“I anticipate that the Stage 2 measures will decrease my efficiency.”
products. Check the online certified health product list (CHPL), http://bit .ly/18FUPrE, to see if your vendor is one of them. Certification ensures the prod- uct has all the necessary capabilities and security components required to success- fully attest to meaningful use. During attestation, the Centers for
The software upgrade mandated by the U.S. Department of Health and Human Services (HHS) Office of the National Coordinator for Health Infor- mation Technology (ONC) requires you to collaborate with your EHR vendors. You’ll also need time to test the system and train your staff on how to use it. Physicians who’ve gone through it al- ready say you should plan for a tempo- rary dip in productivity during the up- grade process.
Allen Schultz, MD, an Abilene family physician, will attest to Stage 2 mean- ingful use next year. The second stage of measures in the Medicare EHR incentive program requires physicians, hospitals, and labs to use their EHRs to deliver collaborative patient care. That means EHRs must be able to communicate with each other to share patient data. The common language EHRs must speak in Stage 2 is known as Systematized No- menclature of Medicine Clinical Terms (SNOMED-CT). Dr. Schultz, a member of the Texas Medical Association’s Ad Hoc Commit- tee on Health Infor- mation Technology (HIT), implemented SNOMED-CT in his EHR system in Sep- tember. He spent 12 hours in one weekend convert- ing to SNOMED-CT, and he still had 180 patient charts to re-
Sidney Ontai, MD 46 TEXAS MEDICINE December 2013
view to ensure accurate SNOMED-CT diagnoses.
“I anticipate that the Stage 2 measures will decrease my efficiency. Now I de- scribe my diagnosis in terms that match a SNOMED-CT set. This is teaching an old dog yet another set of tricks,” Dr. Schultz said.
He encourages physicians to ask their
EHR vendors now how they’ll incorpo- rate SNOMED-CT into the patients’ fam- ily, social, and past medical histories. He says the SNOMED-CT implementation is among the “largest stumbling blocks” to achieving Stage 2 meaningful use. Plainview family physician Sidney Ontai, MD, another member of TMA’s ad hoc committee, says EHR upgrades inev- itably cause system crashes and glitches in features physicians commonly use. “Our last upgrade really affected the software’s performance on prescription writing, so everyone’s productivity took about a 5-percent hit for several months,” he said.
Despite the short-term loss of pro-
ductivity, achieving meaningful use does have the potential to improve care, Dr. Ontai says.
“Better quality of care is possible with
careful selection of indicators and close work with staff and providers so that the indicators are indeed meaningful and do not negatively impact workflow,” he said.
EHR vendors prepare Some EHR vendors already have re- leased Stage 2-certified versions of their
Medicare & Medicaid Services (CMS) requires you to list the EHR Certification ID for the EHR technology you use to demonstrate meaningful use. To obtain the certification ID for a product, consult instructions for using the CHPL website,
http://bit.ly/15Atb0E. A Stage 2-certi- fied product is required for all physicians attesting in 2014, regardless of the par- ticipation year. Physicians attesting to Stage 1 meaningful use need the Stage 2-certified EHR in 2014. For assistance with the EHR incen-
tive program, you can turn to one of four Texas regional extension centers (RECs). The RECs can help you navigate the complexities of the program. Check out TMA’s REC Resource Center, www
.texmed.org/rec, for REC service area information. A Modern Healthcare review of the
CHPL indicates that at press time just 79 companies and other organizations had developed, tested, and certified soft- ware that meets Stage 2 meaningful use functionality standards. Compare that number with the 988 developers of HIT systems tested and certified for Stage 1, and experts worry some physician prac- tices could get left in the dust and could face payment penalties down the road. According to Modern Healthcare, EHR vendors are struggling to develop sys- tems that can calculate measures physi- cians must report to CMS under Stage 2. Lawmakers are trying to buy physi-
cians and vendors more time to comply with Stage 2. In September, 17 U.S. Sen- ate Republicans, led by Sen. John Thune (R-S.D.) and Sen. Lamar Alexander (R- Tenn.), asked HHS Secretary Kathleen Sebelius for a one-year delay. Their letter says aggressive deadlines in Stage 2 may widen the digital divide for small and ru- ral practices and could have other un- intended consequences, such as stifling innovation and increasing medical errors. The American Medical Association,
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68