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Meaningful Use


Meaningful Use is defined as the use of certified electronic health record technologies in a manner that moves a provider towards or achieves the goals of improving health care quality, efficiency and patient safety. A provider can demonstrate this by adopting and using technologies that meet the criteria, standards and capabilities established in the meaningful use rule. The meaningful use criteria, standards and capabilities will evolve in stages over time to continue to advance the state of HIT.
Specifically for Medicare and Medicaid use common definitions of meaningful use are:
  • Use certified EHR technology to track, record and exchange information including:
    • Use CPOE and ePrescribing
    • Record demographics and vital signs
    • Maintain up-to-date problem lists
    • Check insurance eligibility and submit claims
    • Have capability to exchange key clinical information
    • Have certain technical privacy and security capabilities
  • Capture and submit specific clinical quality measures
  • Can provider patients an electronic copy of their health information

Meaningful Use criteria are divided into stages; each subsequent stage requires more capabilities.


Meaning Use criteria stages 


Stage 1 Meaningful Use

Beginning in 2013, there are several changes to the Stage 1 Electronic Health Record (EHR) Incentive Programs meaningful use objectives, measures and exclusions for eligible professionals (EPs), eligible hospitals (EHs) and critical access hospitals (CAHs). These changes took effect on October 1, 2013 for EHs and CAHs and on January 1, 2013 for EPs. To view specification sheets for Stage 1 Meaningful Use visit CMS website at:

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html
 

Stage 2 Meaningful Use 

On September 4, 2012, Centers for Medicare & Medicaid Services (CMS) published a final rule that specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) must meet in order to continue to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. All providers must achieve meaningful use under the Stage 1 criteria before moving to Stage 2.
To help providers better understand Stage 2 Meaningful Use requirements, CMS has developed Stage 2 Meaningful Use Specification Sheets for EPs and EHs that provide detailed information on each Stage 2 objective, including: 
  • How to calculate the numerator and denominator
  • How to qualify for an exclusion
  • Definitions of important terms
  • Requirements for achieving the objectives

Stage 2 Specification Sheets

  1. Eligible Professionals (EPs) 
  2. Eligible Hospitals (EHs) & Critical Access Hospitals

Flexibility Rule

Security/Risk Assessments

One of the core measures under both Stage 1 and Stage 2 Meaningful Use is Protect Electronic Health Information. This specific measure requires the eligible professional and/or eligible hospital to conduct a security risk analysis per 45 CFR 164.308(a)(1) and implement security updates as necessary to correct identified security deficiencies as part of the provider's risk management process. Alaska is providing a security checklist to assist eligible professionals and eligible hospitals with this security risk analysis. Eligible professionals and eligible hospitals will be required to upload either this completed checklist or the final report that is generated from the Office of the National Coordinator downloadable program for security risk assessment at:

http://www.healthit.gov/providers-professionals/security-risk-assessment
.

Public Health Meaningful Use Measures for Alaska

For Meaningful Use, the Eligible Hospital (EH) or Eligible Professional (EP) must determine which of the Meaningful Use Public Health measures, listed in the table below, they plan to report and submit their Intent to Register if needed within the first 60 days of their identified Electronic Health Record (EHR) Reporting period. The EHR reporting period is the time period through which an EH or EP seeking a Meaningful Use Incentive payment must demonstrate meaningful use of EHR technology.
 
For Program Year 2015 the last day an Intent to Register form could be submitted was December 2, 2015.
 
​Description ​State System & Status ​Alaska HIE Status ​Point of Contact
Immunization Information System (EPs & EH) ​VacTrAK is able to accept HL7 2.3.1 or 2.5.1 for Stage 1 but HL7 2.5.1 will be required for Stage 2 ​HIE is able to accept HL7 2.5.1 transactions: able to onboard EPs & EHs hss.hitinfo@alaska.gov
Reportable Lab Results (Hospitals and commercial laboratories only) ​LIMS, commercial labs and hospital labs transmit reportable lab results ​HIE is able to accept HL7 2.5.1 transactions: able to onboard EHs & Commercial Labs hss.hitinfo@alaska.gov
Electronic Syndromic Surveillance Data  (Hospitals only) ​Alaska will be participating in the national BioSense project. ​HIE is able to accept transactions: able to onboard EHs
Cancer Registry Reporting (EPs only) ​Cancer Registry will accept HL7 CDA file format and will process it using CD-NPCR eMaRC Plus software. ​​HL7 CDA file should be transmitted via HIE's Direct Secure Messaging (DSM) solution. hss.hitinfo@alaska.gov
 
Meaningful Use beginning with Stage 2 Public Health objectives require an on-going submission of actual patient data, and as described above, EHs and EPs may need to contact the Alaska Medicaid EHR Incentive Program office to register their intent to do so. An EH or EP can meet Meaningful Use (Stage 2 and later stages) public health objective through any of the following four criteria:
  • The EP or EH's ongoing submission was already achieved in the previous reporting period and continues throughout the current reporting period;
  • EP or EH registers their intent to initiate ongoing submission with the Alaska Medicaid EHR Incentive Program office (within the first 60 days of their EHR reporting period) and ongoing submission was achieved;
  • Registration of intent to initiate ongoing submission was made by the deadline (within the first 60 days of their EHR reporting period or in a previous program year) and the EP or EH is still engaged in testing and validation of ongoing electronic submission; or
  • Registration of intent to initiate ongoing submission was made by the deadline (within the first 60 days of their EHR reporting period or in a previous program year) and the EP or EH is awaiting invitation to begin testing and validation.
There are two scenarios in which the EP or EH will not meet the deadline:
  • The EP/EH fails to register their intent by the deadline (within the first 60 days of their EHR reporting period); or
  • The EP/EH fails to participate in the on-boarding process as demonstrated by failure to respond to written requests for action within 30 days on two separate occasions.

