage – How gloStream EMR technology addresses requirements 2 Final CMS Rule • Specifies criteria eligible professionals must meet to demonstrate MU • Includes both “core” and “optional” items • Outlines a phased approach • CMS will establish graduated criteria over time 3 Final ONC Rule • Sets initial standards, implementation criteria and certification criteria for EMRs • Coordinates the standards required of EMR systems with MU criteria • Providers can be assured that certified EMRs can help them qualify as MU’s. 4 gloStream’s Path to Meaningful Use • We believe that MU is a minimum standard – Product: we will develop and deliver a product that is intuitive and easy to use. – Process: our exclusive gloDNA process ensures that we truly understand the Doctor’s needs. – Partner: we only sell through Partners who provide local, responsive, onsite support. 5 gloStream’s Path to MU Reporting • gloStream’s MU system will automatically monitor MU statistics and provide usage statistics to CMS. • gloStream software will feature an MU dashboard, so Doctors will always know how they are performing against MU criteria. 6 Core Objectives Core Objectives Objective Measure • Record patient demographics • Required fields are sex, race, ethnicity, DOB, preferred language • More than 50% of patient’s demographic data must be recorded as structured data gloStream Strategy • gloEMR supports all required demographics • Patient demographics usage report (5060) 8 Core Objectives Objective • Record vital signs and chart changes • Required measurements: height, weight, blood pressure, BMI, growth chart for children Measure • More than 50% of patient’s two years of age and older must have height, weight and blood pressure recorded as structured data gloStream Strategy • gloEMR supports all required vitals and growth charts in vitals entry screen • Patient vitals usage report (5060) 9 Core Objectives Objective Measure • Maintain up-to-date problem list of current and active diagnosis • More than 80% of patients must have at least one entry recorded as structured data gloStream Strategy • gloEMR problems list feature provides full support for ICD-9 based problems • Patient problem usage report (5060) 10 Core Objectives Objective Measure • Maintain an active medication list • More than 80% of patients have at least one entry recorded as structured data gloStream Strategy • gloEMR currently provides a list of prescribed drugs and patient medication history • Patient medications usage report (5060) 11 Core Objectives Objective • Maintain an active medication allergy list Measure • More than 50% of patients age 13 or older have smoking status recorded as structured data gloStream Strategy • gloEMR provides patient history which includes smoking status • Patient history usage report (5060) 12 Core Objectives Objective • Record smoking status for patients 13 and older Measure • More than 80% of patients have at least one entry recorded as structured data gloStream Strategy • gloEMR currently supports drug allergies in the allergies module • Patient allergy usage report (5060) 13 Core Objectives Objective Measure • Provide patients with clinical summaries for each office visit • Clinical summaries provided to patients for more than 50% of all visits within three business days gloStream Strategy • gloEMR currently supports templates and can provide patient summaries on paper or PDF • gloEMR will support export of a CCD document that meets interoperability standards • Clinical summary usage report (5070) 14 Core Objectives Objective Measure • Upon request, provide patients with an electronic copy of their health information • Required data elements: diagnostic test results, problem lists, medication lists, medication allergies • More than 50% of requesting patients must receive an electronic copy within three business days gloStream Strategy • gloEMR will support export of CCD document that provides a comprehensive electronic medical history (5060) • gloEMR also will support clinical document export, which can provide an export of all exams and other documents for a patient • CCD usage report (5070) 15 Core Objectives Objective • Generate and transmit permissible prescriptions electronically Measure • More than 40% must be transmitted electronically using certified EMR technology gloStream Strategy • gloEMR currently supports electronic prescribing of non-controlled substance • Electronic prescribing usage report (5060) 16 Core Objectives Objective Measure • Computerized Provider entry for medication orders • More than 30% of patients with at least one medication in their medication list must have at least one medication ordered through CPOE gloStream Strategy • gloEMR currently supports order entry for prescriptions • Patient prescription usage report (5070) 17 Core Objectives Objective • Implement drug-drug and drug-allergy formulary checks Measure • Functionality must be enabled for these checks for the entire reporting period gloStream Strategy • gloEMR provides full drug interaction checking including drug allergies • Reporting will be provided to support attestation (5070) 18 Core Objectives Objective Measure • Implement capability to electronically exchange key clinical information among providers and patientauthorized entities • Must perform at least one test of the EMR’s capacity to electronically exchange information gloStream Strategy • gloEMR will support import and export of a CCD that