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Meaningful Use FAQs

Why should I pay for Meaningful Use advice?

The EHR Incentive Program and meaningful use requirements are complex. It is common sense for a busy practice to outsource MU research and know-how to a trusted advisor. Participation in the EHR Incentive (Stimulus) Program is worthwhile for numerous reasons ($44,000 being just one); don't let fear of EHRs or meaningful use stunt your practice's technological growth. The healthcare industry embraces MU and is moving full steam ahead, so should you! Additionally, practices that don't adopt EHRs and Meaningful Use will be penalized in their Medicare and Medical payments from the government starting in 2014.

Meaningful Use Experts offers affordable, reliable, guaranteed services to meet your Meaningful Use Stage 1 and Stage 2 needs. Please visit Services to learn more.

How does Meaningful Use Experts Price its Services?

Meaningful Use Experts prices its services at affordable prices for small to mid-sized practices which can't afford a full-time employee to stay on top of Meaningful Use measures and changes for each stage and run the reports necessary to measure Meaningful Use compliance. We work with practices at all stages of the process to help them achieve attestation and receive their incentive money. Please visit Services to learn more.

Doesn't my EHR vendor teach me everything about Meaningful Use?

No. Rarely (if ever) do EHR vendors have a full-time 100% dedicated meaningful use expert on staff. You will hear they have experts, but these individuals usually wear many hats for the company and only dabble in meaningful use. For something as important as MU, you must demand that every concern you have is addressed. Not to mention, EHR vendors are more concerned with new sales than continued meaningful use compliance.

Doesn't my Regional Extension Center provide Meaningful Use support for free?

No; after 2013 HHS is no longer providing new financial grants to regional extension centers (RECs) to provide meaningful use support to practices. Some RECs have extensions, but those will run out by 2014 and support will not be provided for meeting Stage 2 meaningful use requirements. Practices will, however, have to comply with both Stage 2 and Stage 3 meaningful use requirements.

What is the HIPAA Security Risk Assessment and Why is it Required?

The SRA is a collection of steps and procedures that a covered entity and a business associate must take in order to conduct an accurate and comprehensive assessment of any potential risks and security holes or perhaps expose their lack of proactive security measures that may compromise the confidentiality, integrity and availability of electronic protected health information (ePHI) that the organization stores and maintains in the course of their normal business practice.

The result of the SRA is an overall view and snapshot on how a covered entity and business associate is doing, and a plan to be used in the development of strategies and procedures to mitigate any potential risk.

The SRA is a requirement that must be completed by every covered entity in order to meet Meaningful Use and receive their incentive dollars.

Please visit HIPAA Security Risk Assessment to learn more.

What happens if I don't do a HIPAA Security Risk Assessment?

In order to receive the incentive dollars, an SRA must be performed to meet the Meaningful Use requirements which include a HIPAA Security risk assessment. No SRA, no money. You are also vulnerable to fail a Meaningful Use audit, if one is done.

Can I do a HIPAA Security Risk Assessment myself?

Yes, a self SRA can be done. All the information is online and can be accessed by anyone.

However, it can be time consuming; also there is the possibility of missing important areas or details resulting in not going deep enough in the assessment. This will hinder the privacy and security of the covered entity or business associates, leaving the business with security holes which will expose the ePHI. This increases the chance of getting fines and penalties.

Can HIPAA Security Risk Assessments be done remotely?

Yes, the HIPAA SRA can be done online using forms provided by Meaningful Use Experts. We do the assessment from the information you provide and create a plan for your practice to correct areas that were ranked inadequate or poor in the assessment. A HIPAA Privacy and Security officer follows up with the practice to assure that the measures were corrected. We create all of the documentation that you will need in the case of a Meaningful Use or HIPAA Security audit. Meaningful Use Experts offers this service nationwide. Go to HIPAA SRA Service to learn more.

When Does an SRA Need to be Performed for Meaningful Use?

An SRA must be performed at least once every attestation period.

What is the Meaningful Use HIPAA requirement and documentation that is required in an audit?

The requirement for HIPAA is once every two years, and for meaningful use it’s once during your reporting period. This means one must have done a HIPAA security risk assessment once during the meaningful use reporting period and show documentation that demonstrates compliance with the five categories of security risk and vulnerability.

The five categories include: administrative safeguards, physical safeguards, technical safeguards, organizational requirements, and policies and procedures and documentation requirements.

Please visit HIPAA Security Risk Assessment to learn more.

What are the requirements for interoperability in Stage 1 and Stage 2?

Interoperability requirements

Stage1 -2013

Stage 2 - 2014

Standardized Electronic Exchange

testing

required

Sharing at Transitions of Care and Referrals

optional

required

Standardized Summary of Care Records

required

required

Structured Data

required

required

There are two parts to the definition of interoperability:

  • The ability of two or more systems to exchange information
  • The ability of those systems to use the information that has been exchanged

Stage 1 Core requirements for 2013:

  • to provide summary of care e-copy upon request and
  • In 2014 to make summary of care documents available online to patients.

