1

Meaningful Use Stage 2The Value of Performance Benchmarking

22

LEARNING OBJECTIVES

• Understand how benchmarking leads to improvement

• Understand how analytics help meet MU stage 2 requirements

33

Meaningful Use Stage 2 shifts from data capture to usability

WHAT STAGE 2 MEANS TO YOU

• New Criteria– Starting in 2014, providers participating in the EHR Incentive Programs who have

met Stage 1 two or more years, will need to meet Stage 2 criteria

• Improving Patient Care– Stage 2 includes new objectives to improve patient care through better clinical

decision support, care coordination and patient engagement

• Interoperability– There is a greater emphasis on interoperability and patient engagement, with the

latter requiring action on the patient’s end in order for the objective to be met

44

STAGE 2 OBJECTIVES - MINIMAL CHANGESCore Objective Measure Change from Stage 1

2. e-Prescribing (eRx) • More than 50% of Rx are queried for a drug formulary and transmitted electronically

• Threshold increased from more than 40%• New exclusion

3. Record Demographics

• More than 80% of all unique patients seen by the EP have the following demographics recorded: Language, Sex, Race, Ethnicity, DOB

• Threshold increased from more than 50%

4. Record Vital Signs • More than 80% of all unique patients seen by the EP have BP (age 3+) and/or height and weight (for all ages) recorded

• Threshold increased from more than 50%

5. Record Smoking Status

• More than 80% of all unique patients 13+ seen by the EP have smoking status recorded

• 2 new statuses• Threshold increased from

more than 50%

9. Protect Electronic Health Information

• Conduct or review a security risk analysis, implement security updates as necessary and correct identified security deficiencies

• Unchanged

11. Patient Lists • Generate at least one report listing patients of the EP with a specific condition

• Former menu objective

55

STAGE 2 OBJECTIVES - SIGNIFICANT CHANGESCore Objective Measure Change from Stage 1

1. Computerized physician order entry (CPOE) for Medication, Laboratory and Radiology Orders

• More than 60% of medication, 30% of laboratory, and 30% of radiology orders are created using CPOE

• Order-centric• Inclusion of lab and

radiology• Threshold increased from

more than 30% for medications

7. Patient Electronic Access

• Measure 1: More than 50% of all unique patients seen are provided timely (within 4 business days after the information is available to the EP) online access to their health information subject to the EP's discretion to withhold certain information

• Measure 2: More than 5% of all patients seen (or their authorized representatives) view, download, or transmit to a third party their health information

• Former menu objective• Consolidated patient

electronic info request with timely access• Patient accountability• New exclusion• New IEHR workflow

17. Use Secure Electronic Messaging

• A secure message was sent using the electronic messaging function of CEHRT by more than 5% of unique patients (or their authorized representatives) seen by the EP

• New objective

66

STAGE 2 OBJECTIVES - SIGNIFICANT CHANGESCore

Objective Measure Change from Stage 1

15. Summary of Care

• Measure 1: Provide a summary of care record for more than 50% of transitions of care and referrals

• Measure 2: Provide a summary of care record for more than 10% of transitions of care and referrals, either:

(a) electronically transmitted using CEHRT to a recipient or

(b) where the recipient receives the summary of care record via exchange facilitated by an organization that is a The Nationwide Health Information Network (NwHIN) Exchange participant or in a manner that is consistent with NwHIN standards

• Measure 3: An EP must satisfy one of the following criteria:

(a) Conducts one or more successful electronic exchanges of a summary of care document, with a recipient who has EHR technology from a different EHR technology developer than the sender's EHR technology

(b) Conducts one or more successful tests with the CMS designated test EHR during the EHR reporting period

• Former menu objective• New electronic

measure• New measure

requiring receipt• New IEHR workflow

77

In 2014 and beyond, reporting programs (i.e., PQRS, eRx reporting) will be streamlined and standardized in order to reduce provider burden

CQM REPORTING

• 2014 represents CMS’s commitment to aligning quality measurement reporting among programs, including Hospital Inpatient Quality Reporting Program, PQRS, CHIPRA, and ACO programs

