Preparation, Patient Engagement Key to Meaningful Use

As the industry awaits the next set of objectives and measures for the Stage 3 rules of meaningful use next month, practices are still facing the challenge of meeting Stage 2 requirements for 2015.

Last month, CMS gave assurances of redefined Stage 2 rulemaking to help ease the reporting burden on providers. The forthcoming communication from CMS is intended to be responsive to concerns about software implementation, information exchange readiness, and other related concerns.

Despite the uncertainty, physicians will have to prepare for the Stage 2 rules of meaningful use for the calendar year.

In 2015, CMS data indicate more than 260,000 physicians will have to meet Stage 2 requirements. CMS estimates that more than 257,000 eligible professionals will receive payment penalties in 2015, which casts further doubt about the likelihood of high levels of physician participation.

Shaun Conrad, a manager in Ernst & Young's Americas Health Care Practice, said physicians have been having difficulty with some of the specific objectives of Stage 2.

"The biggest challenge is probably the electronic transmission and the patient portal," said Conrad. "Getting patients to engage can be very difficult and since the measure itself is reliant on the patient being engaged by logging into the portal, but they still need to view, download, or transmit that data in order for the provider to get credit ... there's a lot of changes there where you have to change your culture internally."

"Physician practices should look at having dedicated administrative staff help physicians manage meaningful use, Physician Quality Reporting System (PQRS), and other … quality-related incentive programs," said Rafi Tabib, managing consultant within Navigant's healthcare practice. "If possible, a well-rounded team with knowledge of the EHR functionality, reporting/data analytics, and program requirements, should be put together. The amount of dollars at stake in incentives and penalties warrants such a team."

Get the Data Moving

Mary Griskewicz, senior director of health information systems for the Healthcare Information and Management Systems Society, said she has seen work flow changes affecting her local family physician's office since it implemented an EHR.

"Since they've implemented EHRs they are much more thorough upon entry into the practice," Griskewicz said. "Now on the back-end, they should be giving the patient the information and follow-up instructions and, if they haven't signed up for your portal, let's get them signed up. That's the change in thinking and culture that's needed."

Naomi Levinthal, senior consultant and healthcare IT adviser for The Advisory Board Company, warns that transitions of care measures are incredibly complex and will require practices to know in advance how they will send summary of care records both internally and outside of their offices.

"Practices with a robust patient engagement initiative that includes clinician involvement may be able to meet the secure messaging [requirement] and view, download, and transmit measures of Stage 2 with greater ease," Levinthal said.

Levinthal said providers would be wise to focus on three key actions this year.

• Assign a practice staff person the responsibility to keep on top of meaningful use-related news, and determine whether there are any impacts to current plans.

• Be well-prepared for audits with a comprehensive book of evidence and an internal policy on how the practice would respond to an audit notice.

• Identify ways to align meaningful use with other practice initiatives, for example, electronic quality reporting or population health management.