meets interoperability standards • CCD export (5060) • CCD and CCR import (5070) 19 Core Objectives Objective Measure • Implement one clinical decision support rule and track compliance • One rule must be implemented gloStream Strategy • Clinical decision support is provided via disease management rules and by setting up guidelines, health plans, smart treatments, smart orders, and smart diagnoses • Reporting will be provided to support attestation (5070) 20 Core Objectives Objective • Implement systems to protect privacy and security of patient data in the EMR Measure • Must conduct or review a security risk analysis, implement security updates as necessary and correct identified security deficiencies gloStream Strategy • gloEMR currently supports the security requirements as specified by HHS • Partners and Providers will have to perform any additional security risk analysis and remediation at the site 21 Core Objectives Objective • Report clinical quality measures to CMS or the States Measure • Eligible providers must submit 3 core measures and select 3 additional measures from the 44 available • For 2011, provider numerator and denominator through attestation • For, 2012 submit measures electronically gloStream Strategy • gloEMR will provide a report to provider numerator and denominator for all quality measures for which we have structured data (this includes all core and alternative measures and the majority, if not all of the 44 measures defined by CMS – 5070) 22 Menu Set Menu Set Objective Measure • Implement drug formulary checks • Drug formulary check system must be implemented and access at least one internal or external drug formulary during the reporting period gloStream Strategy • gloEMR provides formulary checking • Reporting will be provided to support attestation (5070) 24 Menu Set Objective Measure • Incorporate clinical laboratory test results into EMRs as structured data • More than 40% of clinical laboratory test results are in positive/negative or numerical format and are incorporated into EMRs as structured data gloStream Strategy • gloEMR includes a labs module as of 5050 which includes electronic ordering and electronic results to many national labs, regional labs, and inoffice lab systems • Electronic results are also available via HL7 interface to unsupported labs 25 Menu Set Objective • Generate lists of patients by specific conditions for quality improvements, reduction of disparities, research or outreach Measure • Must generate one listing of patients with a specific condition gloStream Strategy • gloEMR currently supports patient list reports based on history, problems, and medication (5050) 26 Menu Set Objective • Use EMR technology to identify patientspecific education resources and provide those to the patient as appropriate Measure • More than 10% of patients are provided patient specific education resources gloStream Strategy • gloEMR currently supports printing patient education materials as part of the guidelines feature • Patient guidelines usage report (5070) 27 Menu Set Objective • Perform medication reconciliation between care settings Measure • Medication reconciliation must be performed for more than 50% of transitions of care gloStream Strategy • gloEMR provides medication reconciliation of the patient’s medication history against RxHub and will provide reconciliation against a CCD (5070) 28 Menu Set Objective Measure • Provide summary of care record for patients referred or transitioned to another Provider or setting • Summary of care record must be provided for more than 50% of patient transitions or referrals gloStream Strategy • gloEMR will support export of a CCD in 5060 that meets interoperability standards 29 Menu Set Objective • Submission of electronic immunization data to immunization registries or immunization information systems Measure • Must perform at least one test of data submission and follow up submission • Applies only where registries can accept electronic submissions gloStream Strategy • gloEMR interfaces are able to send HL7 immunizations data to registries which support he CDS IIS HL7 standard 30 Menu Set Objective Measure • Submission of electronic syndromic surveillance data to public health agencies • Must perform at least one test of data submission and follow up submission • Applies only where public health agencies can accept electronic submissions gloStream Strategy • gloEMR interfaces are able to send HL7 syndromic surveillance data to public health agencies that are able to receive it. 31 Menu Set Objective • Send reminders to patients (per patient preference) for preventative and followup care Measure • More than 20% of patients aged 65 or older, or age 5 or younger, must be sent appropriate reminders gloStream Strategy • gloEMR currently supports reminder letters • This functionality will be extended to include a patient preference to receive reminders (5070) 32 Menu Set Objective • Provide patients with timely electronic access to their health information • Required data elements: laboratory results, problem lists, medication lists, medication allergies Measure • More than 10% of patients must be provided with electronic access to information within four days of its being updated in the EMR gloStream Strategy • gloEMR will support expert of a CCD document in 5060 that meets interoperability standards • This CCD will be accessible to the patient via gloPortal or a HealthVault account 33