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Participating in MU and the QPP in 2017

Posted By mceita administration, Thursday, July 20, 2017
With the launch of the Quality Payment Program (QPP) in 2017, and the continuation of Medicaid Meaningful Use running in parallel as a separate, distinct program for several more years, there are many questions regarding the similarities and differences between the Advancing Care Information (ACI) performance category of the QPP and the Medicaid EHR Incentive Program (Meaningful Use). To learn more about both of these programs, view a recording of M-CEITA's webinar "Participating in MU and the QPP in 2017" listed in the Archived Sessions section of our website: www.mceita.org/Webinars

Tags:  ACI  MU  QPP 

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The 2014 Attestation Deadline Has Been Extended to March 20th, Now What?

Posted By M-CEITA Staff, Thursday, March 5, 2015
Many Eligible Professionals have already attested to Meaningful Use for 2014. If you haven’t, there is still time. However, getting started early is always a good idea since the attestation system can be overwhelmed during heavy usage at deadline time. If you haven’t attested yet to 2014, here are some items to consider:


  • Did you perform a Security Risk Assessment? There is still time to do this up until you attest. SRAs no longer have to be done during the reporting period, but must be completed prior to attestation.
  • Make sure you have completed any necessary steps to meet the public health measures. Many providers feel they are exempt from public health reporting if they don’t see patients under the age of 18. However, there is also the option to send a test message to Michigan’s Syndromic Surveillance System. Only six provider types are exempt from Syndromic testing: Dentists, Dental Surgeons, Podiatrists, Optometrists/Ophthalmologists, Chiropractors, and Certified Nurse-midwives. If you are not one of these provider types, you do not qualify for the Syndromic Surveillance measure exclusion.
  • Be sure to document and save back-up documentation for each measure in case of an audit. About 10 percent of providers in Michigan will receive an audit letter and back-up documentation that supports a valid, successful attestation is essential.


Next Steps for 2015

Going forward with 2015 reporting, M-CEITA recommends staying the course with your original reporting period. CMS announced their intent to engage in rulemaking regarding changes for the EHR Incentive Program in 2015, which could include introducing a quarterly reporting period, from the original 365-day period. The process to make these changes is deliberate and any official changes are likely months away, so the best course of action would be to stay the course and ensure the data is reported properly and measures are being met. Additionally, continue to monitor your public health test messages to the Syndromic Surveillance System (MSSS) and Michigan Care Improvement Registry (MCIR); these messages are a work-in-progress that typically require multiple follow-up submissions until everything is correct.


 If you’re struggling to meet Meaningful Use, contact us for technical assistance.


Tags:  C  EHR Incetive Program  Meaningful Use  Security Risk Analysis 

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Proposed Changes to the Meaningful Use Timeline...Now What?

Posted By Cynthia Swihart and Leslie Kiesel, Monday, June 2, 2014

2014 has had a few twists thrown into the mix when it comes to Meaningful Use attestation and subsequent goals. And we are only in the second quarter.


I’m sure like our staff, many of you are wondering after the latest announcement from CMS and ONC about their proposal for CEHRT flexibility and a Stage 2 extension, what this means in terms of meeting your timeline for the EHR Incentive Program. What course do we take now and how do we stay on track to avoid penalties or to ensure our milestones are being met?

That’s where our team is here to help. We have been reading the proposal and talking to our contacts at ONC and CMS, and here is a breakdown of how to look at this proposal.

First and foremost, this isn’t an official rule change… yet. We believe that this proposed rule will move forward in some form. However, it must go through the proper channels, including a 60-day comment period, before the final ruling. The soonest official announcement would be in August.


Second, these proposed changes apply ONLY in 2014, so it’s imperative to keep working toward a 2014 CEHRT upgrade or attestation will be an issue in 2015. In the proposed rule, 2015 remains a 365-day reporting period requiring 2014 CEHRT beginning January 1, 2015 for Eligible Professionals (EPs).  For Medicaid EPs, a 2014 CEHRT product is required for Adopt, Implement or Upgrade (AIU) attestations.   


Proposed Rule Change by Stage



Essentially, if the 2014 certified version of your EHR is not available in time for a 3-month/90-day attestation period, then under this rule you would be allowed to use 2011 certified technology for 2014 only. However, if your 2014 certified version is available, that is the technology and measures reporting you should be following.


Stage 2 Extension



As documented in the official announcement, the proposed alternatives are for providers that could not fully implement 2014 Edition CEHRT to meet meaningful use for the duration of an EHR reporting period in 2014 due to delays in 2014 Edition CEHRT availability. Providers will have to attest to this fact, if the rule passes and becomes available.


So, how do you move forward from here?  Our recommendation is to stay on the course you intended and are capable of meeting, including your upgrade plans to a 2014 CEHRT if this is available to you, as it will only be easier moving into 2015 for your practice. The proposed rule is not final and won’t be for a few months. Though it appears there will be flexibility (if passed) for those that aren’t able to meet the original timeline allotted because of vendor delays in meeting 2014 CEHRT criteria.


Click here to read the full proposal from CMS and ONC. If you have any questions or need assistance, we are here to help. Contact us.



Tags:  CEHRT  CMS  EHR Incetive Program  Meaningful Use  NPRM 

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Can EHRs Save Lives?

Posted By M-CEITA, Tuesday, October 1, 2013
A report released last week by the Centers for Disease Control and Prevention indicated that at least 200,000, or 1 in 4, deaths from heart disease in the U.S. could be avoided each year with better prevention and treatment. Heart disease is the number one cause of death in the U.S., with 1 in 3 Americans developing the disease in their lifetime and over 2 million Americans suffering from a heart attack or stroke each year.