Stage 1 Menu requirement is to:

  • Provide at 50% of transitions of care and referrals

Stage 2 Core requirements for 2014:

  • Make available summary of care documents available online to patients
  • Provide at 50% of transitions of care and referrals
  • The rule also requires that a provider electronically transmit a summary of care for more than 10% of transitions of care and referrals.
  • At least one summary of care document sent electronically to recipient with different EHR vendor or to a CMS test EHR.

Structured Data includes:

  • Electronic prescribing
  • Transition of care records
  • Transmission of lab tests
  • Standardized interface to receive and transmit lab data with standardized clinical terminology

What is the Syndromic Surveillance requirement in meaningful use? How is it met?

The objective of the requirement for Syndromic Surveillance Data Submission is to submit a test of electronic syndromic surveillance data to public health agencies and a follow-up actual submission according to applicable law and practice.

The measure is to perform at least one test of a certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful, (unless none of the public health agencies to which an EP submits such information has the capacity to receive the information electronically) or unless prohibited.

The test to meet the measure of this objective must involve the actual submission of electronic syndromic surveillance data to public health agencies that will accept the information. Simulated transfers of information are not acceptable to satisfy this objective.

The transmission of electronic syndromic surveillance data is not required for the purposes of a test. The use of test information about a fictional patient that would be identical in form to what would be sent about an actual patient would satisfy this objective.

Exclusions

An EP who does not collect any reportable syndromic information on their patients during the EHR reporting period, does not need to submit such information to any public health agency that has the capacity to receive the information electronically, or if it is prohibited.

An unsuccessful test to submit electronic syndromic surveillance data to public health agencies will be considered valid and would satisfy this objective.

Attestation Requirements

YES / NO / EXCLUSION

Eligible professionals (EPs) must attest YES to having performed at least one test of certified EHR technology’s capacity to submit electronic syndromic surveillance data to public health agencies and follow up submission if the test was successful (unless none of the public health agencies to which the EP submits such information has the capacity to receive the information electronically), except where prohibited,to meet this measure.

  • EXCLUSION: If an EP does not collect any reportable syndromic information on their patients during the EHR reporting period, if no public health agency that has the capacity to receive the information electronically, or if it is prohibited, then the EP is excluded from this requirement. EPs must select NO next to the appropriate exclusion, then click the APPLY button in order to attest to the exclusion.

Additional Information

  • If the test is successful, then the EP should institute regular reporting with the entity with whom the successful test was conducted, in accordance with applicable law and practice. There is not a measurement associated with this reporting.

  • EPs must test their ability to submit electronic syndromic surveillance data to public health agencies at least once prior to the end of the EHR reporting period. Testing may also occur prior to the beginning of the EHR reporting period. Each payment year requires it own unique test.

  • If multiple EPs are using the same certified EHR technology in a shared physical setting, testing would only have to occur once for a given certified EHR technology.

  • The transmission of syndromic surveillance information must use the standards at 45 CFR 170.302(l). This specification sheet has been updated to reflect the applicable Stage 1 provisions in the Stage 2 Meaningful Use Final Rule, published on September 4, 2012.

To meet the Stage 1 public health meaningful use objectives, (submitting information to an immunization registry, reporting lab results to a public health agency, or reporting syndromic surveillance information), does the provider have to send information directly from their certified EHR technology to the appropriate receiving entity or can they use an intermediary such as a health information exchange (HIE) or another third party software vendor?

Yes, you can use an intermediary service such as a health information exchange (HIE) or another third party software vendor to submit electronic information.

What services does Meaningful Use Experts offer for HL7 interfaces?

Meaningful Use Experts offers services to develop custom HL7 solutions. We can assist organizations in creating custom HL7 interfaces that are required for Meaningful Use Stage 2 requirements. 

HL7 - What Does it Mean?

"Level Seven" refers to the seventh level of the International Organization for Standardization (ISO) seven-layer communications model for Open Systems Interconnection (OSI) - the application level. The application level interfaces directly to and performs common application services for the application processes. Although other protocols have largely superseded it, the OSI model remains valuable as a place to begin the study of network architecture.

What does HL7 do?

HL7 provides standards for interoperability that improve care delivery, optimize workflow, reduce ambiguity and enhance knowledge transfer among all of our stakeholders, including healthcare providers, government agencies, the vendor community, fellow SDOs and patients. In all of our processes we exhibit timeliness, scientific rigor and technical expertise without compromising transparency, accountability, practicality, or our willingness to put the needs of our stakeholders first.

What are the strategies of HL7?

1.     Develop coherent, extendible standards that permit structured, encoded health care information of the type required            to support patient care, to be exchanged between computer applications while preserving meaning.

2.     Develop a formal methodology to support the creation of HL7 standards from the HL7 Reference Information Model (RIM).

