GE Healthcare. Delivering the capabilities you need for Stage 2 in the Ambulatory Setting

Transcription

1 GE Healthcare Delivering the capabilities you need for Stage 2 in the Ambulatory Setting March 12, 2013

2 Topics Certification Criteria Attestation Requirements Functional Measures Clinical Quality Measures Reporting Support Product Changes

3 Certification Criteria

4 Certification Criteria Already Supported Access Control Accounting of Disclosures: Optional Amendments Authentication Automatic Log-off Calculate Body Mass Index Drug-Drug, Drug-Allergy Interaction Checks (non-% Functional Measure) Electronic Notes (%-based Functional Measure) Electronic Prescribing (%-based Functional Measure) Emergency Access Image Results (%-based Functional Measure) Maintain Active Medication List (%-based Functional Measure) Maintain up-to-date Problem List (%-based Functional Measure) Transmission to Specialized Registries Vital signs, Body Mass Index, and Growth Charts (%-based Functional Measure)

5 Certification Criteria Combined w/ Others Audit Log Electronic Copy of Health Information Encryption when exchanging electronic health information Exchange Clinical Information and Patient Summary Record General Encryption Integrity Plot and Display Growth Charts Timely Access

6 Certification Criteria In Scope Auditable Events and Tamper-resistance Audit Reports Automated Numerator Recording Automated Measure Calculation CQM Capture and Export CQM Import and Calculate CQM Electronic Submission Cancer Case Information: Optional (Required if Transmitting to Cancer Registries) Clinical Decision Support (non-% Functional Measure) Clinical Information Reconciliation (%-based Functional Measure) Clinical Summaries (%-based Functional Measure) Computerized Provider Order Entry (%-based Functional Measure) Data Portability Drug Formulary Checks (non-% Functional Measure) End-User Device Encryption Family Health History (%-based Functional Measure) Generate Patient Lists (non-% Functional Measure) Immunization Information Incorporate Laboratory Test Results (%-based Functional Measure) Maintain Active Medication Allergy List (%-based Functional Measure)

7 Certification Criteria In Scope (Continued) Medication Reconciliation (%-based Functional Measure) Patient Reminders (%-based Functional Measure) Patient Specific Education Resources (%-based Functional Measure) Public Health Surveillance Record Demographics (%-based Functional Measure) Safety Enhanced Design Secure Messaging (%-based Functional Measure) Smoking Status (%-based Functional Measure) Submission to Immunization Registries (non-% Functional Measure) Syndromic Surveillance (non-% Functional Measure) Transitions of Care Create and Transmit Summaries (%-based Functional Measure) Transitions of Care Receive, Display, and Incorporate Summary Care Records Transmission to Cancer Registries: Optional (non-% Functional Measure) Quality Management System View, Download, and Transmit to 3 rd Party (%-based Functional Measure) Consolidated Functional Measure Electronic Health Information Protection (non-% Functional Measure)

8 Attestation Requirements

9 2014 Attestation and Reporting Stage 1 Stage 2 Functional Measures Stage 1 - At least one Menu must be a Public Health Measure 15 Core 17 Core 5/10 Menu 3/6 Menu 20 Total 20 Total Clinical Quality Measures Beginning in 2014, the CQM rules are the same regardless of Stage: EPs must report 9/64 CQMs The 9 reported must include measures from at least 3 of the National Quality Strategy domains

10 Functional Measures

11 2014 Functional Measures Stage 1 Stage 2 Core: Computerized Provider Order Entry Drug-Drug and Drug-Allergy checks eprescribing Record Demographics Problem List Medication List Medication Allergy List Vital Signs Smoking Status Clinical Decision Support Report Clinical Quality Measures Electronic Health Information Clinical Visit Summaries Electronic Exchange of Key Clinical Information Protect Electronic Health Information Menu: Drug Formulary checks Incorporate Laboratory Test Results Patient Lists Patient Reminders Timely Access to Health Information Patient-specific Education Medication Reconciliation Transition of Care Clinical Summary Immunization Registries (PH) Syndromic Surveillance (PH) Core: Computerized Provider Order Entry eprescribing Record Demographics Vital Signs Smoking Status Clinical Decision Support View, Download, and Transmit Clinical Visit Summaries Protect Electronic Health Information Incorporate Laboratory Test Results Patient List Patient Reminders Patient-specific Education Medication Reconciliation Transition of Care Summary of Care Immunization Registries Secure Messaging Menu: Syndromic Surveillance Electronic Notes Imaging results Family Health History Cancer Registry Specialized Registry View, Download, and Transmit functionality will include all requirements for Electronic Health Information, Electronic Exchange of Key Clinical Information, and Timely Access to Health Information

