PR’s Journey Towards Electronic Health Records Adoption & Meaningful Use PRESENTATION TO PR HIT SUMMIT Antonio Fernandez Regional Extension Center for.

Slides:



Advertisements
Similar presentations
Meaningful Use and Health Information Exchange
Advertisements

Understanding Meaningful Use Presented by: Allison Bryan MS, CHES December 7, 2012 Purdue Research Foundation 2012 Review of Stage 1 and Stage 2.
Eligible Hospitals (EH) & Critical Access Hospitals (CAH)
Meeting Stage 1 Meaningful Use Criterion Carlos A. Leyva, Esq. Digital Business Law Group, P.A.
Presenter James S. Dunnick, SESEDN LLC. Credentials: MD. FACC. CHCQM. CPC. Contact Information:
Practice Management System Electronic Medical Records Accelerate Your Practice Stage 2 Meaningful Use with MVE 2014 Practice Management.
GOVERNMENT EHR FUNDING: MEANINGFUL USE STAGE 2 UPDATE October 25, 2012 Jonathan Krasner Healthcare IT Consultant BEI
REC support is. provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services.
Meaningful Use, Standards and Certification Under HITECH—Implications for Public Health InfoLinks Community of Practice January 14, 2010 Bill Brand, MPH,
Quality Matters: Optimizing Health IT Adoption in Puerto Rico Fadesola Adetosoye, M.S. Project Officer, Regional Extension Center Program Office of the.
HITECH, Meaningful Use, and Interoperability. HITECH Health Information Technology for Economic and Clinical Health – HITECH –Part of the 2009 American.
Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series “Ten Minutes at a Time” Module 2: The Role of the Certified Complete.
MEANINGFUL USE UPDATE 2014 Mark Huang, M.D. Chief Medical Information Officer Rehabilitation Institute of Chicago Associate Professor Department of PM.
Medicare & Medicaid EHR Incentive Programs HIT Policy Committee June 5, 2013.
Medicare & Medicaid EHR Incentive Programs
August 12, Meaningful Use *** UDOH Informatics Brown Bag Robert T Rolfs, MD, MPH.
Vermont Information Technology Leaders, Inc. Meaningful Use Stage 2 For Eligible Professionals Carol Kulczyk October 10,
Moderator Kevin Larsen, MD Medical Director, Meaningful Use Office of the National Coordinator for Health Information Technology Washington, D.C. Using.
Meaningful Use Indiana Association for Health Care Quality, May 2013.
A First Look at Meaningful Use Stage 2 John D. Halamka MD.
Meaningful Use Stage 2 Esthee Van Staden September 2014.
Meaningful Use Measures. Reporting Time Periods Reporting Period for 1 st year of MU (Stage 1) 90 consecutive days within the calendar year Reporting.
Saeed A. Khan MD, MBA, FACP © CureMD Healthcare ACOs and Requirements for Reporting Quality Measures Meaningful Use Are you still missing out? © CureMD.
EHRS as a Tool to Improve BP Control 1.Brief history of OQIUN, CCI. Began 1999 using data cards. Started working with multiple practice sites using different.
Daniel T. Golder, DDS, MBA Chief Information Officer Oklahoma Foundation for Medical Quality This material is provided by the Oklahoma Foundation for Medical.
Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series “Ten Minutes at a Time” Module 2: The Role of the Certified Complete.
Practice Management System Electronic Medical Records Accelerate Your Practice Stage 1 Meaningful Use with MVE 2014 Practice Management.
New Jersey Institute of Technology Enterprise Development Center (EDC) 211 Warren Street, Newark, NJ Phone: Fax:
Meaningful Use Stage 1 & 2 Helping Colorado Providers Achieve Meaningful Use Tracy Rue Senior Consultant, Colorado Regional Extension Center.
INFLUENCE OF MEANINGFUL USE AMONG HEALTHCARE PROVIDERS Neely Duffey, Olivia Mire, Mallory Murphy, and Dana Sizemore.
NWH TRANSITION OF CARE DOCUMENT FOR MU STAGE 2 JUNE 6, 2014.
Christopher Geer, MBA Meaningful Use Project Manager Unity Health System
