Dr. Christopher Notte

In last month’s column, we began our discussion of Stage 2 of meaningful use. As a reminder, we noted that clinicians must meet or exceed the thresholds for the 17 core objectives and three of six menu objectives, as well as report on defined Clinical Quality Measures. We reviewed in detail the rationale for the program, as well as details of the core and menu measures.

For Stage 2 of meaningful use, the menu items and quality measures are aimed at enhancing actionable decision support to improve the quality of medical care and enable population management for patients who come into our office (and even for those who don’t). Stage 2 is also meant to facilitate physician-patient communication.

As a point of reminder and clarification, on August 29th the U.S. Department of Health and Human Services published a final rule allowing certain eligible providers the flexibility to continue using the Stage 1 criteria for the 2014 attestation year, even if they were due to start Stage 2. Unfortunately, this only applies to those who have been unable to obtain the 2014-certified software in time because of vendor delays. The reprieve does not extend to those who can’t meet Stage 2 due to measure difficulty or procrastination in purchasing software or adopting new work flow. As always, we recommend speaking with a meaningful use expert or consultant before attempting to take advantage of this flexibility. Either way, you’ll need to proceed with the 2014 Clinical Quality Measures, as these new definitions are now required by both the Stage 1 and Stage 2 goals. In this month’s EHR Report, we will highlight the most noteworthy 2014 Clinical Quality Measures.

Clinical Quality Measures are meant to measure and track the quality of health care services that are provided by the practitioner. Clinical Quality Measures are constructed to measure these aspects of care:

• Health outcomes

• Cinical processes

• Patient safety 

• Efficient use of health care resources 

• Care coordination

• Patient engagements

• Population and public health

• Adherence to clinical guidelines

Beginning in 2014, practitioners must select and report on 9 out of a list of 64 approved Clinical Quality Measures for the EHR Incentive Programs.

Clinical Quality Measures may be reported electronically through the EHR if this function is available through your EHR software. It can also be done through CMS’s Physician Quality Reporting System Portal. In order for a practice to report through the portal, the practice needs to sign up through CMS, which can be done through the CMS website. In addition, reporting can be done through a number of group reporting options if a practice is part of a large group of practices or an ACO, or via attestation as before. While the details go of how to report go beyond what we can cover in this column, your IT support person or consultant should be well acquainted with the process.

The Clinical Quality Measures are divided into six different domains of care, and providers must report on Clinical Quality Measures from at least three different domains (Table 1).

CMS encourages reporting on nine recommended core sets of Clinical Quality Measures, as long as those measures are relevant to a practitioner’s patient population. The recommended core measures focus on aspects of medical care that are felt to have the most significant effect on morbidity and mortality of Medicare and Medicaid beneficiaries.

They also focus on aspects of medical care that are consistent with national public health priorities or that particularly increase healthcare costs. The nine measures recommended by CMS for adult and pediatric populations are listed in Tables 2 and 3.

Between Core Objectives, Menu Objectives, and CQMs, the requirements for Stage 2 meaningful use have gotten more complicated and perhaps more confusing to track and implement than before. We recommend that every practice has an identified individual who will become a resource to help others both understand and implement Stage 2 meaningful use. We anticipate a range of opinion about the challenges of Stage 2 and are interested in your thoughts. Please email us, and we will try to publish some of the comments in upcoming columns.

References:

1. An Introduction to EHR Incentive Programs 2014 Clincial Quality Measure (CQM) Electronic Reporting Guide for Eligible Professionals.

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CQM2014_GuideEP.pdf.

2. Eligible Professionals Guide to Stage 2 of the EHR Incentive Programs http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_Guide_EPs_9_23_13.pdf.

3. For a comprehensive list of the CQMs, see the 2014 CQMs for eligible professionals PDF (available at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_MeasuresTable_Posting_CQMs.pdf).

Dr. Notte is a family physician and clinical informaticist for Abington (Pa.) Memorial Hospital. He is a partner in EHR Practice Consultants, a firm that aids physicians in adopting electronic health records. Dr. Skolnik is associate director of the family medicine residency program at Abington Memorial Hospital and professor of family and community medicine at Temple University in Philadelphia.

