By Jim Tate, EMR Advocate
Meaningful Use Audit Expert
Twitter: @JimTate, eMail: Inquiry@meaningfuluseaudits.com
Changing Requirments: Shifting Gears
In 2015 CMS released a Final Rule that upset the Meaningful Use (MU) apple cart. No longer did we have to remember what were Core vs. Menu measures. Suddenly both Eligible Hospitals (EH) and Eligible Professionals (EP) had a greatly simplified process to follow in terms of MU measures and stages. However, as often the case, simplification can have unintended consequences. This is definitely the case with Patient Engagement measures that could affect both EPs and EHs. What met the requirements in 2015 might not in 2016 or in 2017. An error in understanding of a “easy to meet” patient action MU measure can put the entire year of MU into jeopardy. There are two measures for EPs and one measure for EHs in which patient related actions must be achieved to meet MU requirements. Let’s take a look at what CMS has to say on the topic.
Eligible Professionals:
- Patient Electronic Access: Measure 2: “For an EHR reporting period in 2015 and 2016, at least one patient seen by the EP during the EHR reporting period (or patient-authorized representative) views, downloads or transmits his or her health information to a third party during the EHR reporting period.” Jump forward to 2017 and “more than 5 percent of unique patients seen by the EP during the EHR reporting period (or his or her authorized representatives) view, download or transmit to a third party their health information during the EHR reporting period.” So that’s pretty clear, one patient in 2015 and 2016 but in 2017 that threshold becomes “more than 5 percent”.
- Secure Electronic Messaging: “For an EHR reporting period in 2015, the capability for patients to send and receive a secure electronic message with the EP was fully enabled during the EHR reporting period. For an EHR reporting period in 2016, for at least 1 patient seen by the EP during the EHR reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the EHR reporting period. For an EHR reporting period in 2017, for more than 5 percent of unique patients seen by the EP during the EHR reporting period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient authorized representative) during the EHR reporting period.” On this objective the threshold moves from “fully enabled” (2015) to “1 patient” (2016) to “more than 5 percent” (2017).
Eligible Hospitals:
- Patient Electronic Access: Measure 2: “For an EHR reporting period in 2015 and 2016, at least 1 patient who is discharged from the inpatient or emergency department (POS 21 or 23) of an eligible hospital or CAH (or patient-authorized representative) views, downloads or transmits to a third party his or her health information during the EHR reporting period.” “For 2017: More than 5 percent of unique patients discharged from the inpatient or emergency department (POS 21 or 23) of an eligible hospital or CAH (or patient-authorized representative) view, download, or transmit to a third party their health information during the EHR reporting period.” Just like EPs the requirement is one patient in 2015 and 2016 but in 2017 that threshold becomes “more than 5 percent”.
Relevant CMS Resources
EHR Incentive Programs: 2015 through 2017 (Modified Stage 2) Overview
2016 EP Objectives and Measures
2016 EH Objectives and Measures
Jim Tate is known as the most experienced authority on the CMS Meaningful Use (MU) audit and appeal process. His unique combination of skills has brought successful outcomes to hospitals at risk of having their CMS EHR incentives recouped. He led the first appeal challenge in the nation for a client hospital that had received a negative audit determination. That appeal was decided in favor of the hospital. He has also been successful in leading the effort to reverse a failed appeal, even after the hospital had received notification of the failure with the statement, “This decision is final and not subject to further appeal”. That “final” decision was reversed in less than a week. If you are a hospital with questions or concerns about the meaningful use audit process, contact him at: Inquiry@meaningfuluseaudits.com.