How MU Will Impact Your Practice
March 2011
Analysis of meaningful use—how will it impact your practice?
To receive the $44,000 (Medicare) or $64,000 (Medicaid) incentive payments, you must make “Meaningful Use” of your Certified EHR software. Every physician must ask: How will this affect my practice? There are 15 core objectives and 10 more electives.
How big a burden will this be? And on whose shoulders will the burden fall?
To answer these questions we have analyzed each of the Meaningful Use objectives. We think that the fears of adverse impact are exaggerated. In fact, depending on how you use your system, the physician may experience no impact at all—though there will be some new tasks for the staff.
As you read these analyses, ask yourself, “How will this objective be met in my practice”? If there are points you’d like to discuss more deeply, please call us at VersaForm. Our objective is to help you collect the incentive payments with the least effort.
MU Core Objectives (must do all)
- CPOE for medication orders.
- Implement drug-drug and drug-allergy interaction checks.
- Maintain an up-to-date problem list of current and active diagnoses.
- Generate and transmit permissible prescriptions electronically (eRx).
- Maintain an active medication list for each patient.
- Maintain active medication-allergy list.
- Record demographics.
- Record Vital Signs.
- Record smoking status for patients 13 years old and older.
- Report ambulatory clinical quality measures.
- Implement one clinical decision support rule relevant to specialty or high clinical priority and track compliance.
- Provide patients with an electronic copy of their health information, upon request.
- Provide clinical summaries for patients for each office visit.
- Capability to exchange key clinical information electronically.
- Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
Objective: This simply means that you enter orders for meds (i.e., prescriptions) into the EHR. It will happen automatically when you use electronic prescriptions (eRx)—we will come back to eRx, below.
Who does the work: Can be done by physician or staff.
Impact: on physician: significant. On staff: moderate.
Objective: This happens automatically when you use eRx.
Who does the work: Can be done by physician or staff.
Impact: No adverse impact—it makes the task easier.
Objective: Patients seen by the EP have at least one entry or an indication that no problems are known. It’s easy to enter patient problems into the EHR—but it is something that needs to be done.
Who does the work: Can be done by physician as part of charting, or by staff – can even be entered by clerical staff as byproduct of the billing process.
Impact: Minor. Really this is just a change in format from what is being done already.
Objective: It is slower to write most prescriptions electronically than to write on a pad, there’s no getting around it. Scheduled drugs are not electronic yet, while this is true they are exempt.
Who does the work: The entry may be done by the physician or by staff (except NY state) .
Impact: Slower, but it has benefits—drug-drug interaction, allergy, and formulary checking.
Objective: Automatic byproduct of eRx, except that discontinuances must be noted, too.
Who does the work: No additional work—this is a byproduct of electronic Prescriptions (eRx) and CPOE.
Impact: None
Objective: Patients seen by the provider have at least one entry (or an indication that the patient has no known medication allergies
Who does the work: May be done by physician or staff, following entry on a superbill.
Impact: Moderate. Like keeping a problem list, this is a simple data entry.
Objective: As each patient is seen the record must be updated according to government guidelines. Record all of the following demographics: Preferred language, Gender, Race, Ethnicity, Date of birth.
Who does the work: Staff
Impact: Of course, everybody already records demographics, but there are a couple of new fields. Looking forward, there is not much new here.
Objective: Record and chart changes in vital signs: Height, Weight, Blood pressure, Calculate and display BMI, Plot and display growth charts for children 2-20 years, including BMI.
Who does the work: Very likely already done by staff.
Impact: Enter into the EHR instead of the paper chart. No new effort. The ability to print growth charts is a plus.
Objective: This information can be collected along with Vitals, or with the Demographics (above).
Who does the work: Staff
Impact: Minor
Objective: VersaForm computes these for you based on your recorded patient data; there is no extra effort to collect or compute the data.
Who does the work: You or staff reports them when applying for the incentive payment.
Impact: Modest.
Objective: This is an automatic VersaForm function. You can specify what you want to be reminded of, and VersaForm will remind you automatically.
Who does the work: There is some learning required to set up new rules. In most practices this will be the physician’s task.
VersaForm provides preset rules that can be used.
Impact: Low.
Objective: This can be accomplished by either recording on a CD or flash drive, or sending a secure email.
Who does the work: Staff.
Impact: Low, depending on recording medium. Secure messaging is the easiest-- just a few clicks.
Objective: Summaries that include, at a minimum, diagnostic test results, problem list, medication list, medication allergy list, immunizations and procedures.
Who does the work: Staff would print or send summaries. The system can print a summary at checkout time.
Impact: Small, if done when patient leaves.
Objective: VersaForm produces these electronic documents, and can send them securely to other providers or facilities.
Electronic documents can be received from other providers and displayed, then saved.
Who does the work: Staff or physician.
Impact: Little to none. This makes it easy to send basic data to other providers.
Objective: The practice must conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308(a)(1). This is the HIPAA Security Risk Analysis, and requires the practice to assess the security risks to data it holds.
Who does the work: Must be performed by or on behalf of the practice.
Impact: Significant, as the review or analysis must be attested to. However, it is an annual or one-time event, not a regular workload.
Menu Set Objectives (4 of first 8, 1 of last 2)
- Drug-formulary checks. This happens as a byproduct of eRx. No impact.
- Incorporate clinical lab test results as structured data.
- Generate lists of patients by specific conditions.
- Send reminders to patients for preventative/follow-up care.
- Provide patients with timely electronic access to their health information.
- Use certified EHR technology to identify and provide patient-specific education resources.
- Medication Reconciliation.
- Summary of care record for each transition of care/referrals.
- Capability to submit electronic data to immunization registries/systems.
- Capability to provide electronic syndromic surveillance data to public health agencies.
Objective: At a minimum a provider must have at least one formulary that can be queried. Once insurance plans are set up with their respective formularies, formulary checks are automatic with e-prescribing.
Who does the work: Staff must add formulary choice when setting up an insurance plan.
Impact: No adverse impact on day-to-day workflow.
Objective: This means that VersaForm can read the report that the lab sends to you electronically. It puts the data in the chart automatically.
Who does the work: Physician or staff can read lab results on the screen rather than on paper. If your lab will send results electronically this is a big improvement.
Impact: Improves workflow, avoids paper handling, faxing, etc.
Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.
Who does the work: Staff
Impact: Much faster and easier than non-EHR based methods.
Objective: VersaForm can print a list of patients to be contacted, or it can print or email the letters.
Who does the work: A big time-saver, primarily for staff.
Impact: Positive.
Objective: Sends a secure message to the patient, who can then read it online.
Who does the work: Staff, in response to patient request.
Impact: A regular staff task.
Objective: These can be quickly printed for the patient by physician or staff.
Who does the work: Staff should ensure that patients receive their printouts.
Impact: A regular staff task.
Objective: Helps to identify medication changes after a hospitalization or other transfer of care.
Who does the work: Physician or staff.
Impact: If the data is available electronically, reconciliation will be much faster and easier.
Objective: The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider should provide summary care record.
Who does the work: Staff. VersaForm creates the summary upon request.
Impact: A net time-saver.
Objective: VersaForm creates an electronic file with the required information.
Who does the work: Staff.
Impact: Much faster than preparing paper reports. Positive.
Objective: VersaForm creates an electronic file with the required information.
Who does the work: Staff.
Impact: As with immunization registries, much faster than doing it on paper.
VersaForm will help your office achieve all of these objectives.