In last month’s column, we began our discussion of Stage 2 of meaningful use. As a reminder, we noted that clinicians must meet or exceed the thresholds for the 17 core objectives and three of six menu objectives, as well as report on defined Clinical Quality Measures. We reviewed in detail the rationale for the program, as well as details of the core and menu measures.

For Stage 2 of meaningful use, the menu items and quality measures are aimed at enhancing actionable decision support to improve the quality of medical care and enable population management for patients who come into our office (and even for those who don’t). Stage 2 is also meant to facilitate physician-patient communication.

As a point of reminder and clarification, on August 29th the U.S. Department of Health and Human Services published a final rule allowing certain eligible providers the flexibility to continue using the Stage 1 criteria for the 2014 attestation year, even if they were due to start Stage 2. Unfortunately, this only applies to those who have been unable to obtain the 2014-certified software in time because of vendor delays. The reprieve does not extend to those who can’t meet Stage 2 due to measure difficulty or procrastination in purchasing software or adopting new work flow. As always, we recommend speaking with a meaningful use expert or consultant before attempting to take advantage of this flexibility. Either way, you’ll need to proceed with the 2014 Clinical Quality Measures, as these new definitions are now required by both the Stage 1 and Stage 2 goals. In this month’s EHR Report, we will highlight the most noteworthy 2014 Clinical Quality Measures.

Clinical Quality Measures are meant to measure and track the quality of health care services that are provided by the practitioner. Clinical Quality Measures are constructed to measure these aspects of care:

• Health outcomes

• Cinical processes

• Patient safety 

• Efficient use of health care resources 

• Care coordination

• Patient engagements

• Population and public health

• Adherence to clinical guidelines

Beginning in 2014, practitioners must select and report on 9 out of a list of 64 approved Clinical Quality Measures for the EHR Incentive Programs.

Clinical Quality Measures may be reported electronically through the EHR if this function is available through your EHR software. It can also be done through CMS’s Physician Quality Reporting System Portal. In order for a practice to report through the portal, the practice needs to sign up through CMS, which can be done through the CMS website. In addition, reporting can be done through a number of group reporting options if a practice is part of a large group of practices or an ACO, or via attestation as before. While the details go of how to report go beyond what we can cover in this column, your IT support person or consultant should be well acquainted with the process.

The Clinical Quality Measures are divided into six different domains of care, and providers must report on Clinical Quality Measures from at least three different domains (Table 1).

CMS encourages reporting on nine recommended core sets of Clinical Quality Measures, as long as those measures are relevant to a practitioner’s patient population. The recommended core measures focus on aspects of medical care that are felt to have the most significant effect on morbidity and mortality of Medicare and Medicaid beneficiaries.

They also focus on aspects of medical care that are consistent with national public health priorities or that particularly increase healthcare costs. The nine measures recommended by CMS for adult and pediatric populations are listed in Tables 2 and 3.

Between Core Objectives, Menu Objectives, and CQMs, the requirements for Stage 2 meaningful use have gotten more complicated and perhaps more confusing to track and implement than before. We recommend that every practice has an identified individual who will become a resource to help others both understand and implement Stage 2 meaningful use. We anticipate a range of opinion about the challenges of Stage 2 and are interested in your thoughts. Please email us, and we will try to publish some of the comments in upcoming columns.

References:

1. An Introduction to EHR Incentive Programs 2014 Clincial Quality Measure (CQM) Electronic Reporting Guide for Eligible Professionals.

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CQM2014_GuideEP.pdf.

2. Eligible Professionals Guide to Stage 2 of the EHR Incentive Programs http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_Guide_EPs_9_23_13.pdf.

3. For a comprehensive list of the CQMs, see the 2014 CQMs for eligible professionals PDF (available at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_MeasuresTable_Posting_CQMs.pdf).

Dr. Notte is a family physician and clinical informaticist for Abington (Pa.) Memorial Hospital. He is a partner in EHR Practice Consultants, a firm that aids physicians in adopting electronic health records. Dr. Skolnik is associate director of the family medicine residency program at Abington Memorial Hospital and professor of family and community medicine at Temple University in Philadelphia.

