Stage 2 Meaningful Use brings more stringent requirements for the Stage 1 measures, a host of new measures, and a greater focus on clinical quality measures. In this instructive session, our expert faculty members review: *The requirements and timeline for implementation of Stage 2 Meaningful Use *The top five questions you need to ask to determine if your organization is ready for Stage 2 *The steps you can take to prepare your organization to successfully meet the Stage 2 requirements and get the most out of your EHR system

1. Are You Ready for Stage 2
Meaningful Use ?
Five Key Questions to Determine if You and Your EHR Vendor Are Prepared
Presented by:
Joe Dickason, Product Manager
Mary Givens, Program Manager of Meaningful Use

2. Joseph Naughton-Travers, Ed.M., Senior Associate, OPEN MINDS
OPEN MINDS Technology & Informatics Institute
Wednesday October 17, 2012 – 11:15 AM

3. • The Medicare and Medicaid EHR Incentive
Programs provide financial incentives for the
“meaningful use” of certified EHR technology to
improve patient care.
• To receive an EHR incentive payment, providers
have to show that they are “meaningfully using”
their EHRs by meeting thresholds for a number of
objectives.
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4. • CMS has established the objectives for
“meaningful use” that eligible professionals,
eligible hospitals, and critical access hospitals
(CAHs) must meet in order to receive an incentive
payment.
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5. • Use of certified EHR in a meaningful manner (e.g.,
e-prescribing).
• Use of certified EHR technology for electronic
exchange of health information to improve quality
of health care.
• Use of certified EHR technology to submit clinical
quality measures (CQM) and other such measures
selected by the Secretary.
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6. A Concept ual A ppr oach t o
Meani ngf ul Use
Improved
outcomes
Advanced
clinical
processes
Data capture
and sharing
http://www.cms.gov/EHRIncentivePrograms/
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7. • Stage 1: Data Capture & Sharing - Electronic
capture of health information in a structured
format, Stage 1 begins in 2011.
• Stage 2: Advanced Clinical Processes - Quality
improvement at the point of care and electronic
exchange of information, Stage 2 scheduled to
begin in 2014.
• Stage 3: Improved Outcomes - Improvements in
quality, safety, and efficiency clinical decision
support & patient self-management tools, Stage 3
is scheduled to begin in 2016.
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8. 7

