Embed Size (px)
Citation preview
Page Header
© 2018 Purdue University
Medicaid PI: Challenge the Requirements to STOP Addictions
IPHCA
April 30, 2019
Page Header
© 2018 Purdue University
Agenda
1) Overview of 2019 Medicaid PI (20 min)
2) Q&A (10 min)
3) Small Group Activity! (10 min)
4) Large Group Activity! (10 min)
5) Take-Home Plans
6) Last Minute Q&A (5 min)
3© 2018 Purdue University EA/EOU
▪ Reasonable changes to workflow
▪ Improve patient health
▪ Improve staff satisfaction
▪ Use CEHRT in a meaningful way
▪ Reports
▪ Patient lists
▪ Preventive care reminders
▪ 1 Year of AIU (adopt, implement, upgrade) + 5 years
attestation = $63,750
▪ Last year to begin was 2016
Medicaid PI (MUPI)
Previously called Meaningful Use
4© 2018 Purdue University EA/EOU
2015 Certification
2015 CEHRT
• Optional in previous years
• REQUIRED in 2019
• Must have 2015 functionality for ENTIRE PI reporting period
• Last day to be 2015 CEHRT is 10/03/2019
5© 2018 Purdue University EA/EOU
Objective
1 Security risk assessment
2 eRx
3 Clinical Decision Support
4 CPOE (Meds, Diagnostic, Labs)
5 Patient Electronic Access
6 Coordination of Care Through Patient Engagement
7 Health Information Exchange
8 Public Health Reporting
2019 PI Requirements
Many Changes from 2018
*Must be on 2015 Certified Software!
https://chpl.healthit.gov/#/search
6© 2018 Purdue University EA/EOU
Prevention of Information Blocking
Required to submit PI
• Must attest that you are not preventing information from being shared
• Patients
• Other providers, as needed
• Acting in good faith
This is important! We
are in the age of
interoperability. You
need to play nice ☺ and
share information as
needed.
7© 2018 Purdue University EA/EOU
▪ Evaluate on 2015 software
▪ Conduct in 2019 calendar year
Objectives
Protect Electronic Health Information
eRx
▪ >60%
▪ Query drug formulary
Clinical Decision Support
▪ 5 CDS interventions
▪ Enabled drug-drug interactions
▪ Enabled drug-allergy interactions
8© 2018 Purdue University EA/EOU
Security Risk Assessment
2019
• Conduct or review a security risk analysis including addressing the
security (to include encryption) of ePHI data created or maintained by
CEHRT
• Implement security updates as necessary
• Correct identified security deficiencies
• Conduct during 2019
9© 2018 Purdue University EA/EOU
▪ >60% Medication orders
▪ >60% Laboratory orders
▪ >60% Diagnostic imaging orders
▪ Exclusions if less an 100 orders
for any of the 3 objectives
Objectives
Computerized Provider Order Entry (CPOE)
To enter orders, you must be
certified! Medical Assistants
and scribes who are not
certified will need to become
so.
10© 2018 Purdue University EA/EOU
Measure 1 >80%
Timely access to view, download, or transmit health info that
is configured to meet the technical specification of the API in
the CEHRT. Data must be available within 4 business days
of the information being available to the provider. **Please note that the MIPS PI requirement is 48 hours!
Objectives
Patient Electronic Access to Health Information
▪ Info for EVERY encounter
Measure 2 >35%
Provide patient-specific educational resources from CEHRT
Electronic access through the portal for education
Talk with your vendor as
to how these happen!
11© 2018 Purdue University EA/EOU
Objectives
Coordination of Care Through Patient Engagement
Three Measures
View, download or transmit health information through portal
OR
Access health information through API
OR
Combination
>5%
A secure message is sent to a patient or clinic responds to a
secure message sent by patient
>5%
Patient generated health data from nonclinical setting is
incorporated into CEHRT
>5%
*Providers must attest to all three but meet at least 2
12© 2018 Purdue University EA/EOU
Data from a Non-Clinical Setting
What is this?
• Includes data generated by:
• Medical device data
• Glucometer data
• Blood pressure data
• Fitness monitor data
• Fitbit data
• My Fitness Pal data
13© 2018 Purdue University EA/EOU
Objectives
Health Information Exchange
Three Measures
Electronic Summary of Care provided for each transition of
care going out of the clinic
>50%
For electronic Summaries of Care received (or new patients
where provider has never seen the patient), EP incorporates
the E-SOC into the CEHRT
>40%
Clinical information reconciliation for transitions into clinic or
new patients (medication including name, dosage,
frequency, route, allergies, and current problem list)
>80%
*Providers must attest to all three but meet at least 2
14© 2018 Purdue University EA/EOU
Health Information Exchange
Deep Dive
Support Electronic Referral Loops by Sending Health Information
• Create a summary of care using CEHRT
• Submit the summary of care electronically to receiving provider
• Must have “reasonable certainty” that it was received (keep for audit)
• Excluded if refer less than 100 times
• Be careful! Might be a red flag depending on specialty
Definition
Transition of Care – The movement of a patient from
one setting of care (hospital, ambulatory primary care
practice, ambulatory, specialty care practice, long-term
care, home health, rehabilitation facility) to another. At a
minimum this includes all transitions of care and
referrals that are ordered by the MIPS eligible clinician.
