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Ideas and insights to help health care providers stay informed and profitable in today's challenging health care environment.

Is Using a Certified EHR Enough for Meaningful Use Success?

by Liz Dunn, Director of Product Innovation

True or false: Having a 2014-certified Complete EHR is all that’s needed to achieve Meaningful Use.

False. At least in my opinion.

2014 electronic health record (EHR) certification, a requirement from the Office of the National Coordinator, is only the beginning of preparing for Stage 2 Meaningful Use, which begins in January 2014. Yet, it’s usually where many EHR vendors stop.

Most health IT vendors update their system, get certified, and spend the remainder of the time upgrading all their providers to the certified version, from single-doctor practices to large medical groups—often at additional costs. After that, providers and staff are left on their own to perform against those measures, track progress, and attest at the end of the reporting period. Sound familiar?

When your vendor acts like a partner on the road to Stage 2 Meaningful Use attestation they won’t stop there. And you shouldn’t expect them to. Health IT vendors should take a holistic approach to support their providers, making it as easy as possible for caregivers to attest to Stage 2—without taking their focus away from patients.

At athenahealth, this means taking our 2014-certified Complete EHR, and really putting it through the ringer prior to and during Stage 2. Here are just a few aspects to what we feel is a sound approach in getting Stage 2-ready for participating providers…

Before 2014:

  • Performance assessment
    Vendors should pre-determine how well providers will perform against the Stage 2 measures ensuring that 1) there is no slip in their Stage 1 performance, and 2) workflows smoothly integrate into their normal clinical day-to-day activity. Status should be measured by actual provider performance as well as provider feedback. Insights from this process should be used to identify potential performance issues so they can be addressed ahead of time, before any provider needs to report on the measures.

    athenahealth providers using our cloud-based EHR athenaClinicals will actually begin practicing for Stage 2 in 2013, giving us great insight to any problematic measures—and the time to address them—before the formal beginning of Stage 2.
  • Change management
    Some practices will have all of their providers going for Stage 2 in 2014; others will have some physicians still in Stage 1. Educating the practices on the differences between Stage 1 and Stage 2 and how their workflows will be impacted, are critical to provider adoption and performance. As a practice, who can you contact when you have a question relating to Meaningful Use? Does your vendor have client support staff that’s knowledgeable and up-to-speed on the differences between Stage 1 and Stage 2? Making sure all parties are aware and fully prepared in advance of the reporting period is critical component to provider success.

Throughout 2014:

  • Performance management
    With Stage 2, being ready to hit the ground running on January 1, 2014 is critical. Since Stage 2 is using quarterly reporting periods, each provider has exactly four chances at achieving Meaningful Use. If even one measure is not met in Q1, the provider has to start over from scratch in Q2. If providers are not able to attest successfully in Q1 or Q2, they will be in the unenviable position of trying to achieve Stage 2 requirements at the same time they are preparing to switch to the ICD-10 code set. It is extremely dangerous for vendors to treat the quarterly reporting period as an opportunity to slow down or delay if they’re not ready to support you on January 1st.

    Here at athenahealth, every practice using our cloud-based EHR service is already on a 2014 Complete EHR-certified version. With this readiness, we’re aiming for all practices to attest to Stage 2 in early 2014 so they can devote as much time as possible to preparing for the October 1, 2014 ICD-10 compliance deadline.
  • Enrollment & Attestation
    With a heavier focus on public health and data exchange measures, providers may need to be enrolled with several different registries – immunization registry, syndromic surveillance registry, cancer registry, and/or specialized registries. That’s a lot of paperwork and dependencies to prepare within a short window of time.

    Attestation in 2014 is further complicated by the fact that, while the Medicare Meaningful Use program supports a quarterly reporting period, Physician Quality Reporting Service (PQRS) still requires a full reporting year of clinical quality measures in order to attest. This means that for those caregivers participating in Meaningful Use and PQRS, there will be two separate reporting windows and attestation processes. The more touch points, the greater risk of failure. Our response is to help satisfy the Stage 2 health information exchange measures by handling registry enrollment for practices, in addition to building, testing, and maintaining these new connections. We also manage the dual enrollment for PQRS and will submit all clinical quality and attestation data directly to CMS on providers’ behalf.

As you can see, achieving 2014 EHR certification is only the first step. With each passing year and each subsequent stage of Meaningful Use, your EHR vendor should continue to step up their game, just as providers are asked to do. 2014 is going to bring many new challenges to those hoping to achieve Meaningful Use. As many organizations clamor for a delay in Stage 2 due to “lack of vendor readiness,” providers need to know that their certified EHR is ready to go — beyond just being certified. Having the certified software is one thing. But isn’t the achievement the real goal?

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