Prepare your practice for Stage 1 meaningful use changes

The U.S. Department of Health & Human Services (HHS) announced several changes to its Stage 1 Electronic Health Records (EHR) meaningful use program for 2014.

If you are participating in this program, prepare for software and recording procedure updates, according to David Jaco, O.D., AOAExcelTM EHR consultant.

Update your software

Ask vendors if their EHR products are certified to meet Stage 2 specifications.

The HHS now requires all EHR systems to meet both Stage 1 and Stage 2 meaningful use requirements to be certified for use in government incentive programs. This means all health care practitioners attempting to meet Stage 1 meaningful use criteria must have EHR systems that also meet Stage 2 criteria.

If you are entering the government incentive program, ask vendors if their EHR products are certified to meet Stage 2 specifications. If you already have EHR systems in place, check with vendors to determine when system updates will be available, Dr. Jaco advised.

Make health information available online

Stage 1 objectives now require participants to provide patients timely access to their health information online. Until now, Stage 1 practitioners were allowed to use CDs or similar media to meet requirements for providing health care information electronically.

Stage 2-certified EHR systems will provide functionality to make patient information available securely online. However, practitioners must learn how to use it and make patients aware of the feature.

Check vital signs

Beginning this year, Stage 1 meaningful use participants are required to record the following in EHRs:

  • Blood pressure for patients age 3 and older
  • Height and weight for all patients.

Recording such data was optional in 2013.

Exclusions do exist, but Dr. Jaco recommends optometrists record all three vital signs as a matter of good patient care. For example, height and weight are required in order to enter a body mass index for a patient in an EHR—and that relates directly to a patient's overall health.

"Many clinical studies have shown an increased risk of AMD, glaucoma, and cataracts in overweight patients," Dr. Jaco noted.

The required data is not hard to obtain, he added. Height and weight can easily be added to any patient questionnaire, and EHRs will calculate body mass index automatically when height and weight are entered.

"Similarly, we should be checking blood pressure on all patients," Dr. Jaco said. "It facilitates the diagnosis of hypertensive retinopathy. You may be surprised how many patients have significantly elevated blood pressure. You could prevent them from having a stroke."

Exclusions exist

As in the past, Stage 1 EHR meaningful use will require compliance with at least five objectives selected from a "menu." However, practitioners will now only be allowed to count "exclusions" in that total when they cannot find a total of five menu objectives relevant to their practices.

In most cases, ODs should be able to find five menu objectives relevant to their practices, Dr. Jaco noted.

Report clinical quality measures

As of this year, all providers—regardless of their stage of meaningful use—will report on clinical quality measures (CQMs) using the same set of ambulatory clinical quality measures.

To help you prepare for all of the above, AOAExcelTM offers additional information and a complete list of updated Stage 1 core and menu meaningful use objectives.

January 28, 2014

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