Prepared by: Health Technology Services Regional Extension Center A division of Mountain-Pacific Quality Health.
A First Look at Meaningful Use Stage 2 John D. Halamka MD.
Medicare & Medicaid EHR Incentive Programs Stage 2 Final Rule Robert Anthony HITPC
Medicaid EHR Incentive Program For Eligible Professionals Overview of the Proposed 2015 Modification Rule Kim Davis-Allen Outreach Coordinator
Meaningful Use Elizabeth W. Woodcock, MBA, FACMPE, CPC Update: 2015 Sponsored by.
What Did I Work on in Washington? John Glaser April 16, 2010.
Meaningful Use Presentation for Fall Faculty Meeting October 24, 2014.
Affordable Healthcare IT Solutions. MU RX Compliance with Meaningful Use Stage 2.
INTRODUCTION TO THE ELECTRONIC HEALTH RECORD CHAPTER 1.
Configuring Electronic Health Records Meaningful Use and Implementation Lecture a This material (Comp11_Unit8a) was developed by Oregon Health & Science.
State HIE Program Chris Muir Program Manager for Western/Mid-western States.
Discussion with BEACON Council ODJFS/OHP Medicaid Provider Incentive Program.
Making better healthcare possible ® Meaningful Use Stage 2 The Changing Seasons of Healthcare Conference WV-HFMA/WV-HIMSS September 27, 2012.
Component 11: Configuring EHRs Unit 2: Meaningful Use of the Electronic Health Record (EHR) Lecture 1 This material was developed by Oregon Health & Science.
Unit 1b: Health Care Quality and Meaningful Use Introduction to QI and HIT This material was developed by Johns Hopkins University, funded by the Department.
1 Meaningful Use Stage 2 The Value of Performance Benchmarking.
Medicare & Medicaid EHR Incentive Programs Jason McNamara Technical Director for Health IT.
Medicare & Medicaid EHR Incentive Programs Stage 2 Final Rule Travis Broome HIT Standards Committee
Medicare & Medicaid EHR Incentive Programs Stage 2 NPRM Overview Robert Anthony March 7, 2012.
Medicare & Medicaid EHR Incentive Programs Robert Anthony HIT Policy Committee March 7, 2012.
©2011 Falcon, LLC. All rights reserved. Proprietary. May not be copied or distributed without the express written permission of Falcon, LLC. Falcon EHR.
June 18, 2010 Marty Larson.  Health Information Exchange  Meaningful Use Objectives  Conclusion.
Component 3-Terminology in Healthcare and Public Health Settings Unit 15-Overview/ Introduction to the EHR This material was developed by The University.
HIT Policy Committee Stage 2 Recommendations Presentation to HIT Standards Committee June 22, 2011.
Component 11/Unit 2a Meaningful Use of the Electronic Health Record (EHR)
Meaningful Use Made Easy Step by Step Approach to Stage 1 Compliance and 2013 Changes My Vision Express Practice Management and EMR Software Presented.
Terminology in Health Care and Public Health Settings Unit 15 Overview / Introduction to the EHR.
Meaningful Use: Stage 2 Changes An overall simplification of the program aligned to the overarching goals of sustainability as discussed in the Stage.
CMS Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs Final Rule Overview 1 Robert Anthony.
Electronic Health Records in Small Latino Practices Antonio Fernandez National Advisory Council Director, Ponce School of Medicine Regional Extension Center.
Configuring axiUm for Meaningful Use
New Jersey Institute of Technology Enterprise Development Center (EDC) 211 Warren Street, Newark, NJ Phone: Fax:
Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a – Introduction to the EHR This material Comp3_Unit15 was developed.
Moving Toward HITECH Healthcare EHR Adoption at the Dawn of a New Era
Meaningful Use Update 2015: How Does It Impact Family Medicine? Ryan Mullins, MD, CPE, CPHQ, CPHIT.
The Value of Performance Benchmarking
2017 Modified Stage 2 Meaningful Use Objectives Overview Massachusetts Medicaid EHR Incentive Program September 19 & 20, 2017 September 19,
Presentation transcript:

