As a multi-specialty, multi-provider practice, Quillen ETSU Physicians will be pursuing stages of meaningful use in various years, and the criteria that must be met is determined by the stage of the eligible provider’s (EP’s) participation (either Stage 1, Stage 2, or Stage 3). EP’s progress through six years of the program—two payment years in each stage.
Each month, in our newsletter and here on our blog, we provide information and updates on the EHR Incentive Program, as a “roadmap,” so to speak, as we make this journey together.
The Centers for Medicare and Medicaid Services (CMS) recently updated the criteria for Stage 1 Meaningful Use (MU) for 2013 and beyond. For most of our EPs, these changes will not affect their 2012 attestations. If an EP is pursuing his or her first or second payment year of Stage 1 in 2013, respectively, the following updates do apply.
Core Measure 1: More than 30 percent of all unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE.
The Update: This particular update (in the form of an alternative measure) took effect in September 2012. EPs have the option to use the alternate measure with a denominator of all medication orders created by the EP during the EHR reporting period. EPs should choose whichever measure (the original or alternative) works best for them.
How this effects you: As a multi-specialty organization, we often share patients among our providers. Being able to choose the alternate will help the percentages of many of our specialists.
Core Measure 4: More than 40 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.
The Update: A new exclusion has been added for EPs who qualify. Along with the previous exclusion of “any EP who writes fewer than 100 prescriptions during the EHR reporting period,” now “any EP who does not have a pharmacy within their organization and there are no pharmacies that accept electronic prescriptions within 10 miles of the EP’s practice location at the start of his/her reporting period” can also be excluded.
How this effects you: This update will not affect us. We have several pharmacies near our offices.
Core Measure 8: For more than 50 percent of all unique patients age 2 and over seen by the EP, height, weight, and blood pressure are recorded as structured data/ More than 50 percent of all unique patients seen by the EP during the EHR reporting period have blood pressure (for patients age 3 and over) and height and weight (for all ages) recorded as structured data.
The Update: Even Tenncare describes this change as complicated, but basically, in 2013, EPs will have a choice to separate the measure and exclusions. Blood pressure can be separated from height and weight, and EPs can specify an age range of 3 and up for blood pressure.
How this effects you: This change will be particularly welcomed by our pediatricians, as well as specialty providers, for whom these vitals are not applicable to their scope of practice.
Core Measure 10: Successfully report to CMS ambulatory clinical quality measures selected by CMS in the manner specified by CMS.
How this effects you: Core Measure 10 will no longer be listed as a measure. In 2013, providers will simply report the clinical quality measures rather than attest to a separate measure.
Menu Measure 9: Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submissions if the test is successful (unless none of the immunization registries to which the EP submits such information has the capacity to receive the information electronically).
The Update: The verbiage “except where prohibited” was added by CMS for understanding that if EPs are “authorized to submit the data, they should do so even if it is not required by either law or practice.” Technically, this update is not a change but a clarification
How this effects you: It doesn’t. We are NOT prohibited to submit data and are working with the state of Tennessee to have our immunizations sent directly to their registry.
Menu Measure 10: Performed at least one test of the certifies EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP submits such information has the capacity to receive the information electronically)
How this effects you: It doesn’t. The change is the same as in Menu Measure 9; however, the Tennessee Office of E-Health Initiatives (TDOH )is not currently participating in testing Syndromic Surveillance messages for Meaningful Use.
Core Measure 14: Performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information.
The Update: Beginning in 2013 and beyond, this objective and measure will not be required for 2013 and beyond. This objective and measure will still be a part of the core set for anyone attesting to Stage 1 MU for 2012, but CMS felt that preparing for Stage 2’s emphasis on exchanging data was incentive enough for EPs to start testing this capability.
How this effects you: Look for updates and improvements on Quillen’s ability to exchange data, as the beginning of Stage 2 begins in 2014.