In our last blog we discussed two new ways that 2014 EHR technology should make practicing medicine with an EHR more convenient. Secure email via the ONC Direct Project standard will help facilitate electronic communication between providers of disparate EHRs. In addition, bulk download of patient CDA (Clinical Document Architecture) files will increase the level of data portability for providers that choose to switch EHRs but as discussed in our prior blog this is, at best, a partial solution. Below are a few more wins for providers that must be incorporated into Meaningful Use Stage 2 final rule technology by EHR vendors in 2014.
Clinical Data Reconciliation – Meaningful Use Stage 2 encourages the electronic exchange of data in the CDA format and the most likely way that providers will receive those electronic files is via the new secure email protocol. Exchanging those files during transitions of care is a meaningful use performance measure. You may be wondering; what will providers do with those files once they receive them?
2014 EHR technology requires certified vendors to provide an interface to reconcile data related to allergies, medications and problem list. At the time of transition providers will want to compare patient data from a CDA sent by another provider with the data stored in their EHR. 2014 EHR technology must furnish an interface to perform that comparison and reconciliation. These new methods seem complex but they are actually faster than fax and paper. There is no requirement that the EHR vendor provide an import utility once reconciliation is complete, but we expect most advanced EHR vendors to provide this critical function. Essentially this is a win for providers because they now have a way to merge two versions of at least part of the patient record into their EHR with less data entry then would be required if they had received just a paper version of the record.
Clinical Decision Support – In the 2014 version of certified EHR technology Decision Support and standard CQM (Clinical Quality Measure) compliance begin to become more unified. By definition when a provider participates in the Meaningful Use Stage 2 final rule program they must track CQMs for reporting to CMS. In addition they may be tracking CQMs because they choose to participate in other Quality Measurement programs such as PQRS.
In 2014 EHR vendors must create interventions triggered in accordance with standard CQMs that occur automatically and electronically when a user is interacting with EHR technology. This means that EHR vendors must have “reminder messages” that integrate with standard CQMs and display them when the system calculates that the patient meets the denominator for that measure (i.e., the patient needs Health Maintenance). Most providers love an EHR system that assists them in identifying patients that require a Health Maintenance intervention (example: Diabetics that require a HbA1c test). The reason we know this is because MediTouch EHR has been unifying Health Maintenance reminders with standard CQMs for several years!
Alignment with PQRS – In the first stage of Meaningful Use providers reported CQM measures along with the rest of the other Meaningful Use final rule measures on the CMS website during attestation. With 2014 Certified technology CQMs must be reported directly to CMS by the EHR vendor in a special export file format called QRDA Quality Reporting Document Architecture). This export file is the same file format that will be required for PQRS reporting in 2014. In 2014 we expect that the CQM “measure list” (defined as the measures the providers can choose to report and their specifications) for PQRS to also align at least in part, with the Meaningful Use CQM measure list. The unification of export file format and CQM “measure list” will make PQRS compliance in 2014 easier than it has ever been. Providers should only choose an EHR vendor that will be able to facilitate this alignment for the user and export files to CMS for both programs.
Note: Reporting periods and the required number of measures to report will not align in 2014.
MediTouch is one of the first ONC certified Complete EHR software products. We are ready for 2014 today and now is the time for your practice to begin to learn how 2014 software works so that your practice can “hit the ground running” next year. With ICD-10 looming in the latter part of 2014 it is best for your practice to become proficient in 2014 approved software today and because of our early certification MediTouch users are well positioned to learn and prepare for 2104.