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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

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 Stage 1 and Stage 2 Meaningful Use, the Eligible Hospital (EH) or Eligible Professional (EP) must determine which of the below Meaningful Use Public Health measures they plan to report to and register their intent annually to the Alaska Medicaid EHR Incentive Program office no later than the 60th day of their 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.
 
​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 Stage 2 (MU2) public health objectives require an on-going submission of actual patient data, and as described above, EHs and EPs will need to contact the Alaska Medicaid EHR Incentive Program office to register their intent to do so. An EH or EP can meeting MU2 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. The EP/EH selecting this option will still have to complete the Intent to Register form prior to the 60th day of their EHR Reporting Period;
  • EP or EH registers their intent to initiate ongoing submission with the Alaska Medicaid EHR Incentive Program office (prior to the 60th day of their EHR reporting period) and ongoing submission was achieved;
  • Registration of intent to initiate ongoing submission was made by the deadline 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 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; 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 (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 and can upload in their Medicare or Medicaid EHR Incentive Program attestation a copy of the HL7 acknowledgement message (ACK) showing they are submitting electronic, production level messages. 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 they will need to submit the Registration of Intent form to hss.hitinfo@alaska.gov before the 60th day 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. Once the test message has been sent the EP or EH will receive an acknowledgement email from Alaska eHealth Network (HIE) or message via their EHR when the test message has been successful or not. The EP or EH can upload a copy of this acknowledgement message in their Medicare or Medicaid EHR Incentive Program attestation.

Stage 2

  • 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 and can upload in their Medicare or Medicaid EHR Incentive Program attestation a copy of the HL7 acknowledgement message (ACK) showing they are submitting electronic, production level messages. 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 they will need to submit the Registration of Intent form to hss.hitinfo@alaska.gov before the 60th day 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. This instruction email is the confirmation that the EP or EH has been added to the "queue" to be onboarded via the HIE to submit Public Health measure data. The EP or EH can upload a copy of this email in their Medicare or Medicaid EHR Incentive Program attestation.

Registration of Intent Form

 
The Registration of Intent form must be submitted prior to the 60th day 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 are allowed but will need to be completed by the same group of EPs that will be identified in the Medicare or Medicaid attestation. The Registration of Intent form, if needed, is a one time submission. Once the EP/EH has submitted this form they will need to continue to work towards ongoing submission as required by the CMS Stage 2 Final Rule. EP/EH that are already submitting electronic production level messages do not need to complete the Registration of Intent form.
 
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

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