• Alignment includes:– Choosing the same measures for different program measure sets– Coordinating quality measurement stakeholder involvement efforts and

opportunities for public input– Identifying ways to minimize multiple submission requirements and mechanism– Alignment with HHS Priorities requiring CQM selection to occur across the 6 HHS

National Quality Strategy domains

• No longer a core objective of the EHR Incentive Programs, however still required in order to demonstrate meaningful use

88

Reporting CQM data is no longer a core objective of the EHR Incentive Programs, however it is still required in order to demonstrate meaningful use

CQM REPORTING

Prior to 2014 2014 and Beyond for all Stages of Meaningful Use

• Complete 6 out of 44– 3 core or 3 alternate core– 3 menu

• Complete 9 out of 64– Choose at least 1 measure in 3 NQS Health Domains– Recommended core CQMs include:

• 9 CQMs for the adult population

• 9 CQMs for the pediatric population

99

BENCHMARKING FOR MEANINGFUL USE

• Meet with all staff to ensure understanding of requirements, how this will affect their duties and obtain buy-in– Front office staff will obtain specific demographics, clinical staff will document smoking status

during triage, etc.

• Gauge starting clinical performance via dashboards and/or reporting

• Identify the leaders, e.g., those providers with the most compliant threshold %– Publish results to all providers

• Study the leaders to learn what they are doing– Compare the leaders' environments and processes to those of the other providers

• Decide what changes the practice is willing and able to make

• Implement the acceptable changes

• Rinse and repeat at a regular interval

1010

Knowing the score provides the opportunity to address gaps before it is too late

BENCHMARKING - KNOW THE SCORE

1111

Drill down to identify which patients are missing demographics - address the missing data

IDENTIFY AND ADDRESS GAPS

1212

Benchmarking helps identify leading providers for best practice sharing and laggards who may need additional education or “workflow assistance” on a particular measure

BENCHMARKING PROVIDER SCORES

Measure Practice Provider Numer Denom Goal Performance

Menu 6 Access to Patient Education Resources MMC Kobayashi, Mary R (MRK) 27 78 10% 35%

Menu 6 Access to Patient Education Resources TJ HW Davis, Carol C (CD) 33 101 10% 33%

Menu 6 Access to Patient Education Resources MMC Martinez, Benicio DO (BM) 25 80 10% 31%

Menu 6 Access to Patient Education Resources MMC Payne, Samuel MD (SP) 20 78 10% 26%

Menu 6 Access to Patient Education Resources MMC Monroe, J ames T MD (J M) 22 89 10% 25%

Menu 6 Access to Patient Education Resources MMC Alan, Nicole MD (NA) 21 88 10% 24%

Menu 6 Access to Patient Education Resources MMC Lesion, Laura MD (LL) 15 67 10% 22%

Menu 6 Access to Patient Education Resources TJ HW Kleary, Steven MD (SK) 18 90 10% 20%

Menu 6 Access to Patient Education Resources TJ HW Ford, David E MD (DF) 15 98 10% 15%

Menu 6 Access to Patient Education Resources TJ HW Hartman, Ira MD (IH) 10 78 10% 13%

Menu 6 Access to Patient Education Resources MMC Aiken, Isabella Dr. (IA) 8 90 10% 9%

Menu 6 Access to Patient Education Resources YACH Babar, Franco Manolo MD (FB) 7 77 10% 9%

Menu 6 Access to Patient Education Resources TJ HW Kim, Lisa M MD (LK) 8 88 10% 9%

Menu 6 Access to Patient Education Resources YACH Cutter, Scott MD (SC) 6 80 10% 8%

Menu 6 Access to Patient Education Resources YACH Carly, Ian Stephen MD (IC) 5 75 10% 7%

Menu 6 Access to Patient Education Resources YACH Crutch, Patricia PT (PC) 3 70 10% 4%

1313

BENCHMARKING AND MU - SUMMARY

• Meaningful Use Stage 2 – increased focus on:– Clinical decision support– Care coordination– Patient engagement– Interoperability

• Benefits of Dashboards:– Immediate understanding of performance– Quickly identify and address data gaps at patient and provider level

• Benchmarking– Creates healthy competition and performance based culture– Leads to best practice workflows and sharing– Identifies locations/providers who are struggling

14

www.viterahealthcare.com