Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

Why Clinicians Need a 2015 Certified EHR

Posted on January 11, 2018 I Written By

The following is a guest blog post by Lisa Eramo, a regular contributor to Kareo’s Go Practice Blog.

What does “2015 Certified EHR” mean to practicing clinicians? The once-flooded EHR market is now whittling down to those vendors equipped to respond to regulatory and industry changes. The Office of the National Coordinator (ONC) for Health Information Technology listed more than 4,000 EHRs with 2014 certification criteria, according to the most recent data from healthIT.gov. And to date, only about 200 EHRs have passed the rigorous 2015 certification criteria.

However, beyond the fact that 2015 is indeed the most recent certification criteria as issued by the HHS, why should medical practices care?  

When vendors certify their EHRs, physicians—and patients—are ultimately the beneficiaries, says Beth Onofri, EHR and industry advisor at Kareo, who led the 2015 Certification process for the Kareo Clinical EHR. Physicians benefit because the technology allows them to easily attest that they’ve met quality requirements specified in the Medicare Access and CHIP Reauthorization Act (MACRA). This includes Advancing Care Information (ACI)-related measures that help physicians boost their payments. ACI accounts for 25 percent of a physician’s performance score that dictates reimbursement under the Merit-based Incentive Payment System (MIPS). Patients benefit because they’re able to access and exchange their own health information more easily than ever before. It’s a win-win all around, says Onofri.

“The 2015 criteria require functionality supporting unprecedented patient engagement, care coordination, and information exchange, all of which bodes well for physicians striving to improve outcomes.”
—Beth Onofri, EHR and Industry Advisor at Kareo

Although using a certified EHR is important, implementing one that’s certified using only the 2015 criteria (not the 2014 criteria or a combination of the two) is a critical piece of the puzzle under MACRA, says Onofri. EHRs certified with the 2015 criteria help pave the way for physicians to receive a bonus in 2018. In addition, the 2015 criteria require functionality that supports unprecedented patient engagement, care coordination, and information exchange, all of which bodes well for physicians striving to improve outcomes.

Still, many physicians aren’t aware of how the 2015 certification criteria can help their practices, says Onofri.

Of the 60 different 2015 certification criteria, Onofri says these five are particularly helpful for practices seeking to improve the quality of the care they provide, ultimately fostering accurate payments under value-based payment reform:

1. View, download, and transmit health information to a third party

The 2015 criteria require a secure method of access (usually through a patient portal) as well as the ability to send information to an unsecured email address of the patient’s choice, says Onofri. The idea is that offering various access options improves overall patient engagement and outcomes.

She suggests creating a brochure that explains to patients how they can access and use the portal, including how to view, download, and transmit their health information. Another idea is to recruit a volunteer who can show patients how to use the portal while they wait in the waiting area. “There needs to be a strong advocate in each practice to make sure that these functionalities are implemented and used,” she adds. “Those practices with an advocate are the ones that will succeed.”

2. Secure messaging

This functionality allows physicians to send messages to—and receive messages from—patients in a secure manner, helping to improve engagement and communication. Practices must define how they’ll use secure messaging, including who will respond and what types of questions they’ll permit (e.g., fulfill appointment requests vs. answering clinical inquiries). “There are a small percentage of doctors who will want to answer their own messages, but there is a larger percentage of doctors who will want their staff to answer the emails and, if necessary, escalate to the provider,” says Onofri.

3. Patient health information capture

This functionality allows physicians to accept patient-generated health data into the EHR. For example, Onofri notes that the Kareo Clinical 2015 Edition EHR allows patients to record their health information at home to easily upload the information to their portal and transmit it securely to the physician for shared decision-making. The idea is that access to more comprehensive health data can help physicians prevent and manage disease—and it could be a game-changer in terms of population health management.

Start small when rolling out this functionality, she says. For instance, encourage patients with high blood pressure to upload their blood readings daily before engaging a second population (e.g., those with diabetes who upload their glucose levels).

4. Transitions of care

This functionality calls for interoperable documents that include key health data (e.g., name, date of birth, and medications) as well as standardized format for exchange. A transition of care summary provides critical information as patients transfer between different physicians at different health organizations or even distinct levels of care within the same organization.

“It’s not uncommon for our providers to send the referral right as they are completing the note with the patient in the room,” says Onofri. “This obviously speeds the care coordination for patients in terms of seeing another doctor.” The only caveat is that practices must compile a list of direct email addresses for physicians to whom patients are frequently referred, she adds.

