Beginning in 2011 and continuing until 2017, the Centers for Medicare & Medicaid Services (CMS) have been providing incentive payments to adopt and "Meaningfully Use" Electronic Health Records (EHRs) in the practice of Medicine. The maximal payment for those who started as of 2012 is $44,000 through the Medicare EHRs Incentive Program and $63,750 through the Medicaid EHRs Incentive Program. Payment cuts are scheduled for those Eligible Professionals (EPs) who fail to participate by 2015.
The standards for Meaningful Use of EHRs have recently been raised from Stage 1 Measures to Stage 2. To qualify for Stage 2 all EPs must first submit the Stage 1 measures for two consecutive years. The means to collect and report on the data for these measures should be part of your EHR already. Stage 2 reporting will begin for many physicians within a year.
For Stage 2, most of the Stage 1 measures have been retained but the thresholds for those qualifying has increased. Many of these measures focus on the collection of data, such as demographics, vitals, diagnoses, medication lists, allergies as well as the reporting of Clinical Quality Measures (CQM). Patient’s access to their health information has been modified to the ability to view online, download and transmit their health information within four business days of the information being available to the EP.
As of 2012, over 50% of healthcare providers are using EHRs. Commercial and Government plans have used the momentum created by Meaningful Use to also begin acknowledging and offering increased compensation for similar programs, such as Patient Centered Medical Homes and Accountable Care Organizations.
EHR vendors are busy upgrading their systems to fulfill the new Stage 2 requirements. EPs will need to use these upgraded EHR systems to fulfill the new requirements, many of which focus on sharing information with our patients and our peers. Stage 2 requirements are reviewed below:
For EPs, there is one new core measure and five new menu measures:
Send relevant health information as a secure message; a secure message was sent using the electronic messaging function of Certified EHR Technology by more than 5% of unique patients seen during the EHR reporting period. This will need to be information specific to a patient’s condition, ie, a review of the medication recently prescribed.
1) Enter at least one electronic progress note created, edited, and signed by an EP for more than 30% of unique patients.
2) More than 10% of all scans and tests whose result is an image ordered by the EP for patients seen during the EHR reporting period are incorporated into or accessible through Certified EHR Technology.
3) More than 20% of all unique patients seen by the EP during the EHR reporting period have a structured data entry for one or more first-degree relatives or an indication that family health history has been reviewed.
4) Successful ongoing submission of cancer case information from Certified EHR Technology to a cancer registry for the entire EHR reporting period.
5) Successful ongoing submission of specific case information from Certified EHR Technology to a specialized registry for the entire EHR reporting period.
Next month, we will review some EHR features that will be needed to facilitate meeting these objectives.
While using an EHR may change your office's workflow, your access to essential information from PDR remains unchanged. PDR Network has pioneered new ways to deliver critical drug reference information to support today's healthcare provider from within your EHR. Ask your EHR provider about PDR® BRIEF, a drug-specific information hub to support your treatment decisions, and PDR® Search, an on-demand resource offering access to PDR’s full content set. Or, to request PDR tools be added to your EHR, contact us at ProviderFeedback@pdr.net.
Salvatore Volpe, MD, FAAP, FACP, CHCQM
Chief Medical Officer