1. ARRA Meaningful Use Update Mount Auburn Hospital Information Systems Update March 2011

2. Topics Outline ARRA Meaningful Use – A brief history Overview of Measures – Core Set – Menu Set – Clinical Quality Measures Project List Attestation and Reporting; Timeline and Structure

3. ARRA – The American Recovery and Reinvestment Act Effective February 19 th, 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

4. Established measures to meet 5 core goals 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

5. Meeting MU Requirements For Hospitals – Meet 14 requirements from a core set – Meet 5 requirements from a menu set. At least one must be a public health reporting requirement – Establish the infrastructure to report on 15 Core Quality Measures Quality measures are one of the core requirements – Achieve all of the above using certified functionality within a certified Electronic Health Record.

6. Stages of Meaningful Use PaymentYear 1 ST Year of Payment 20112012201320142015 2011Stage 1 Stage 2 Stage 3 2012Stage 1 Stage 2TBD 2013Stage 1 TBD 2014Stage 1TBD * Note that Year 1 of Stage 1 reporting period is 90 days. Remainder of reporting requirements are for full fiscal year.

7. Mount Auburn Hospital Status – Core Requirements Status update consists of 3 categories of reporting: – 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

8. MTA Status – Core Requirements Measures, Core SetThreshold Project Statu s Technology Certificati onsMeasurement Tool 1 CPOE for Med Orders30% 2 Interaction Checking Attestation 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

9. MTA Status – Menu Requirements Measures, Menu SetThreshold Project Statu s Technology Certificat ionMeasurement Tool 1 Drug Formulary CheckAttestation 2 Record Advanced Directives50% 3 Lab Results into the HER40% 4 Generate Patient ListAttestation 5 Patient Specific EducationN/A 6 Summary of CareN/A 7 Medication ReconciliationN/A 8 Immunization RegistriesAttestation 9 Lab Results to Public HealthAttestation 10 Syndromic Surveillance DataAttestation

10. Meaningful Use Quality Measures 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.

11. Health Information Technology Standards Panel Electronic specifications for Quality Measures are defined in the HITSP Technical Note (906) Meaningful Use Quality Measures for phase one include: – ED Throughput – VTE Measures – Stroke Measures

12. Mount Auburn Project List 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

13. Attesting and Reporting 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 15 th, 2011 – August 13, 2011 Final date to begin reporting period for 2011 payment is July 3, 2011

14. Next Steps in Meaningful Use 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

15. Resources www.cms.gov/EHRIncentivePrograms/ Healthit.hhs.gov www.hitsp.org www.meditech.com www.himss.org