Well into the second year of The Health Information Technology for Economic and Clinical Health Act (HITECH), eligible practices are well on their way to being prepared for Stage 2 Meaningful Use incentives offered by the act. Changes have pushed the deadline for compliance to January 2014 and also have adjusted clinical quality measures and core objectives. Theses changes have made the process of attestation easier in some respects, but still place a considerable responsibility on eligible professionals to have a process in place.
While there is are significant financial benefits for practices who install certified electronic health records system. The Center for Medicare and Medicaid Services (CMS) has detailed the measures and objectives that practices will begin reporting on beginning in 2014 to qualify for the incentives.
Rewards require attestation to 90 consecutive days of meaningful use the first year and full calendar year meaningful use in the following years of the program through 2016 for those registered for the $44,000 incentive through Medicare and 2021 for those eligible professionals registered for the $63,750 incentive available through Medicaid. There are 17 of 20 core objectives that must be met and attested to under Stage 2 incentives. According to CMS they include and are summarized as:
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Meaningful use of computerized ordering for imaging, labs and medications as well as generate and transmit prescriptions through the system. Practices must also incorporate test results into the system.
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Record demographic information, chart vital signs for all patients and smoking status for patients 13 years old or older.
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Provide patients the ability to view and manage their health information with clinical summaries for each office visit. In addition, protect electronic health information created or maintained by the Certified EHR system. Practices will also use secure email to communicate with patients in regard to their information.
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Generate condition specific lists of patients for quality improvement, reduction of disparities, research as well as clinical decision support to improve care on high-priority health conditions.
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Use certified EHR to identify patients who should receive reminders for follow up or preventative care and identify patient-specific education resources as well as perform reconciliation of medications.
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Through secure electronic methods transfer records, send referral data to specialists, as well as submit electronic data to immunization registries
In addition to the core objectives, eligible professionals must also meet three of six menu objectives which are summarized as:
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Report syndromic data to public health agencies
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Record electronic notes patient and family health history in patient records as well as assure imaging reports are available through the system
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Report cancer cases to state cancer registries as well as other specific cases to specialized registries (other than a cancer registry)
While adhering to and reporting on core and menu objectives may seem like a daunting task. Certified electronic health systems have most of the functionality necessary for adherence incorporated into their operating systems. This simplifies the process and only requires staff to learn a new method of approach to daily functions. In the larger picture, better records will be kept, better care will be delivered, less mistakes will be made and the work day might be a little easier.
In addition to reporting on core and menu objectives, eligible practitioners must choose nine clinical quality measures from a list of 64 and are also from at least three of six categories determined by the Department of Health and Human Services. The categories are:
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Patient and Family Engagement
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Patient Safety
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Care Coordination
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Population and Public Health
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Efficient Use of Healthcare Resources
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Clinical Processes/Effectiveness
Clinical quality measures were formally core objectives, but as of 2014 will be a separate requirement for meaningful use for Stage 2 incentives. Eligible providers established in the program must report and attest one of two ways, either the Physician Quality Reporting System or the CMS Portal. For practices only reporting Medicaid, information must be provided to their state.
The Health Information Technology for Economic and Clinical Health Act provides significant financial incentives for the meaningful use of certified electronic health records systems. As the deadline for Stage 2 incentive looms closer, so do the rewards through established incentives, increased proficiency in patient care and streamlined processes.