15© 2018 Purdue University EA/EOU
Health Information Exchange
Deep Dive
Support Electronic Referral Loops by Receiving and Incorporating Health
Information
• EC has never encountered patient before OR receipt of electronic summary of
care from another provider
• EC does clinical information reconciliation for: medications, medication allergies,
and problem list
• Need to query for health information
• If not available but queried, it still counts
• Exclusions if EC cannot implement measure OR has less than 100 transitions
• 20 points re-distributed to sending health information measure
16© 2018 Purdue University EA/EOU
Clinical Information Reconciliation
Number of transitions of care where the following are
reconciled:
• Medication list reconciliation
• Medication allergy list reconciliation
• Current problem list
• Includes manual and automated reconciliation
• If not update necessary
• Verify as such
17© 2018 Purdue University EA/EOU
Two of Five Four Measures for Active Engagement Yes/No
Immunization Registry - CHIRP
Syndromic Surveillance
Electronic Case
Public Health Registry - INSPECT!
Clinical Data Registry
Objectives
Public Health Reporting
Active engagement = letter of intent, testing phase, production
You must re-register for CHIRP for Stage 3!
https://eportal.isdh.in.gov/MeaningfulUse/
18© 2018 Purdue University EA/EOU
CHIRP Requirements
2019
• Stage 3 (2015 CEHRT) requires more information to be gathered by CHIRP
• Re-register ASAP once you have Stage 3
• Must re-register within first 60 days of start of reporting period – or before
• Check with your vendor
• Are they setup for bi-directional interface?
• If not, cannot submit PI data
https://eportal.isdh.in.gov/MeaningfulUse/
19© 2018 Purdue University EA/EOU
Common Registries
2019
• Cancer Registry (same registration site as CHIRP)
• INSPECT (Indiana’s Prescription Drug Monitoring Portal)
• National Healthcare Surveys Registry (CDC) – free ☺
• Vendor specific
• Epic
• eCw
• Professional Society
• Cardio – Pinnacle
• Trauma registries
• DM Registries
• Hundreds more! Make sure they are verified as a registry for MIPS
20© 2018 Purdue University EA/EOU
Clinical Quality Measures
Report 6 eCQMs for a full calendar year
• Must have 1 outcomes measure
• If none available, choose a high priority measure
• If none, report on 6 relevant measures to your practice
Not very many quality
measures focused on
addiction. See
handout.
Are you going well in a
measure?
✓ Move on to another
relevant to your patients
and staff!
✓ Set goals
✓ Challenge your clinic
✓ Provide best quality
care by knowing where
you were and where
you’re going
21© 2018 Purdue University EA/EOU
Medicaid eCQMs Related to Addictions
2019
MEASURE NAME QUALITY ID MEASURE
TYPE
HIGH
PRIORITY
MEASURE
Initiation and Engagement of Alcohol and Other
Drug Dependence Treatment
305 Process FALSE
Preventive Care and Screening: Tobacco Use:
Screening and Cessation Intervention
226 Process FALSE
Documentation of current medications in the
medication module
130 Process FALSE
22© 2018 Purdue University EA/EOU
To Do Checklist
What do we do now?
✓ Are you on 2015 CEHRT?
✓ If not, when?
✓ Register with INSPECT for 2019 if prescribe schedule drugs
✓ Begin using HIE for transitions of care in and out
✓ How? Check with vendor
✓ Arrange for HIE confirmation with another provider
✓ Email verification is ok
✓ Public Health – do you have at least 2?
✓ Look into options
23© 2018 Purdue University EA/EOU
Links
CHIRP Portal to Re-Register Stage 3 and Cancer Registry
INSPECT
CDC's National Health Care Surveys Registry
Information Blocking Fact Sheet
24© 2018 Purdue University EA/EOU
Q&A Time
25© 2018 Purdue University EA/EOU
Activity!
Work With Your Group
26© 2018 Purdue University EA/EOU
Activity
Rules!
• Work in teams
• Discuss challenges with each/any objective
• Let everyone participate!
• Listen!
• Write challenges on your papers
• Half-way through activity discuss solutions
• Every solution is a good idea ☺
• Write solutions on your papers
• Come back as a whole group
• Around the room sharing
• Ideas on large post-its
• Update your own sheet
• Take your sheet back to the clinic with you and share ideas towards success!
27© 2018 Purdue University EA/EOU
Activity!
Share With Group
28© 2018 Purdue University EA/EOU
Q&A Time
29© 2018 Purdue University EA/EOU
Contact Us
Jennifer Anglin MS, CHES, PCMH CCE
Managing Advisor
Promoting Interoperability, MIPS, PCMH, Healthy Hearts in the Heartland
Purdue Healthcare Advisors
(574) 773-5870 (phone)
(765) 496-6990 (fax)
www.pha.purdue.edu
Visit us on @ Purdue Healthcare Advisors