9. Flow Chart to Help Eligible Professionals (EP) Determine Eligibility
for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs
How to Use this Flow Chart: A Medicaid eligible professional may also be eligible for the Medicare incentive and should follow the path of answering no to the question
of Medicaid patient volume to determine Medicare eligibility. An eligible professional who qualifies for both programs may only participate in one program. Eligible
Professionals eligible to receive EHR incentive payments under Medicare or Medicaid will maximize their payments by choosing the Medicaid EHR Incentive Program.
*Section 1903(t)(3)(F) of the Act defines needy individuals
h
as individuals meeting any of the following three criteria:
(1) They are receiving medical assistance from Medicaid
or the Ci ldren’s Health Insurance Program (CHIP);
(2) they are furnished uncompensated care by the provider;
or (3) they are furnished services at either no cost or
reduced cost based on a sliding scale.
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10. • Meaningful use includes both a core set and a
menu set of objectives that are specific to eligible
professionals or eligible hospitals and CAHs.
• For eligible professionals, there are a total of 25
meaningful use objectives. To qualify for an
incentive payment, 20 of these 25 objectives must
be met:
◦ 15 required core objectives.
◦ 5 objectives chosen from a list of 10 menu set
objectives.
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11. • For eligible hospitals and critical access
hospitals, there are a total of 24 meaningful
use objectives. To qualify for an incentive
payment, 19 of these 24 objectives must be
met:
◦ 14 required core objectives.
◦ 5 objectives chosen from a list of 10 menu set
objectives.
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12. • In addition to meeting the core and menu
objectives, eligible professionals, eligible
hospitals and CAHs are also required to
report clinical quality measures.
◦ Eligible professionals must report on 6 total clinical
quality measures: 3 required core measures (or 3
alternate core measures) and 3 additional measures
(selected from a set of 38 clinical quality measures).
◦ Eligible hospitals and CAHs must report on all 15 of
their clinical quality measures.
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15. • Eligible professionals can receive up to
$44,000 over five years under the Medicare
EHR Incentive Program.
• Eligible professionals can receive up to
$63,750 over the six years that they choose
to participate in the Medicaid EHR Incentive
Program.
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16. • CMS has delayed the onset of Stage 2 criteria.
The earliest that the Stage 2 criteria will be
effective is in fiscal year 2014 for eligible
hospitals and CAHs or calendar year 2014 for
EPs.
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17. • Note that providers who were early
demonstrators of meaningful use in 2011 will
meet three consecutive years of meaningful
use under the Stage 1 criteria before
advancing to the Stage 2 criteria in 2014.
• All other providers would meet two years of
meaningful use under the Stage 1 criteria
before advancing to the Stage 2 criteria in
their third year.
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18. Report on all 17 Core Objectives:
1. Use computerized provider order entry (CPOE) for medication, laboratory
and radiology orders
2. Generate and transmit permissible prescriptions electronically (eRx)
3. Record demographic information
4. Record and chart changes in vital signs
5. Record smoking status for patients 13 years old or older
6. Use clinical decision support to improve performance on high-priority
health conditions
7. Provide patients the ability to view online, download and transmit their
health information
8. Provide clinical summaries for patients for each office visit
9. Protect electronic health information created or maintained by the
Certified EHR Technology
10. Incorporate clinical lab-test results into Certified EHR Technology
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19. 11. Generate lists of patients by specific conditions to
use for quality improvement, reduction of
disparities, research, or outreach
12. Use clinically relevant information to identify
patients who should receive reminders for
preventive/follow-up care
13. Use certified EHR technology to identify patient-
specific education resources
14. Perform medication reconciliation
15. Provide summary of care record for each transition
of care or referral
16. Submit electronic data to immunization registries
17. Use secure electronic messaging to communicate
with patients on relevant health information
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20. Report on all 16 Core Objectives:
1. Use computerized provider order entry (CPOE) for medication,
laboratory and radiology orders
2. Record demographic information
3. Record and chart changes in vital signs
4. Record smoking status for patients 13 years old or older
5. Use clinical decision support to improve performance on high-priority
health conditions
6. Provide patients the ability to view online, download and transmit
their health information within 36 hours after discharge.
7. Protect electronic health information created or maintained by the
Certified EHR Technology
8. Incorporate clinical lab-test results into Certified EHR Technology
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21. 9. Generate lists of patients by specific conditions to use for quality
improvement, reduction of disparities, research, or outreach
10. Use certified EHR technology to identify patient-specific education
resources and provide those resources to the patient if appropriate
11. Perform medication reconciliation
12. Provide summary of care record for each transition of care or referral
13. Submit electronic data to immunization registries
14. Submit electronic data on reportable lab results to public health
agencies
15. Submit electronic syndromic surveillance data to public health
agencies
16. Automatically track medications with an electronic medication
administration record (eMAR)
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22. Report on 3 of 6 Menu Objectives:
1. Record whether a patient 65 years old or
older has an advance directive
2. Record electronic notes in patient records
3. Imaging results accessible through CEHRT
4. Record patient family health history
5. Generate and transmit permissible
discharge prescriptions electronically (eRx)
6. Provide structured electronic lab results to
ambulatory providers
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23. • Mary Givens, Meaningful Use Program
Manager, Qualifacts Systems, Inc.
• Joe Dickason, Product Manager, Qualifacts
Systems, Inc.
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24. Questions & Discussion
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25. The market intelligence to navigate.
The management expertise to succeed.
www.openminds.com
openminds@openminds.com
717-334-1329 | 877-350-6463
163 York Street, Gettysburg , Pennsylvania 17325

26. Are You Ready for Stage 2
Meaningful Use ?
Five Key Questions to Determine if You and Your EHR Vendor Are Prepared
Presented by:
Joe Dickason, Product Manager
Mary Givens, Program Manager of Meaningful Use

27. Question 1:
How soon can a Medicaid EP collect the 2014 incentives?
• Depends on when the
EP attested to Stage 1
year 1. Stage 1 year 2?
• Date certified technology
is in EP’s production
• Date business process
changes are stabilized
• The first day of the next
calendar quarter
Open Minds October 2012 Stage 2 presentation

28. Example:
Open Minds October 2012 Stage 2 presentation

29. Question 2:
How well do the EP’s current processes measure up to 2014?
• eRx increase 40% to 50%
(includes compare to at
least 1 drug formulary)
• Demographics increase
50% to 80%
• Vital Signs increase 50% to
80% (only BP in exclusion)
• Smoking Status increase
from 50% to 80%
• Lab results increase from
40% to 55%
Open Minds October 2012 Stage 2 presentation

30. Question 2:
How well do the EP’s current processes measure up to 2014?
• Patient list-no change
• Patient specific education
resources-no change
• Risk Analysis-no change
• Medication reconciliation –
no change
• Immunization Registry –no
change
• Syndromic Surveillance-no
change
• Clinical summary for each
office visit-went from 3
business days to 1
Open Minds October 2012 Stage 2 presentation

31. Question 3:
How prepared are your EPs for
the new processes?
• CPOE – expanded to include labs and
imaging.
– Medications increased from 30% to
60%
– Labs 30%
– Radiology 30%
• Timely Access has been combined with
electronic copy of health record
– changes from 10% in 3 business
days to 50% in 4 business days.
– New measure for 5% must do view,
download, or transmit.
• Clinical Decision Support Rules
– includes drug-drug & drug-allergy.
– changes from 1 rule to 5 rules.
– 4 of 5 rules related to CQM.
– 1 of 5 rules to healthcare efficiency. Open Minds October 2012 Stage 2 presentation