PR’s Journey Towards Electronic Health Records Adoption & Meaningful Use PRESENTATION TO PR HIT SUMMIT Antonio Fernandez Regional Extension Center for PR and USVI

2 HITECH: How the Pieces Fit Together Medicare and Medicaid EHR Incentive Programs Health IT Practice Research Improved Individual & Population Health Outcomes Increased Transparency & Efficiency Improved Ability to Study & Improve Care Delivery ADOPTION EXCHANGE State Grants for Health Information Exchange Medicaid Administrative Funding for HIE Standards & Certification Framework Privacy & Security Framework Regional Extension Centers Medicaid EHR Program 1 st Year Incentive Workforce Training MEANINGFUL USE 2

Program Timeline

4 EHR ADOPTION PROGRESS IN PR Physicians who have selected a Certified EHR 3,900 Installations in Physician Practices 2,512 Meaningful Users 325 Dentists in Process of Adoption 197 FQHC’s in EHR Adoption Process 49 Hospitals Having Attested under Medicaid AIU 21 Number of eRx’s during Month of May 451,110 Pharmacies Dispensing e-Rx’s in May 1,012 Active E-Prescribers during month of May 1,854

Physician Adoption by Health Region

Hospitals Attesting under AIU for 2012 Medicaid Incentives

FQHC’s in Process of Certified HER Adoption

Puerto Rico Monthly ePrescriptions

11 Stage 1 Data capture and sharing Stage 1 Data capture and sharing Stage 2 Advanced clinical processes Stage 2 Advanced clinical processes Stage 3 Improved outcomes Stage 3 Improved outcomes Ascending Meaningful Use Stages For more information on meaningful use of EHRs, visit:  Better clinical outcomes  Improved population health outcomes  Increased transparency and efficiency  Empowered individuals  More robust research data on health system Improved quality of patient care

13 Meaningful Use: Changes from Stage 1 to Stage 2 Eligible Professionals 15 core objectives 5 of 10 menu objectives 20 total objectives Eligible Professionals 17 core objectives 3 of 6 menu objectives 20 total objectives Eligible Hospitals & CAHs 14 core objectives 5 of 10 menu objectives 19 total objectives Eligible Hospitals & CAHs 16 core objectives 3 of 6 menu objectives 19 total objectives Stage 2 Stage 1

16 EPs must meet all 17 core objectives: Core ObjectiveMeasure 1. CPOE Use CPOE for more than 60% of medication, 30% of laboratory, and 30% of radiology 2. E-Rx E-Rx for more than 50% 3. Demographics Record demographics for more than 80% 4. Vital Signs Record vital signs for more than 80% 5. Smoking Status Record smoking status for more than 80% 6. Interventions Implement 5 clinical decision support interventions + drug/drug and drug/allergy 7. Labs Incorporate lab results for more than 55% 8. Patient List Generate patient list by specific condition 9. Preventive Reminders Use EHR to identify and provide reminders for preventive/follow-up care for more than 10% of patients with two or more office visits in the last 2 years Stage 2 EP Core Objectives

17 EPs must meet all 17 core objectives: Core ObjectiveMeasure 10. Patient Access Provide online access to health information for more than 50% with more than 5% actually accessing 11. Visit Summaries Provide office visit summaries for more than 50% of office visits 12. Education Resources Use EHR to identify and provide education resources more than 10% 13. Secure Messages More than 5% of patients send secure messages to their EP 14. Rx Reconciliation Medication reconciliation at more than 50% of transitions of care 15. Summary of Care Provide summary of care document for more than 50% of transitions of care and referrals with 10% sent electronically and at least one sent to a recipient with a different EHR vendor or successfully testing with CMS test EHR 16. Immunizations Successful ongoing transmission of immunization data 17. Security Analysis Conduct or review security analysis and incorporate in risk management process Stage 2 EP Core Objectives

