1 Meaningful Use Stage 2 The Value of Performance Benchmarking

22 LEARNING OBJECTIVES Understand how benchmarking leads to improvement Understand how analytics help meet MU stage 2 requirements

33 Meaningful Use Stage 2 shifts from data capture to usability WHAT STAGE 2 MEANS TO YOU New Criteria –Starting in 2014, providers participating in the EHR Incentive Programs who have met Stage 1 two or more years, will need to meet Stage 2 criteria Improving Patient Care –Stage 2 includes new objectives to improve patient care through better clinical decision support, care coordination and patient engagement Interoperability –There is a greater emphasis on interoperability and patient engagement, with the latter requiring action on the patient’s end in order for the objective to be met

44 STAGE 2 OBJECTIVES - MINIMAL CHANGES Core Objective MeasureChange from Stage 1 2. e-Prescribing (eRx) More than 50% of Rx are queried for a drug formulary and transmitted electronically Threshold increased from more than 40% New exclusion 3. Record Demographics More than 80% of all unique patients seen by the EP have the following demographics recorded: Language, Sex, Race, Ethnicity, DOB Threshold increased from more than 50% 4. Record Vital Signs More than 80% of all unique patients seen by the EP have BP (age 3+) and/or height and weight (for all ages) recorded Threshold increased from more than 50% 5. Record Smoking Status More than 80% of all unique patients 13+ seen by the EP have smoking status recorded 2 new statuses Threshold increased from more than 50% 9. Protect Electronic Health Information Conduct or review a security risk analysis, implement security updates as necessary and correct identified security deficiencies Unchanged 11. Patient Lists Generate at least one report listing patients of the EP with a specific condition Former menu objective

55 STAGE 2 OBJECTIVES - SIGNIFICANT CHANGES Core ObjectiveMeasureChange from Stage 1 1. Computerized physician order entry (CPOE) for Medication, Laboratory and Radiology Orders More than 60% of medication, 30% of laboratory, and 30% of radiology orders are created using CPOE Order-centric Inclusion of lab and radiology Threshold increased from more than 30% for medications 7. Patient Electronic Access Measure 1: More than 50% of all unique patients seen are provided timely (within 4 business days after the information is available to the EP) online access to their health information subject to the EP's discretion to withhold certain information Measure 2: More than 5% of all patients seen (or their authorized representatives) view, download, or transmit to a third party their health information Former menu objective Consolidated patient electronic info request with timely access Patient accountability New exclusion New IEHR workflow 17. Use Secure Electronic Messaging A secure message was sent using the electronic messaging function of CEHRT by more than 5% of unique patients (or their authorized representatives) seen by the EP New objective

66 STAGE 2 OBJECTIVES - SIGNIFICANT CHANGES Core Objective MeasureChange from Stage Summary of Care Measure 1: Provide a summary of care record for more than 50% of transitions of care and referrals Measure 2: Provide a summary of care record for more than 10% of transitions of care and referrals, either: (a) electronically transmitted using CEHRT to a recipient or (b) where the recipient receives the summary of care record via exchange facilitated by an organization that is a The Nationwide Health Information Network (NwHIN) Exchange participant or in a manner that is consistent with NwHIN standards Measure 3: An EP must satisfy one of the following criteria: (a) Conducts one or more successful electronic exchanges of a summary of care document, with a recipient who has EHR technology from a different EHR technology developer than the sender's EHR technology (b) Conducts one or more successful tests with the CMS designated test EHR during the EHR reporting period Former menu objective New electronic measure New measure requiring receipt New IEHR workflow

77 In 2014 and beyond, reporting programs (i.e., PQRS, eRx reporting) will be streamlined and standardized in order to reduce provider burden CQM REPORTING 2014 represents CMS’s commitment to aligning quality measurement reporting among programs, including Hospital Inpatient Quality Reporting Program, PQRS, CHIPRA, and ACO programs Alignment includes: –Choosing the same measures for different program measure sets –Coordinating quality measurement stakeholder involvement efforts and opportunities for public input –Identifying ways to minimize multiple submission requirements and mechanism –Alignment with HHS Priorities requiring CQM selection to occur across the 6 HHS National Quality Strategy domains No longer a core objective of the EHR Incentive Programs, however still required in order to demonstrate meaningful use

88 Reporting CQM data is no longer a core objective of the EHR Incentive Programs, however it is still required in order to demonstrate meaningful use CQM REPORTING Prior to and Beyond for all Stages of Meaningful Use Complete 6 out of 44 –3 core or 3 alternate core –3 menu Complete 9 out of 64 –Choose at least 1 measure in 3 NQS Health Domains –Recommended core CQMs include: 9 CQMs for the adult population 9 CQMs for the pediatric population

99 BENCHMARKING FOR MEANINGFUL USE Meet with all staff to ensure understanding of requirements, how this will affect their duties and obtain buy-in –Front office staff will obtain specific demographics, clinical staff will document smoking status during triage, etc. Gauge starting clinical performance via dashboards and/or reporting Identify the leaders, e.g., those providers with the most compliant threshold % –Publish results to all providers Study the leaders to learn what they are doing –Compare the leaders' environments and processes to those of the other providers Decide what changes the practice is willing and able to make Implement the acceptable changes Rinse and repeat at a regular interval

10 Knowing the score provides the opportunity to address gaps before it is too late BENCHMARKING - KNOW THE SCORE

11 Drill down to identify which patients are missing demographics - address the missing data IDENTIFY AND ADDRESS GAPS

12 Benchmarking helps identify leading providers for best practice sharing and laggards who may need additional education or “workflow assistance” on a particular measure BENCHMARKING PROVIDER SCORES

13 BENCHMARKING AND MU - SUMMARY Meaningful Use Stage 2 – increased focus on: –Clinical decision support –Care coordination –Patient engagement –Interoperability Benefits of Dashboards: –Immediate understanding of performance –Quickly identify and address data gaps at patient and provider level Benchmarking –Creates healthy competition and performance based culture –Leads to best practice workflows and sharing –Identifies locations/providers who are struggling

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