BIDMC's Meaningful Use Email

As hospitals and eligible professionals prepare for their meaningful use reporting period (registration begins today), they will want to communicate the details of the program to stakeholders.   Here's the email we're sending out today.  Feel free to use any part of it for your organization.

"As part of the Stimulus Package, the federal government has allocated $19 billion to encourage the health care industry to adopt Electronic Health Records. Demonstrating "meaningful use" of our electronic systems will mean several million dollars in additional reimbursement from CMS for the medical center, and additional funds for physicians. To be eligible for these additional payments, we must do 3 things:
1. Be an eligible professional or hospital
2. Implement a certified Electronic Health Record (EHR)
3. Use the certified EHR in a meaningful way

Who qualifies as an eligible professional?
Eligible professionals include doctors of medicine, osteopathy, dental surgery, dental medicine, podiatry, optometry, and chiropractors. Professionals who perform 90% or more of their services in the inpatient or emergency setting are considered “hospital-based” and are not eligible.

Are we using a certified Electronic Health Record?
Collectively, all of the clinical systems we use here at BIDMC make up our Electronic Health Record. The hospital is in the process of having our collective systems certified by the Certification Commission for Health Information Technology (CCHIT) via their EACH program for hospitals. We expect to be one of the first hospitals in the country to do so.

What does it mean to use our systems in a Meaningful Way?
Simply put, 'meaningful use' means hospitals and professionals need to show they are using a certified EHR in ways that can be measured significantly in quality and quantity.
Hospitals have 14 required ('core') criteria and eligible professionals (clinicians) have 15 required criteria. There is 100% overlap, with the only difference that the hospital is not measured on e-prescribing because that is seen as an ambulatory clinician activity.
There are 10 optional ('menu') criteria of which hospitals and eligible professionals must choose 5. There is 100% overlap except that reporting lab results to public health and advanced directive management is hospital only.

A grid of the criteria is available here. We have completed an assessment of the criteria and how well BIDMC is doing in meeting the required metrics. Good news! As of January 1, 2011 BIDMC has the necessary system functions to meet meaningful use criteria and with few exceptions we, collectively (hospital and eligible professionals), are doing well in meeting the required metrics.

When does this program begin?
The earliest possible 'reporting period' for demonstration of meaningful use is January 3-March 31, 2011. Measurement of performance on the 15 required and the chosen 5 optional criteria is done during this time. CMS will make a website available to register hospitals and eligible professionals for participation in the meaningful use program. The process for registering is being launched by CMS today, and BIDMC/BIDPO will act swiftly to ensure all eligible providers are enrolled. In April, the hospital and eligible clinicians 'attest' that they have achieved meaningful use, with additional reimbursements starting in May.

What do I need to do on January 3, 2011?
For Core Requirements:
As mentioned above, we are collectively doing well in meeting most criteria as the information collected is required for a patient to receive care here at BIDMC or part of our standard workflow. Here is where we need your help in collecting and documenting additional information within webOMR/other points of entry systems:
Problem Lists: Requirement: 80% of all unique patients must have at least one entry or an indication that the patient has no known problems documented as part of the problem list in webOMR.
Medication Allergy List: 80% of all unique patients must have at least one entry or an indication that the patient has no known allergies/ADRs documented in the Allergy module in webOMR
Smoking Status: 50% of patients age 13 or older must have smoking status recorded in webOMR (within Sheets).
Clinical Summaries: Clinical summaries must be provided to patients for 50% of all outpatient office visits within 3 business days. This is not currently standard practice throughout our outpatient practices. With the help of the webOMR User Group, a standard clinical summary will be available for printing from webOMR and other CCC applications. Your administrative staff will be briefed on this within the next few days and are ready to help implement this within the outpatient practices.
Within the next few days you will receive additional information from OMR Support describing how you can use the system to meet the criteria. In the meantime if you have questions or concerns about webOMR functions, please contact: omrsupport@bidmc.harvard.edu.

Ideally, we believe that the documentation requirements needed to meet meaningful use are in the best interest of providing safe patient care and allowing clinicians to communicate with each other and patients effectively and efficiently. Therefore, we support the continued use of webOMR and other BIDMC systems for Problems, Medications, Allergies, Smoking Status, etc. So although the reporting period ends in March/April of 2011, we request your ongoing use of our systems for this documentation.

How do funds flow?
Assuming we begin our measurement period on January 3rd and we complete attestation in April: Beginning in May, increased Medicare payments to the hospital and to the clinicians begin to flow. For the hospital, the value of these increased payments will be approximately $2 million per year. For clinicians, the value is:
2011 $18,000
2012 $12,000
2013 $8000
2014 $4000
2015 $2000

Thus, the flow of funds will follow whatever path Medicare payments to the hospital and clinicians have in place today.

Note that Meaningful Use Stage 1 is 2011-2012, Stage 2 is 2013-2014 and Stage 3 is 2015. This means that the criteria for meaningful use will get more challenging to meet over time and that the hospital and eligible professionals will need to repeat the "reporting period" and attestation in 2013 and 2015."