18 EPs must select 3 out of the 6: Menu ObjectiveMeasure 1. Imaging Results More than 10% of imaging results are accessible through Certified EHR Technology 2. Family History Record family health history for more than 20% 3. Syndromic Surveillance Successful ongoing transmission of syndromic surveillance data 4. Cancer Successful ongoing transmission of cancer case information 5. Specialized Registry Successful ongoing transmission of data to a specialized registry 6. Progress Notes Enter an electronic progress note for more than 30% of unique patients Stage 2 EP Menu Objectives

19 Eligible hospitals must meet all 16 core objectives: Core ObjectiveMeasure 1. CPOE Use CPOE for more than 60% of medication, 30% of laboratory, and 30% of radiology 2. Demographics Record demographics for more than 80% 3. Vital Signs Record vital signs for more than 80% 4. Smoking Status Record smoking status for more than 80% 5. Interventions Implement 5 clinical decision support interventions + drug/drug and drug/allergy 6. Labs Incorporate lab results for more than 55% 7. Patient List Generate patient list by specific condition 8. eMAR eMAR is implemented and used for more than 10% of medication orders Stage 2 Hospital Core Objectives

20 Eligible hospitals must meet all 16 core objectives: Core ObjectiveMeasure 9. Patient Access Provide online access to health information for more than 50% with more than 5% actually accessing 10. Education Resources Use EHR to identify and provide education resources more than 10% 11. Rx Reconciliation Medication reconciliation at more than 50% of transitions of care 12. Summary of Care Provide summary of care document for more than 50% of transitions of care and referrals with 10% sent electronically and at least one sent to a recipient with a different EHR vendor or successfully testing with CMS test EHR 13. Immunizations Successful ongoing transmission of immunization data 14. Labs Successful ongoing submission of reportable laboratory results 15. Syndromic Surveillance Successful ongoing submission of electronic syndromic surveillance data 16. Security Analysis Conduct or review security analysis and incorporate in risk management process Stage 2 Hospital Core Objectives

21 Eligible Hospitals must select 3 out of the 6: Menu ObjectiveMeasure 1. Progress Notes Enter an electronic progress note for more than 30% of unique patients 2. E-Rx More than 10% electronic prescribing (eRx) of discharge medication orders 3. Imaging Results More than 10% of imaging results are accessible through Certified EHR Technology 4. Family History Record family health history for more than 20% 5. Advanced Directives Record advanced directives for more than 50% of patients 65 years or older 6. Labs Provide structured electronic lab results to EPs for more than 20% Stage 2 Hospital Menu Objectives

22 Stage 2 focuses on actual use cases of electronic information exchange: Stage 2 requires that a provider send a summary of care record for more than 50% of transitions of care and referrals. The rule also requires that a provider electronically transmit a summary of care for more than 10% of transitions of care and referrals. At least one summary of care document sent electronically to recipient with different EHR vendor or to CMS test EHR. Closer Look at Stage 2: Electronic Exchange

23 Changes to Stage 1: E-Copy & Online Access Current Stage 1 Objective Objective= Provide patients with e-copy of health information upon request Provide electronic access to health information Provide patients with e-copy of health information upon request Provide electronic access to health information New Stage 1 Objective 23 Objective= Provide patients the ability to view online, download and transmit their health information The measure of the new objective is 50% of patients are provided access to their information; there is no requirement that 5% of patients do access their information for Stage 1. The change in objective takes effect in 2014 to coincide with the 2014 certification and standards criteria

24 Patient engagement – engagement is an important focus of Stage 2. EXCULSIONS – CMS is introducing exclusions based on broadband availability in the provider’s county. Requirements for Patient Action: More than 5% of patients must send secure messages to their EP More than 5% of patients must access their health information online Closer Look at Stage 2: Patient Engagement

