In our last post, we covered why Meaningful Use is so big in 2014. When talking about Meaningful Use, there are a lot of terms and requirements that are thrown around and it can get quite confusing. This week we delve a little deeper into some of the main terms and requirements for meeting Meaningful Use.
Meaningful use attestation is the process of demonstrating that an individual or organization is meeting the requirements in order to qualify for the federal government payments. They must prove (attest to) that they are meaningfully using a certified EHR. Providers are required to register and attest using the Centers for Medicare & Medicaid Services (CMS) website. As we mentioned last week, there are three different stages to Meaningful Use and providers must attest annually to whichever stage they are on. There are three sets of requirements providers must attest to at each stage: core objectives, menu objectives, and clinical quality measures.
2. Core Objectives
Each stage of Meaningful Use has its own set of Core Objectives that a provider must meet and attest to. All Core Objectives are required and have a specific measurement for each objective that must be achieved. For Stage 1 there are 15 Core Objectives and for Stage 2 there are 17 Core Objectives. As providers move on to the next stage, the measures get higher and/or include more requirements.
Here’s an example:
Core Objective: Generate and transmit permissible prescriptions electronically (eRx)
Stage 1 Measure: More than 40% of all permissible prescriptions written by the EP (Eligible Provider) are transmitted electronically
Stage 2 Measure: More than 50% of all permissible prescriptions, or all prescriptions, written by the EP are queried for a drug formulary and transmitted electronically using CEHRT.
3. Menu Objectives
In addition to the Core Objectives, providers also have to meet and attest to a set of Menu Objectives. Not all Menu Objectives are required, and providers are allowed to choose a certain number from the set. In Stage 1, providers must attest to 5 out of 10 Menu Objectives, with at least 1 public health objective selected. In Stage 2, providers must attest to 3 out of 6 Menu Objectives.
Here’s an example:
Stage 1 Menu Objective: Medication reconciliation
Measure: The EP performs medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the EP.
Stage 2 Menu Objective: Record electronic notes in patient records.
Measure: Enter at least one electronic progress note created, edited and signed by an EP for more than 30 percent of unique patients with at least one office visit during the EHR reporting period.
4. Clinical Quality Measures
Lastly, providers must attest to a set of Clinical Quality Measures (CQMs). CQMs look at how well a provider delivers appropriate clinical services to their patients, or the quality of care. They assess everything from treatments to experiences to outcomes. As stated on the CMS website, “CQMs help identify areas that require improvement in care delivery, identify differences in care among various populations, and may improve care coordination between health care providers.”
As of 2014, all providers have to report on the same CQMs regardless of what stage they are on. There are 64 CQMs categorized into six National Quality Strategy domains which include: (1) Patient and Family Engagement (2) Patient Safety (3) Care Coordination (4) Population/Public Health (5) Efficient Use of Healthcare Resources and (6) Clinical Process/Effectiveness. Providers must report on 9 of the 64 CQMs and they must cover at least three of the National Quality Strategy domains. Providers are only allowed to attest to CQMs that their EHR vendor has certified on, so some providers might have a lot less than 64 to pick from.
Here’s an example:
Clinical Quality Measure: Documentation of Current Medications in the Medical Record
Measure Description: Percentage of specified visits for patients aged 18 years and older for which the eligible professional attests to documenting a list of current medications to the best of his/her knowledge and ability
Domain: Patient Safety