What is required to improve prevention and treatment of heart disease?


According to Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, the recent wide-spread adoption and use of EHRs and other medical information technology systems creates "the best place to start” in this effort. But what do EHR’s have to do with saving people from heart disease? More than you might think.


Kaiser Permanente Colorado discovered this first hand in a 2-year randomized trial of innovative EHR use. They discovered that LDL-C measures can remain controlled in most patients discharged from a cardiac disease management program by using an EHR to help patients keep in touch with caregivers electronically.


Health information technologies, like electronic health records and health information exchanges, can also help physicians:


  • track clinical quality metrics related to the ABCS outlined by the Million Hearts® campaign (see chart below)
  • engage patients in their care by providing them with the health information and clinical summaries they need, particularly those patients with chronic conditions like cardiovascular disease
  • use clinical decision support tools, patient registries and patient reminders to more aggressively manage the care of high risk patients
  • coordinate care of high risk patients among multiple providers 


Fair warning, however – there is nothing magic about plugging in an EHR. From our experience working with over 2,000 providers to implement electronic health record technology and meet Meaningful Use requirements, we have found that the key to saving lives has more to do with how the technology is used than the technology itself. That’s why M-CEITA assists providers with things like Targeted Process Optimization (TPO), to help redesign practice workflows to effectively leverage technology and other tools that improve patient care. 


Through TPO, we help physicians focus on one or two key opportunities for process improvement leading to improved quality outcomes. Our research has identified several key processes, such as referral tracking or chart prep, that can be aligned with best practices using Lean concepts to reduce risk, improve care coordination and aid in the capture and improvement to specific clinical quality metrics. When EHRs are used to store, track and communicate critical patient health information, that’s where life saving measures can be realized.


Tags:  CEHRT  EHR  Meaningful Use  Million Hearts 

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2014: Time to Plan for Care Coordination through Interoperability

Posted By Laura Rappleye, Interoperability Project Lead, Altarum Institute, Tuesday, August 6, 2013
Are the 2014 certification requirements for electronic health records (EHRs) and the health information exchange (HIE) Meaningful Use measures set forth in the Stage 2 final rules enough to drive the electronic exchange and use of this information at the point of care? 

My answer is no.  It is up to providers and their staff to embrace the technology and modify business processes to enable true interoperability. 


Upgrading to the 2014 Certified EHR Technology (CEHRT) and meeting the Stage 2 measures in a calendar quarter period make it extremely difficult to achieve interoperability for care coordination in 2014.  However, providers should take advantage of the 2014 CEHRT and Meaningful Use HIE measures to move in the direction of interoperability for future care coordination. 


Here are a few recommendations to consider during the 2014 CEHRT upgrade and the Stage 2 Meaningful Use period:


Structured Lab Result Delivery.  It is possible to meet the Stage 2 measure of incorporating 55% of ordered lab tests as structured data by manual entry, option selecting, scanning, or other means.  Structured data does not have to be received via health information exchange.  This approach does not promote interoperability but does promote duplicative data entry.  Providers should seek out laboratories supporting electronic structured lab result delivery and consider manual entry as a last resort.  In Michigan, several of the HIE-qualified organizations within the Michigan Health Information Network (MiHIN) provide lab result delivery.  Providers should check with the qualified organizations to see if the HIE supports integrated lab result delivery with their CEHRT.


Transition of Care.  To meet the summary of care objective third measure, in place of conducting one or more successful electronic exchanges of a summary of care document with a recipient who has a different CEHRT vendor, providers can send one or more successful tests to Centers for Medicare and Medicaid Services (CMS) designated test EHR.  The option of sending one test message to CMS should be a last resort.  This does not measure the sharing and use of the summary of care.  This does not facilitate care coordination.  Providers should test the interoperability of the summary of care with providers in their existing referral network.  I highly recommend this testing is conducted during the 2014 CEHRT implementation.  This activity could be included in the service contract with the vendor to ensure true interoperability exists with an EHR in the provider’s care delivery system.


Public Health Reporting.  Stage 2 eliminates the senseless measure of submitting one test message to the public health agencies and forces the coordination needed for interoperability between providers and public health agencies.  Providers can attest "yes” to meeting the public health measures if they are engaged in testing and validation with each of the public health systems supporting the objectives (immunizations, syndromic, cancer, and specialized registry reporting).  Testing and validation is a crucial step in achieving interoperability.  However, providers could potentially be caught between a rock and a hard place during testing and validation.  CEHRT products are certified to meet the message structure standard required for the measure (HL7 2.5.1, CDA), not certified on the content or the data that populates the message.  Interoperability requires the information received to be usable.  If the content of the message does not meet the requirements of a complete record, the message will not be acceptable to the public health agency and may require adjustments to the CEHRT to ensure the appropriate data is captured and sent to the registry.  The changes to the CERHT may require vendor assistance.  The timing for making the changes becomes dependent on the vendor’s schedule.  Providers should include public health interoperability completion in their vendor service contracts.  True interoperability with the public health agency can reduce duplicate data entry for mandated public health reporting.


In 2014, we may not experience volumes of information exchanged and used at the point of care, but there are steps providers can take now to get the interoperability ball rolling for the future of care coordination.


Contact us for assistance with understanding your entire story.  M-CEITA stands ready to help all providers state-wide achieve meaningful and efficient use of EHR technology in patient care.







Tags:  CEHRT  CMS  EHR  HIE  Meaningful Use 

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