3.     Educate the healthcare industry, policy makers, and the general public concerning the benefits of healthcare information           standardization generally and HL7 standards specifically.

4.     Promote the use of HL7 standards world-wide through the creation of HL7 International Affiliate organizations, which                   participate in developing HL7 standards and which localize HL7 standards as required.

5.    Stimulate, encourage and facilitate domain experts from healthcare industry stakeholder organizations to participate in            HL7 to develop healthcare information standards in their area of expertise.

6.    Collaborate with other standards development organizations and national and international sanctioning bodies (e.g. ANSI            and ISO), in both the healthcare and information infrastructure domains to promote the use of supportive and compatible            standards.

7.    Collaborate with healthcare information technology users to ensure that HL7 standards meet real-world requirements, and            that appropriate standards development efforts are initiated by HL7 to meet emergent requirements.

What is Inter-operability?

In this context, interoperability refers to the ability of two or more computer systems to exchange information.

  • Ability of two or more systems or components to exchange information and to use the information that has been exchanged.
  • Source: IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990

"Functional" interoperability is the capability to reliably exchange information without error

"Semantic" interoperability is the ability to interpret, and, therefore, to make effective use of the information so exchanged.

In our context, 'effective use' means that the information can be used in any type of computable algorithm (appropriate) to that information.

What are HL7 Standards?

HL7 and its members provide a framework (and related standards) for the exchange, integration, sharing, and retrieval of electronic health information. These standards define how information is packaged and communicated from one party to another, setting the language, structure and data types required for seamless integration between systems. HL7 standards support clinical practice and the management, delivery, and evaluation of health services, and are recognized as the most commonly used in the world.

HL7 standards are grouped into reference categories:

  • Section 1: Primary Standards - Primary standards are considered the most popular standards integral for system integrations, inter-operability and compliance. Our most frequently used and in-demand standards are in this category. 
  • Section 2: Foundational Standards - Foundational standards define the fundamental tools and building blocks used to build the standards, and the technology infrastructure that implementers of HL7 standards must manage. 
  • Section 3: Clinical and Administrative Domains - Messaging and document standards for clinical specialties and groups are found in this section. These standards are usually implemented once primary standards for the organization are in place. 
  • Section 4: EHR Profiles - These standards provide functional models and profiles that enable the constructs for management of electronic health records. 
  • Section 5: Implementation Guides - This section is for implementation guides and/or support documents created to be used in conjunction with an existing standard. All documents in this section serve as supplemental material for a parent standard. 
  • Section 6: Rules and References - Technical specifications, programming structures and guidelines for software and standards development. 
  • Section 7: Education & Awareness - Find HL7's Draft Standards for Trial Use (DSTUs) and current projects here, as well as helpful resources and tools to further supplement understanding and adoption of HL7 standards.

What is an HL7 interface engine?

An HL7 interface engine is an interface or integration engine built specifically for the healthcare industry. It connects legacy systems by using a standard messaging protocol. Because hospitals and other healthcare providers usually have different systems for different aspects of services, they are often unable to communicate with each other. HL7 gets around that problem by providing the framework for the exchange, integration, sharing and retrieval of electronic health information. These standards are the most commonly used throughout the world.

What are the benefits of an HL7 interface engine?

By using a HL7 interface engine, health providers can realize the benefits of existing legacy information systems without major re-investment in new technologies, lowering costs and extending the life and efficiencies of current systems. There is also opportunity to link to systems outside the healthcare provider such as providers of outsourced services like radiology.

How do HL7 interface engines work?

HL7 interface engines are software which work as a go-between for different systems. They monitor different types of interfaces and communication points and perform actions according to rules defined by the organization.

HL7 works with a number of standards (Conceptual Standards, Document Standards, Application Standards and Messaging Standards). Messaging standards define how information is packaged and communicated from one system to another.

Where can I find an HL7 interface engine?

Various HIT services companies can create an HL7 interface engine to interface with between a clients EHR system and an outside EHR system or an HIE. Meaningful Use Experts provides HL7 interface services to connect to an HIE.

ICD-10 Questions

For questions regarding ICD-10, go to Frequently Asked Questions on ICD-10.

How do we Setup a Patient Portal?

A patient portal is setup differently in each EHR. However, there is planning involved with setting up a patient portal. A portal that includes interactive and personalized tools and information will be more relevant to patients’ needs. Patients are more likely to register and continue using a portal that has a problem-solving orientation, interactive decision tools, and the ability to communicate securely with their doctors.

Key questions to answer during planning include:

What are the goals for the portal in terms of potential benefits for patients and the practice?

Which features and services should be offered?

Should they be offered all at once, or phased in?

Will the portal be open initially to all interested patients, or to a select group during early deployment?

How will you handle marketing, enrollment, training, and support for patients’ use of the portal?

Aim to establish efficient workflows and policies, and avoid burdening providers with troubleshooting during initial rollout. 

 

 

 

 

 

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