Public Health Measure Reporting Process

 

Stage 1

  • If an EP or EH is already submitting electronic, production level messages to a Public Health registry they are attesting to there is no need to complete the Registration of Intent form. The EP or EH will need to continue to submit electronic, production level messages.
    • For the EP or EH Medicare or Medicaid attestation one of the following will be required:
        • EP or EH upload a copy of the acknowledgement message their EHR receives from either the HIE or directly from the Public Health registry showing they are submitting production level data.
        • EP or EH upload a copy of the acknowlegement message their EHR receives from either the HIE or diectly from the Public Health registry showing they have submitted a test message.
    • The EP/EH will need to contact Alaska eHealth Network (Alaska's HIE) to coordinate the transition for sending Public Health registry data via the HIE.
  • If an EP or EH is not currently submitting electronic, production level messages, and they have not submitted in a previous program year an Registration of Intent for, they will need to submit the Registration of Intent form to hss.hitinfo@alaska.gov within the first 60 days of their identified EHR Reporting Period.
    • Once the Registration of Intent form has been received the EP or EH will receive instructions of next steps.
    • For the EP or EH Medicare or Medicaid attestation one of the following will be required:
        • EP or EH upload a copy of the acknowledgement message their EHR receives from either the HIE or directly from the Public Health registry showing they are submitting production level data.
        • EP or EH upload a copy of the acknowlegement message their EHR receives from either the HIE or diectly from the Public Health registry showing they have submitted a test message.
        • EP or EH upload a copy of the acknowledgement email they received from the Alaska Medicaid EHR Incentive Program office informing them their form was received and additional next steps.  
    • The EP/EH will need to contact Alaska eHealth Network (Alaska's HIE) to coordinate the transition for sending Public Health registry data via the HIE.

Stage 2 and later stages

  • If an EP or EH is already submitting electronic, production level messages to a Public Health registry (Immunization, Reportable Labs, Syndromic Surveillance or Cancer Registry) there is no need to complete the Registration of Intent form. The EP or EH will need to continue to submit electronic, production level messages.
    • For the EP or EH Medicare or Medicaid attestation one of the following will be required:
        • EP or EH upload a copy of the acknowledgement message their EHR receives from either the HIE or directly from the Public Health registry showing they are submitting production level data.
        • The EP/EH will need to contact Alaska eHealth Network (Alaska's HIE) to coordinate the transition for sending Public Health registry data via the HIE.
  • If an EP or EH is not currently submitting electronic, production level messages, and they have not submitted in a previous program year an Registration of Intent for, they will need to submit the Registration of Intent form to hss.hitinfo@alaska.gov within the first 60 days of their identified EHR Reporting Period.
    • Once the Registration of Intent form has been received the EP or EH will receive instructions for next steps.
    • For the EP or EH Medicare or Medicaid attestation one of the following will be required:
        • EP or EH upload a copy of the acknowledgement message their EHR receives from either the HIE or directly from the Public Health registry showing they are submitting production level data.
        • EP or EH upload a copy of the acknowledgement email they received from the Alaska Medicaid EHR Incentive Program office informing them their form was received and additional next steps. 
    • The EP/EH will need to contact Alaska eHealth Network (Alaska's HIE) to coordinate the transition for sending Public Health registry data via the HIE.

Registration of Intent Form

 
The Registration of Intent form, if needed per instructions above, must be submitted within the first 60 days of the EP/EH identified EHR Reporting Period. The Registration of Intent form will need to be emailed to: hss.hitinfo@alaska.gov. Group Registration of Intent is allowed and will need to be completed on a organization/clinic level including all the potential EPs or the EH that may be completing attestations for either the Medicare or Medicaid Incentive Programs.  
 
Any EP or EH that has submitted an Registration of Intent form in a previous program year is not required to submit another form in subsequent years, even if they decide to attest to additional Public Health measures with the State of Alaska Division of Public Health.
 
If an EP or EH misses the deadline for submitting an Registration of Intent form for a program year will not meet the requirements for the Public Health measure they are attesting for unless:
  • The EP/EH are in Stage 1 Meaningful Use and have either sent a test message or are in production status with the Public Health registry they are attesting for.
  • The EP/EH have already submitted an Registration of Intent form in a previous program year.
  • The EP/EH are in Stage 2 (or later stage) Meaningful Use and are in a produc tion status with the Public Health registry they are attesting for. 
If you have any questions, please contact the Alaska Medicaid EHR Incentive Program office at:
hss.hitinfo@alaska.gov.
 

Onboarding Process for Public Health Measures

Other Related Links

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