In last month’s column, we began our discussion of Stage 2 of meaningful use. As a reminder, we noted that clinicians must meet or exceed the thresholds for the 17 core objectives and three of six menu objectives, as well as report on defined Clinical Quality Measures. We reviewed in detail the rationale for the program, as well as details of the core and menu measures.

For Stage 2 of meaningful use, the menu items and quality measures are aimed at enhancing actionable decision support to improve the quality of medical care and enable population management for patients who come into our office (and even for those who don’t). Stage 2 is also meant to facilitate physician-patient communication.

As a point of reminder and clarification, on August 29th the U.S. Department of Health and Human Services published a final rule allowing certain eligible providers the flexibility to continue using the Stage 1 criteria for the 2014 attestation year, even if they were due to start Stage 2. Unfortunately, this only applies to those who have been unable to obtain the 2014-certified software in time because of vendor delays. The reprieve does not extend to those who can’t meet Stage 2 due to measure difficulty or procrastination in purchasing software or adopting new work flow. As always, we recommend speaking with a meaningful use expert or consultant before attempting to take advantage of this flexibility. Either way, you’ll need to proceed with the 2014 Clinical Quality Measures, as these new definitions are now required by both the Stage 1 and Stage 2 goals. In this month’s EHR Report, we will highlight the most noteworthy 2014 Clinical Quality Measures.

Clinical Quality Measures are meant to measure and track the quality of health care services that are provided by the practitioner. Clinical Quality Measures are constructed to measure these aspects of care:

• Health outcomes

• Cinical processes

• Patient safety 

• Efficient use of health care resources 

• Care coordination

• Patient engagements

• Population and public health

• Adherence to clinical guidelines

Beginning in 2014, practitioners must select and report on 9 out of a list of 64 approved Clinical Quality Measures for the EHR Incentive Programs.

Clinical Quality Measures may be reported electronically through the EHR if this function is available through your EHR software. It can also be done through CMS’s Physician Quality Reporting System Portal. In order for a practice to report through the portal, the practice needs to sign up through CMS, which can be done through the CMS website. In addition, reporting can be done through a number of group reporting options if a practice is part of a large group of practices or an ACO, or via attestation as before. While the details go of how to report go beyond what we can cover in this column, your IT support person or consultant should be well acquainted with the process.

The Clinical Quality Measures are divided into six different domains of care, and providers must report on Clinical Quality Measures from at least three different domains (Table 1).

CMS encourages reporting on nine recommended core sets of Clinical Quality Measures, as long as those measures are relevant to a practitioner’s patient population. The recommended core measures focus on aspects of medical care that are felt to have the most significant effect on morbidity and mortality of Medicare and Medicaid beneficiaries.

They also focus on aspects of medical care that are consistent with national public health priorities or that particularly increase healthcare costs. The nine measures recommended by CMS for adult and pediatric populations are listed in Tables 2 and 3.

Between Core Objectives, Menu Objectives, and CQMs, the requirements for Stage 2 meaningful use have gotten more complicated and perhaps more confusing to track and implement than before. We recommend that every practice has an identified individual who will become a resource to help others both understand and implement Stage 2 meaningful use. We anticipate a range of opinion about the challenges of Stage 2 and are interested in your thoughts. Please email us, and we will try to publish some of the comments in upcoming columns.

References:

1. An Introduction to EHR Incentive Programs 2014 Clincial Quality Measure (CQM) Electronic Reporting Guide for Eligible Professionals.

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/CQM2014_GuideEP.pdf.

2. Eligible Professionals Guide to Stage 2 of the EHR Incentive Programs http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_Guide_EPs_9_23_13.pdf.

3. For a comprehensive list of the CQMs, see the 2014 CQMs for eligible professionals PDF (available at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_MeasuresTable_Posting_CQMs.pdf).

Dr. Notte is a family physician and clinical informaticist for Abington (Pa.) Memorial Hospital. He is a partner in EHR Practice Consultants, a firm that aids physicians in adopting electronic health records. Dr. Skolnik is associate director of the family medicine residency program at Abington Memorial Hospital and professor of family and community medicine at Temple University in Philadelphia.