12 Clinical Quality Measures

13 2014 Clinical Quality Measures Clinical Process / Effectiveness Domain * Controlling High Blood Pressure * Pneumonia Vaccination Status for Older Adults * Diabetes: Hemoglobin A1c Poor Control * Preventive Care and Screening: Cholesterol Fasting Low Density Lipoprotein (LDL-C) Test Performed * Hypertension: Improvement in blood pressure * Cervical Cancer Screening * Use of Appropriate Medications for Asthma * Diabetes: Eye Exam * Diabetes: Foot Exam * Diabetes: Low Density Lipoprotein (LDL) Management and Control * Breast Cancer Screening * Colorectal Cancer Screening * Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control * Hemoglobin A1c Test for Pediatric Patients * Diabetes: Urine Screening Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic Coronary Artery Disease (CAD): Beta- Blocker Therapy Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <40%) Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) In Scope for v12 indicated by *

14 2014 Clinical Quality Measures Clinical Process / Effectiveness Domain Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care Major Depressive Disorder (MDD): Suicide Risk Assessment Anti-depressant Medication Management: (a) Effective Acute Phase Treatment, (b)effective Continuation Phase Treatment ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication Bipolar Disorder and Major Depression: Appraisal for alcohol or chemical substance use Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer HIV Medical Visits Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery In Scope for v12 indicated by *

15 2014 Clinical Quality Measures Clinical Process / Effectiveness Domain Pregnant women that had HBsAg testing Depression Remission at Twelve Months Children who have dental decay or cavities Dementia: Cognitive Assessment Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: (a) Initiation, (b) Engagement Pneumocystitis jiroveci pneumonia (PCP) Prophylaxis HIV RNA control after six months of potent antiretroviral therapy Depression Utilization of the PHQ-9 Tool Preventive Care and Screening: Risk-Stratified Cholesterol Fasting Low Density Lipoprotein (LDL-C) In Scope for v12 indicated by *

16 2014 Clinical Quality Measures Efficient Use of Healthcare Resources Domain * Appropriate Testing for Children with Pharyngitis * Use of Imaging Studies for Low Back Pain * Appropriate Treatment for Children with Upper Respiratory Infection (URI) Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients In Scope for v12 indicated by *

17 2014 Clinical Quality Measures Patient Safety Domain * Documentation of Current Medications in the Medical Record * Falls: Screening for Falls Risk Use of High-Risk Medications in the Elderly Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures Child and Adolescent Major Depressive Disorder: Suicide Risk Assessment Title: ADE Prevention and Monitoring: Warfarin Time in Therapeutic Range. In Scope for v12 indicated by *

18 2014 Clinical Quality Measures Population / Public Health Domain * Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention * Preventative Care and Screening: Influenza Immunization * Preventive Care and Screening: Screening for High Blood Pressure * Adult Weight Screening and Follow-Up * Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents * Childhood Immunization Status * Chlamydia Screening in Women Screening for Clinical Depression Maternal depression screening In Scope for v12 indicated by *

19 2014 Clinical Quality Measures Care Coordination Domain Closing the referral loop: receipt of specialist report In Scope for v12 indicated by *

20 2014 Clinical Quality Measures Patient and Family Engagement Domain Functional status assessment for knee replacement Functional status assessment for hip replacement Functional status assessment for complex chronic conditions Oncology: Measure Pair: Oncology: Medical and Radiation Pain Intensity Quantified In Scope for v12 indicated by *

21 2014 Clinical Quality Measures 27 of 64 were selected for our Initial Certification All 64 are in scope before the end of 2013 The 27 were selected to provide support for the majority of the recommended Adult and Pediatric measures, those currently supported with Crystal or MQIC for Stage 1, and a minimum of reasonable measures for Pediatrics, Geriatrics, OBGYN, Cardiology, and Orthopedic specialties.

