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Public Health Measures: Meet, Exclude, or Defer? – Meaningful Use Monday

Posted on August 1, 2011 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

Last week’s Meaningful Use Monday identified the two meaningful use public health measures—electronic reporting of immunizations and electronic reporting of syndromic surveillance data—at least one of which EPs must include among their 5 menu measures. So, what do you do if you can’t meet one or both of the public health measures? 

The requirement: EPs must accomplish at least one of these measures or they must exclude both. Another way to look at this is: If an EP attests to an exclusion for one of the measures, then the EP must attest to either accomplishing or excluding the other. What the EP cannot do is exclude one and then skip (“defer”) the other. (Examples of acceptable and unacceptable scenarios are described below.) 

There is a difference between “excluding” a measure and “deferring” a measure:

  • To exclude a measure, the EP must meet the criteria for exclusion as spelled out in the definition of the measure. Example: an EP does not collect any reportable (i.e., syndromic surveillance) information, or there is no agency that can accept this information electronically. Excluding a measure counts as meeting the measure.
  • Defer is the CMS term for electing to skip this measure, i.e., not count it as one of the EP’s 5 menu measures. (The term “defer” implies that the EP is postponing compliance to Stage 2.)

 Acceptable scenarios:

  • Accomplish both public health measures.  This satisfies 2 of the 5 menu measures required for meaningful use.
  • Accomplish one of the public health measures and defer (skip) the other measure. This satisfies 1 of the 5 menu measures.
  • Accomplish one of the public health measures and exclude the other (assuming the EP meets the criteria for exclusion). This satisfies 2 of the 5 menu measures.  Note: Although CMS prefers that EPs not use up measures with exclusions if there are measures for which they have actual data or experience to report, the rules do not require EPs to do so.
  • Exclude both public health measures (assuming the EP meets the criteria).

 Unacceptable scenario:

  • Exclude one public health measure and defer the other. For example, an EP’s local public health agencies cannot accept syndromic surveillance information, but there are local registries that can accept immunization information. If this EP excludes syndromic surveillance, he/she would have to also report on immunizations—either by meeting the measure or by attesting to an exclusion.

SuiteMED IMS Demo Series: Billing

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SuiteMed IMS Billing Overview, this SuiteMed IMS overview will give the user a good idea of how the billing functionality works in SuiteMed IMS.



Watch the video here.

Mycrisisrecords: Providing Critical Information During an Emergency

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There are few things in life more difficult than going through a medical emergency.  In many emergencies there is next to nothing that you can do to help those giving you medical care because you are generally incapacitated.  Unfortunately, there is a lot of information that they need to have to give you the best care possible.

There is now a way to get that information to the people who could save your life without you being able to communicate with them.  Mycrisisrecords (MCR) has developed a system for getting all of your important medical information to doctors at the hospital, or even paramedics on the scene.

They offer a few different options when it comes to sharing your information with medical personnel: My Crisis Card and the My Crisis Capsule.

The My Crisis Card is just what it sounds like: a card that you can carry in your wallet.  The card provides basic information such as your name, an emergency contact name and number, and the name and phone number of your physician.  It also provides a My Crisis Record ID number that can be used to access your personal health record.  There are also instructions for the first responder to gain access to your record through the mycrisisrecords website, or to call and get help from an operator. 

The MCR release of the My Crisis Card is the first mobile healthcare technology solution to have fully integrated QR technology.  Using the QR code a first responder could simply scan the code on their smartphone to retrieve your vital medical information and forward it to the emergency room before you even get there.  When every second counts in saving your life, this could be the difference.

The second offering is the My Crisis Capsule.  This brilliant little device is essentially just a thumbdrive that millions of people around the world carry to school and work everyday.  The difference with this little thumbdrive is that it contains access to your personal health record, and could possibly save your life.  All a healthcare professional has to do is plug it into a computer and they have access to your vital medical information.  Again, saving minutes, or even seconds that could be the difference in saving your life.

In conjunction with these tools, there is also a mobile web app that allows you to more easily keep your personal health record up to date.  This would be even more useful for people who have serious, or chronic health problems where there are regular doctors visits and your health information could be changing regularly.  It is also essential with these major illnesses for healthcare professionals to have access to that information to give you proper treatment.

One drawback that I do see is the cost.  It ranges from $25 to $65 a year per person.  While that may not seem like a lot, and in terms of saving your life it really isn’t, it may not be something that everyone can afford.  I for one think long and hard about anything that I will have to continue to pay for year after year.  While I don’t think this will be a major hurdle to jump I do think it will prevent some people from considering it.

The major news for this company is the release of MCR Africa.  Anyone who follows this blog, and many other healthcare blogs, has seen the reoccurring trend of healthcare technology in Africa.  There are so many reasons why Africa is perfect for these technologies, and they may very well prove to be the breeding grounds for success for many of these companies.

Another feature that may prove even more valuable in Africa is the usefulness of this technology in the midst of an emergency.  Not only can you receive better medical care, but it will be easier for healthcare providers to contact your friends and family so they can learn about your situation.

There are so many new devices out there that it can be hard to know which ones are worth anything.  While the technology involved may not seem groundbreaking compared to some of the amazing stuff out there, It is not always something groundbreaking that may save your life.  It may be something as simple as a card in your wallet, or a thumbdrive on your keychain.

For more information about mycrisisrecords please visit their website at