5. Application programming interfaces (APIs)

“This is one of those requirements that is the foundation of things to come,” says Onofri. “It’s the first step toward interoperability.” API functionality will eventually allow patients to aggregate data from multiple sources in a web or mobile application of their choice.

Physicians who take the time to explore each of these 2015 certification functionalities may be more likely to improve outcomes and reap financial rewards under MACRA, says Onofri. “The improved functionality is there—is your practice taking advantage of it?”

About Lisa Eramo
Lisa Eramo is a regular contributor to Kareo’s Go Practice Blog, as well as other healthcare publications, websites and blogs, including the AHIMA Journal. Her focus areas are medical coding, clinical documentation improvement and healthcare quality/efficiency.  Kareo is a proud sponsor of Healthcare Scene.

Where Are We At With Meaningful Use?

Posted on December 11, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest post by Barry Haitoff, CEO of Medical Management Corporation of America.
Barry Haitoff
It seems like meaningful use is in a constant state of flux with moving deadlines and multiple stages that apply to each organization differently. With meaningful use stage 2 just around the corner for many providers it is worth taking a quick look at where we are on the journey to meaningful use.

Meaningful Use Timelines
The most important thing many organizations need to remember is the various timelines for each meaningful use stage. This can be pretty complex because it changes based on when you first attest to meaningful use. Plus, last Friday CMS announced an extension to meaningful use stage 2 and a delay of meaningful use stage 3 for one year.

Before this recent change, CMS put out the following chart which clearly illustrates how much EHR incentive money a provider will get for showing meaningful use of a certified EHR. Plus, it shows which meaningful use stages you will have to comply with based on the year you started attesting to meaningful use. After the aforementioned announcement, the only change to this chart would be that both meaningful use stage 3’s would become meaningful use stage 2.

Meaningful Use Medicare Incentive Timelines and Stages

The above chart is just for EHR incentive money under Medicare. The chart for Medicaid is much simpler and hasn’t changed much since the EHR incentives were first announced.

Meaningful Use Medicaid Incentive Timelines and Stages

EHR Penalties
While the incentive money for EHR is important for many, it seems like doctors are motivated as much or more by the Medicare adjustments that will be enforced if they aren’t meaningful users of a certified EHR system. Here’s the timeline for the EHR payment adjustments:

Meaningful Use Penalty Schedule

There are a number of hardship exemptions that a provider can claim to avoid the penalties. If you plan to pursue one of these hardship exemptions, you have to apply for one by July 1, 2014. CMS has put out a nice tipsheet covering payment adjustments and hardship exemptions. As you can see, the exemptions are pretty narrow. Although, maybe they’ll create more exemptions over time like they did with the eRX penalties.

Other Notable Meaningful Use Updates
Regardless of what stage of meaningful use you are at or any prior years reporting, all eligible professionals will only have to attest to 90 days of meaningful use in 2014. This change was made to give organizations plenty of time to upgrade to the 2014 certified EHR technology. However, many EHR vendors have taken this extra time into account and are still not 2014 certified because they know eligible providers only have to attest to 90 days in 2014. Anyone attesting to meaningful use regardless of meaningful use stage will have to be on a 2014 certified EHR. The 2011 EHR certification will be expired and not accepted.

It is also worth noting that those who have not begun participation in the Medicare EHR incentive program will need to attest to meaningful use in 2014 if they want to be eligible for any EHR incentive money.

Meaningful Use Audits
If you’ve already attested to meaningful use stage 1, then you better make sure your documentation is in order. Meaningful Use audits have already begun and a number of organizations are getting caught without the proper documentation. This is worth also noting for those planning to attest to meaningful use for the first time. Make sure that you keep all your meaningful use attestation documentation in case you’re ever audited.

The most common audit issue organizations have is with core measure 15 which requires an organization to conduct a security risk analysis. Many organizations checked off this box without actually doing a security risk analysis. That’s a very risky proposition. This is one meaningful use requirement where you can’t rely on your EHR vendor to do it for you. This is not a hard task and many organizations will be happy to come and do one for you. Just make sure you’ve actually done it before you attest.

Medical Management Corporation of America, a leading provider of medical billing services, is a proud sponsor of EMR and HIPAA.