22 Reporting Support

23 Clinical Quality Measures: End-to-End CCC Dashboard Xxx 12 yy Data base Xxx 12 yy Xxx 12 yy Xxx 12 yy Ht Wt BP Dx Meds xxxx xxxx xxxx xxxx xxxx Data Normalization & Mapping Reporting QRDA-III CMS Collect Clinical Data Map to Regulatory Standards Process/Calculate emeasures Visual Analysis Tools Electronic Submission

24 Data Normalization/Mapping Standard set of mappings will be configured to support the documented intended use User tool to map additional terms to support unique, site specific, workflows This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

25 Reporting Crystal Reports and MQIC [1.0] will no longer be supported Hilton Head (internal program name) will be our reporting solution Dashboards and Electronic Reporting (QRDA-III) All data manipulations take place on CPS/CEMR This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

26 Product Changes

27 Clinical Decision Support Evidence Based Interventions (Triggered by the patient s clinical data) ONC requirement for certification Each of, and at least one combination of: Problem list; Medication list; Medication Allergy list; Demographics; Laboratory tests and value/results; Vital signs CMS requirement for attestation/reporting 5 Required; 4 or more tied to CQMs, and if not, must be related to high-priority health conditions Support Referential CDS Clinical data requested by the provider This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

28 Clinical Information Reconciliation Supporting the importation and incorporation of C-CDA Will include some level of Clinical Decision Support Evaluating the use of HTML5 This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

29 Clinical Visit Summaries Will include some ability to block/edit the contents Driving the capture of specific data Patient name, Sex, DOB, Race, Ethnicity, Preferred language, Smoking Status, Problems, Medications, Medication allergies, Laboratory tests, Laboratory values/results, Vital Signs (height, weight, BP, BMI), Care plan (including goals and instructions), Procedures, Care team member(s) Provider s name and office contact information; date and location of visit; immunization and/or medications administered during visit; diagnostic tests pending; clinical instructions; future appointments; referrals; future scheduled tests; and recommended patient decision aids This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

30 Computerized Provider Order Entry Medication, Laboratory, Radiology/Imaging orders are calculated separately, with different thresholds The Order dialog box will support classification of Rad, Lab, Other order types Ability to identify those users who s use of CPOE can be counted in the numerator Certified Medical Assistants have been added as able to be counted in the numerator for CPOE, if they are allowed by state, local and professional guidelines to enter orders into the medical record This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

31 Family Health History More structured capture of Family Health History A new problem entry dialog Capture problem as SNOMED-CT Associate the family member s relationship Support an additional description This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

32 Generate Patient Lists Add ability to create lists based on patients seen by a provider Additional support to use the list to generate reminders This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

33 Patient Specific Education Resources Support for the InfoButton standard Any 3 rd party vendor, supporting InfoButton, could provide content to the customers Review 3 rd party patient education resources Range from free to very sophisticated This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

34 Transitions of Care Explicitly indicate a transfer of care Create Care/Referral Summary (C-CDA) Support interactive Direct-protocol, C-CDA sending Support facilitated C-CDA through an Interface Engine Ability to Receive, Display, and Incorporate C-CDAs received from other providers This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

35 View, Download, and Transmit to 3 rd Party Provide a Clinical Summary C-CDA to the portal Receive audit information for reporting Support a patient activity history report Our approach is to make this portal agnostic This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

36 Centricity Clinical Content Basic Retire Basic Practice content Bundle a small set of forms to be included with release Includes data elements and data validation required for MU 2014 functional and CQMs Full CCC release will follow and will include the Basic functionality Customers who build own content will need to develop, to meet the new requirements as presented in the MU 2014 reporting user guide This functionality is currently in design and development. Changes are likely as the process continues. This is represents our current thinking and direction.

37 Questions?