25 CQM Selection and HHS Priorities All providers must select CQMs from at least 3 of the 6 HHS National Quality Strategy domains:  Patient and Family Engagement  Patient Safety  Care Coordination  Population and Public Health  Efficient Use of Healthcare Resources  Clinical Processes/Effectiveness

26 CMS’s commitment to alignment includes finalizing the same CQMs used in multiple quality reporting programs for reporting beginning in 2014 Other programs include Hospital IQR Program, PQRS, CHIPRA, and Medicare SSP and Pioneer ACOs, and Patient-Centered Medical Homes Hospital Inpatient Quality Reporting Program Physician Quality Reporting System Children’s Health Insurance Program Reauthorization Act Medicare Shared Savings Program and Pioneer ACOs Aligning CQMs Across Programs

27 Patient-Centered Medical Homes Model for care provided by physician practices that seeks to strengthen the physician-patient relationship and replaces episodic care based on illnesses and patient complaints with coordinated care and a long-term healing relationship. It is a Model of care where each patient has an ongoing relationship with a personal physician who leads a team that takes collective responsibility for patient care. The physician- led care team is responsible for providing all the patient’s health care needs and, when needed, arranges for appropriate care with other qualified physicians.

28 Patient-Centered Medical Home Six MUST PASS elements are considered essential to the patient-centered medical home, and are required for practices at all recognition levels by NCQA. Practices must achieve a score of 50% or higher on must-pass elements: 1.PCMH 1, Element A: Access During Office Hours 2.PCMH 2, Element D: Use Data for Population Management 3.PCMH 3, Element C: Care Management 4.PCMH 4, Element A: Support Self-Care Process 5.PCMH 5, Element B: Referral Tracking and Follow-Up 6.PCMH 6, Element C: Implement Continuous Quality Improvement

29 Patient-Centered Medical Home PCMH 1: Access and Continuity PCMH 2: Identify and Manage Patient Populations PCMH 3: Plan and Manage Care PCMH 4: Self- Management Support PCMH 5: Track and Coordinate Care PCMH 6: Performance Measurement and Quality Improvement Meaningful Use Criteria Improving quality, safety, efficiency, and reducing health disparities Engage patients and families in their health care Improve care coordination Ensure adequate privacy and security protections for personal health information Improve population and public health

30 REC 2.0 Scope of Services Medicaid/Medicare EHR Incentive Program Eligible Provider Registration & Attestation Support Outreach to Other Eligible Providers (Hospitals, Physicians Specialists & Dentists) Meaningful Use Education and Provider Support Privacy & Security Education & Risk Assessment Direct Messaging/Health Information Exchange ADT (Admissions/Discharge/Transfer) Care Transitions Coordination Accountable Care Organizations, Patient-Centered Medical Homes & Transformation Project Support Meaningful User Groups/Communities of Practice HIT Education, Training, and Workforce Development Healthcare Analytics

31 AREAS OF OPPORTUNITY Specialized EHR Needs for Key specialty areas: Psychiatric/Behavioral Health Care Pediatric/Children’s HealthCare Correctional Health Care Strategies for Consumer Engagement & Mobile Health Applications for Consumers, Patients and Families Population Health Management Privacy & Security Education, Risk Assessment & Management Designing Integrated Models of Care which could be adapted to Serving Underserved Populations outside of Puerto Rico

33 CMS Stage 2 Webpage: Guidance/Legislation/EHRIncentivePrograms/Stage_2.html Links to the Federal Register Tipsheets: – Stage 2 Overview – 2014 Clinical Quality Measures – Payment Adjustments & Hardship Exceptions (EPs & Hospitals) – Stage 1 Changes – Stage 1 vs. Stage 2 Tables (EPs & Hospitals) Stage 2 Resources

RECPR.ORG/BLOG

Other Links U.S. Department of Health & Human Services Welcome to the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) National Plan & Enumeration System Puerto Rico Immunization Registry Puerto Rico Health Informatio Network (PRHIN) Mi Salud

Contact Information Antonio Fernandez Regional Extension Center (REC) Ponce School of Medicine & Health Sciences