1. INFLUENCE OF MEANINGFUL USE AMONG HEALTHCARE PROVIDERS Neely Duffey, Olivia Mire, Mallory Murphy, and Dana Sizemore

2. WHAT IS MEANINGFUL USE?  Meaningful use is using certified Electronic Health Record (EHR) technology to:  Improve quality, safety, efficiency, and reduce health disparities  Engage patients and family  Improve care coordination, and population and public health  Maintain privacy and security of patient health information

3. INCENTIVE PROGRAMS  Medicare  Run by CMS  Maximum incentive amount= $44,000  Payments over 5 consecutive years  Payment adjustments will being in 2015 for providers who are eligible but decide not to participate  Providers must demonstrate meaningful use every year to receive incentive payments  Medicaid  Run by State Medicaid Agency  Maximum incentive amount= $63,700  Payments over 6 years, does not have to be consecutive  No payment adjustments for providers who are only eligible for the Medicaid program  In the first year providers can receive an incentive payment for adopting, implementing, or upgrading EHR technology. Providers must demonstrate meaningful use in the remaining years to receive incentive payments

4. HOW TO ACHIEVE MEANINGFUL USE  Must attest to demonstrating meaningful use of EHRs  If qualifying for Medicaid Incentive Program, they must adopt, implement, or upgrade to an EHR in their first year

5. STAGE 1  Financial incentives are provided to those who show improvements of patient care from utilizing the use of EHR  To obtain the incentives there are certain objectives and guidelines that must be met in the specific time frame  Eligible professionals, eligible hospitals, and Critical Access Hospitals (CAHs) are required to report clinical quality measures (CQMs) throughout each year of participation to be able to receive their incentive.

6. STAGE 1 CRITERIA  The Criteria for eligible professionals includes:  13 required core objectives  5 menu objectives from a list of 10  Total of 18 objective  Criteria for eligible hospitals and CAHs must meet:  11 required core objectives  5 menu objectives from a list of 10  Total of 16 objectives

7. PROGRESSING FROM STAGE 1 TO STAGE II  All providers of care must show the first stage of meaningful use before moving on into Stage 2  2014 was the earliest year that health care providers would be able to demonstrate Stage 2 of meaningful use

8. STAGE II CRITERIA  Eligible professionals must meet:  17 core objectives  3 menu objectives that they select from a total list of 6  Total of 20 objectives  Eligible hospitals and CAHs must meet:  16 core objectives  3 menu objectives that they select from a list of 6  Total of 19 objectives

9. STAGE III  Focuses on improved outcomes  Stage 3 was originally planned to be implemented in 2016, but Stage 2 requirements were extended through 2016 leaving Stage 3 to begin in 2017

10. FACTS CONCERNING THE MEANINGFUL USE PROGRAM  Medicare will initiate reprimands towards physicians who aren't EHR meaningful users. They will be cutting their pay by 1% starting in 2015.  In September 2013, 17 Republican Senators asked CMS to slow down the speed of the meaningful- use program. They wanted Stage 2 requirements deferred until 2015  Some physicians and hospitals needed more time

11. WHAT DOES THIS MEAN FOR NURSES?  The best way to look at how meaningful use affects nurses is to look at its 5 priorities…  Improve Quality and Reduce Disparities  EHR allow us to catch errors before they reach the patient  Medication errors, incorrect orders, critical lab values, etc.  Engage Patients and Families  Patients will gain more access to their records  increases their voice  Nurses need to be prepared to help patients navigate the new system  Enhance Care Coordination  Creates ease of hand-off communication, prescription orders, physician orders, etc.  Quickly connects the entire healthcare team  Target Public Health  Allows for increased surveillance of diseases, adverse events, near misses, etc.  Nurses are able to better evaluate situations  Ensure Privacy  Nurses are the most trusted profession.  It is crucial to understand how to maintain privacy with incoming technology

12. WHAT DOES THIS MEAN FOR NURSES?  Additional implications  Provides a way for Generation X/Y to connect with and aid older nurses  Opens opportunities to work more effectively as a team  With patients and other healthcare workers  Nurses must comply in order to help the hospital receive incentives from Medicare and Medicaid  Healthcare is a business, and funds are crucial to survival

13. IMPACT OF MEANINGFUL USE ON HEALTHCARE  On patients  Patients are experiencing positive changes in how they interact with healthcare system  Greater access to health information or through enhanced engagement and collaboration with their providers  Examples:  Electronic prescribing  Patient reminders  Patient electronic access

14.  On providers  Focus on helping providers make more informed decisions, deliver better care, and create greater efficiencies  Help prevent duplicate testing, eliminate adverse drug reactions, and enhance provider collaboration  Example:  Medication reconciliation  Transition of care summary IMPACT OF MEANINGFUL USE ON HEALTHCARE

15.  On public health  Stage 1 objectives encourage providers to send data to immunization registries and public health agencies  Stage II will continues to encourage the transmission of data to registries and public health agencies to inform health care policy decisions, drive best practices, and improve our nations public health IMPACT OF MEANINGFUL USE ON HEALTHCARE

16. QUESTIONS?

17. REFERENCES  http://www.healthit.gov/providers-professionals/meaningful-use-definition- objectives  http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRIncentivePr ograms/01_Overview.asp  http://www.healthit.gov/providers-professionals/how-attain-meaningful-use  http://www.cms.gov/eHealth/ListServ_RealWorldImpact_MeaningfulUse.html  http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_Attestation_Workshe et.PDF  http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/Stage_2.html  http://www.medscape.com/viewarticle/817443  http://www.nursingcenter.com/lnc/static?pageid=981642 http://sophia.stkate.edu/cgi/viewcontent.cgi?article=1033&context=ma_nursing