Guest Spot: Meaningful Use -- Have the Right Answers!  (Part II)

Contributed by: Kay Jackson, Compliance and Financial Manager, Iatric Systems, Inc.

If you know the right answers, there are many paths to achieving Meaningful Use, even as early as 2011! In last month’s issue of MCB, Part I covered the differences between complete and modular EHR certification, how to register to receive incentive payments, Medicare vs. Medicaid incentive programs, and important dates to remember. This Part II article will cover a critical and timely update on complete vs. modular certification, understanding the scope and depth of reporting Clinical Quality Measures, the status of Stage 2 requirements, and helpful hints on how to keep track of the status of your hospital’s achievement of Meaningful Use.

Update on Complete vs. Modular EHR Certification

Since last month, there’s been a lot of public concern and discussion around complete vs. modular EHR certification and what it means for hospitals registering to receive incentive payments in 2011/2012. The concern was that if a hospital does not purchase and implement every single module from a certified complete EHR vendor like MEDITECH, then the system is no longer “complete” and therefore may not qualify for Meaningful Use certification and incentive payments.

I wasn’t able to attend HIMSS, but heard the good news that MEDITECH announced at HIMSS that they are in the process of obtaining modular certification for their software. So keep your eye on the ONC CHPL list of certified products for MEDITECH’s modular certification to appear.

More good news for hospitals… Drummond Group recently announced another certification path for hospitals with systems comprised of software from multiple vendors. Hospitals can follow this roadmap to obtain ONC certification and incentive payments in 2011/2012. To learn more, visit http://www.marketwire.com/press-release/Drummond-Group-Introduces-EHR-Certification-for-Hospitals-1398812.htm.

If you’d like to read a brief history of the issue, or would like to follow its progression to date, take a look at the following links:

• http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&objID=3163&PageID=20776
• http://healthit.hhs.gov/portal/server.pt/community/onc_regulations_faqs/3163/faq_21/21597
• http://histalk2.com/2011/02/12/monday-morning-update-21411/ (see posted comments from “Held Hostage” and “Frank Poggio”)
• http://histalk2.com/2011/02/23/from-himss-22311/ (see posted comment from “Fred” re: MEDITECH)

Clinical Quality Measures

Be sure to understand the depth and scope of Meaningful Use core objective #9, reporting clinical quality measures. Clinical quality measures are not the same as Joint Commission “Core Measures” your hospital may be reporting currently. There are 15 clinical quality measures that hospitals must report on in order to comply with just that one Meaningful Use core objective:

• NQF 0371 – Venous Thromboembolism prophylaxis within 24 hours
• NQF 0372 – Intensive Care Unit Venous Thromboembolism prophylaxis
• NQF 0373 – Overlapping Anticoagulation therapy
• NQF 0374 – Platelet Monitoring on Unfractionated Heparin
• NQF 0375 – Venous Thromboembolism discharge instructions
• NQF 0376 – Incidence of potentially preventable Venous Thromboembolism
• NQF 0435 – Stroke: Discharge on anti-thrombotics
• NQF 0436 – Ischemic Stroke- Anticoagulation for A-fib/flutter
• NQF 0437 – Ischemic Stroke - Thrombolytic therapy
• NQF 0438 – Ischemic or Hemorrhagic stroke- Antothrombotic therapy
• NQF 0439 – Ischemic stroke- Discharge on statins
• NQF 0440 – Ischemic or Hemorrhagic Stroke- Stroke education
• NQF 0441 – Ischemic or Hemorrhagic Stroke- Rehabilitation assessment
• NQF 0495 – Emergency Department Throughput - Arrival to Departure
• NQF 0497 – Emergency Department Throughput - Admission to Inpatient

Iatric Systems NPR Report Services can help hospitals comply with this objective, as well as maintain an audit trail that substantiates the results even after data on the patients has been purged from the originating database. The biggest challenge for hospitals to achieve this objective will be putting procedures in place to collect the data.

AHIMA provides a great whitepaper on this subject at: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_048554.pdf.

Status of Stage 2 Requirements

You’re in the middle of attempting to comply with Stage 1 requirements, but it’s not too soon to become familiar with proposed Stage 2 requirements. Most Stage 2 proposed requirements are either a continuation or an expansion of an existing Stage 1 objective, but there are also several new proposed requirements:

• More than 30% of hospital patient days have at least one electronic note by a physician, NP, or PA.
• 30% of hospital medication orders automatically tracked via electronic medication administration recording.
• 80% of patients offered the ability to view and download via a web-based portal, within 36 hours of discharge, relevant information contained in the record about hospital inpatient encounters. Data are available in human-readable and structured forms.
• Patient preferences for communication medium recorded for 20% of patients.
• List of care team members (including PCP) available for 10% of patients in EHR.
• Record a longitudinal care plan for 20% of patients with high-priority health conditions.

The comment period for feedback on proposed Stage 2 requirements closed on February 25, 2011. The CSC Meaningful Use Community has put together a nice summary of Stage 2 requirements and recommendations for achieving Stage 1 and Stage 2 objectives at: http://assets1.csc.com/health_services/downloads/CSC_Summary_of_Preliminary_Stage_2_MU_Requirements.pdf.

What’s Your Hospital’s Status?

Do you know how far along your hospital has come in achieving Meaningful Use? Is your facility ready to attest? HIMSS has compiled a “Meaningful Use Stage 1 Hospital and Eligible Provider Self Assessment Tool” available for download at http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=198. You or your hospital must be a HIMSS member in order to access this tool. MEDITECH has also created a color-coded Excel spreadsheet checklist we’re told is called the “ARRA Meaningful Use Checklist.”

Keep your eye out for Iatric Systems Meaningful Use Manager solution, which provides a central location for hospitals to monitor progress in connection with Meaningful Use Objectives, soon to be installed at its first beta test site.

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Kay Jackson is the Software Certification, Compliance and Financial Marketing Manager at Iatric Systems, Inc. Kay is a well-known educator in the MEDITECH community and has been a requested speaker at more than 100 conventions. She will be presenting education on Meaningful Use and other topics at International MUSE 2011 in Nashville, TN. For more information, visit Iatric Systems online at www.iatric.com.