32. Question 3:
How prepared are your EPs for
the new processes?
• Patient Reminders
– decreased from 20% >
10%, but different
population
• Transition of Care
– 50% to 10%, but must
directly send (likely via
Direct protocol)
• Secure Electronic
Messaging
– Send message to more
than 5% of unique
patients Open Minds October 2012 Stage 2 presentation

33. Question 3:
How prepared are your EPs for
the new processes?
• Electronic Notes
– create, edit, sign for
more than 30% of unique
patients
• Imaging Results
– more than 10% of all
scans & test are
incorporated into or
accessible through
• Family Health History -
more than 20% have
structured data for 1 or
more first-degree relatives
or indication of review
Open Minds October 2012 Stage 2 presentation

34. Question 4:
How are your EPs preparing for reporting on clinical quality measures for 2014?
• Increase number of CQMs from 6 out of 44 to 9 out of 64
• Must cover 3 “National Quality Strategy Domains”
• Medicaid providers will have to electronically report their
CQMs to state
• Regardless of the stage of MU, all EPs
will have to complete this number of
CQMs in 2014.
Open Minds October 2012 Stage 2 presentation

35. Question 4: How are your EPs preparing for
Question 4:
reporting on clinical quality measures for stage 2?
How are your EPs preparing for reporting on clinical quality measures for 2014?
• NQF 0105 Title: Anti-depressant medication management: (a) Effective Acute Phase Treatment,(b)Effective Continuation Phase Treatment
• NQF 0004 Title: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: (a) Initiation, (b) Engagement
• NQF 0028 Title: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
• 0022 Title: Use of High-Risk Medications in the Elderly
• 0101 Title: Falls: Screening for Fall Risk
• 0104 Title: Major Depressive Disorder (MDD): Suicide Risk Assessment
• 0108 Title: ADHD: Follow-Up Care for Children Prescribed Attention Deficit Hyperactivity Disorder (ADHD) Medication
• 0110 Title: Bipolar Disorder and Major Depression: Appraisal for alcohol or chemical substance use
• 0418 Title: Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
• 0419 Title: Documentation of Current Medications in the Medical Record
• 0421 Title: Adult Weight Screening and Follow-Up
• 0710 Title: Depression Remission at Twelve Months
• 0712 Title: Depression Utilization of the PHQ-9 Tool
• 1365 Title: Child and Adolescent Major Depressive Disorder: Suicide
Risk Assessment
• Title: Dementia: Cognitive Assessment
Open Minds October 2012 Stage 2 presentation

36. Question 5:
How is the EP preparing for health
information communication ?
• EPs will need to register with a service
that support direct messaging.
– State HIE
– CMS
– Vendor
– Third Party
• Need to establish a relationship and
process for transition of care that
includes electronic transmission of
transition of care/referral summary.
• Secure messaging between EP and
consumer (to and from) must be
integrated into patient engagement
practices
Open Minds October 2012 Stage 2 presentation

37. Question 4: How are your EPs preparing for
2014 Ambulatory Measures of Meaningful Use
reporting on clinical quality measures for stage 2?
CORE-Report on all 17 Objectives MENU- Report on 3 out of 6 objectives
• Use computerized provider order entry (CPOE) for medication,
laboratory and radiology orders • Submit electronic surveillance data
• Generate and transmit permissible prescriptions electronically (eRx) to public health agencies
• Record Demographic information
• Record and chart changes in vital signs • Record electronic notes in patient
• Record smoking status for patients 13 years or older records
• Use clinical decision support to improve performance in high-priority
health conditions • Imaging results accessible through
• Provide patients the ability to view online, download and transmit
their health information CEHRT
• Provide clinical summaries for patients for each office visit • Identify and report cancer cases to
• Protect Electronic health information created or maintained by the
CEHRT State cancer registry
•
•
Incorporate clinical lab test results into CEHRT
Generate lists of patients by specific conditions to use for quality
• Identify and report specific cases to a
improvement, reduction of disparities, research, or outreach. specialized registry (other than
• Use clinically relevant information to identify patients who should cancer registry)
receive reminders for preventive /follow –up care
• Use CEHRT to identify patient-specific education resources.
• Perform medication reconciliation
• Provide summary of care record for each transition of care referral
• Submit electronic data to immunization registries
• Use secure electronic messaging to communicate with patients on
relevant health information.
Open Minds October 2012 Stage 2 presentation

38. Open Minds October 2012 Stage 2 presentation

39. Open Minds October 2012 Stage 2 presentation

40. www.MUforBH.com
A resource for behavioral health professionals seeking advice, guidance, and
information on meeting Meaningful Use requirements.
• FAQs
o Get quick answers to the most common Meaningful Use
questions
• Forum
o Chat and exchange ideas with others in your community
• Play the MU Game
o A step-by-step guide to claiming your Meaningful Use dollars
• Videos and Webinars
o Access past Meaningful Use presentations for additional help
or join our free live webinars
• MU State University
o Meaningful Use Education State by State
Open Minds October 2012 Stage 2
presentation

41. Open Minds October 2012 Stage 2
presentation