Last week, we explored changes in the Vital Signs measure. For pediatricians and specialists, the vitals adjustment will be a welcome relief from an unnecessary burden. This week, our final post in the Changes to Stage 1 Meaningful Use (MU) in 2013 series, we turn our attention to the changes around electronic exchange of health information.
These changes represent small adjustments that you could leverage in 2013 to make your second year of Meaningful Use (or third if you completed your first MU year in 2011) a little easier. Or, for those considering a 2013 start to MU, make the transition a little lighter.
Electronic Exchange of Health Information
This measure (previously Core 14) was removed for 2013′s Stage 1 criteria. There is a lot of discussion in the Final Rule about why this was removed, and M-CEITA has had a lot of real-life experience with the confusion it caused. If you recall completing this test the first time, it’s likely that you downloaded an XML file, attached it to an email or referral in your HIE (Health Information Exchange) system, and transmitted it along. Your vendor may also have implemented some integrated module to do this as well (i.e. P2P in eCW) so you never actually saw the XML file that was being sent.
In our experience, the confusion arose when the workflow described above was compared to that for the “Summary of Care” Measure. That measure stipulated that you provide a Summary of Care Record to specialists for 50% of your referrals. While this record could be faxed, it could also be transmitted in the same manners as the Core 14 test. In essence, if you were completing the Summary of Care Record measure, you were likely completing the Core 14 Electronic Exchange Measure, too, unless you were faxing the records.
In removing this measure, the Department of Health and Human Services is paving the way for a more aggressive stance on the Summary of Care Record, namely where it specifies that the record must be transmitted electronically (not via fax) in a machine-readable format (i.e. XML not PDF).
Taken together, the changes to computerized provider order entry (CPOE), electronic prescribing, vital signs, and electronic information exchange don’t represent a significant shift from what you’ve worked to achieve.
One thing to remember is that while these changes offer greater flexibility in meeting Meaningful Use, you are limited to what your vendor is willing to build by the end of 2013. These adjustments are rather minor for a report writing developer, but you’ll have to be vigilant to make sure that you (as a pediatrician, for example) have the ability to track the number of patients that have Blood Pressure recorded, separate from the Height and Weight - a new report that wasn’t previously required. Further, if that report isn’t made available until say June 2013, will it back-date results to January 1, 2013, to align with the 365-day reporting period? These are questions to ask as you consider leveraging the changes to Stage 1 MU in 2013.
Note: This series focused on changes that take effect January 1, 2013. There are additional changes that start in 2014. Visit the CMS EHR Incentive Program website for a complete list.
– Nick Glauch, Client Services Manager, M-CEITA