Home Forums Discussions General Discussion meaningful use in 2012

Hi,

When do you think we should start meaningful use with AC for 2012? I haven't started yet. But a lot of the items do not requie 100% to pass. So the question is when? to reach max. effiency for us.

Thanks,

Cindy,
If you attested in 2011 for year one, you have to report data for the full 12 months of 2012.

Donna,

I have a similar question??? And am looking for honest feedback on a strawmodel MU project plan for this year 2012 we are trying to flush out.

Here is our current strawmodel plan:

Feb/March-Complete and aquire our needed architecture (hardware, software such as Updox etc...and AC)

March/April-Deploy and work to understand and become conformtable with new systems while developing possible new workflow & getting our hand fully around MU requiremetns etc...(BTW-Is there a Dr. Suess like publication Maybe "MU for Dummies" that anyone can recommend?

May/June-Work through workflow, and other items surfaced by deployment.

July/Aug/Sept/Oct-Full speed ahead into capturing MU data and completing efforts to satisfy all other MU requirments.

So as to be able to attest in Nov/Dec. And we assume will place our MU requirements for all of 2013 in play??

B/R

Roxanne

sounds like a great plan. I did 6 months of data in 2011. Your plan needs to be modified as I think you need to get 90 days in 2012 so Oct, Nov, Dec would do it..get a good system and I tried wireless, but thank goodness I am good with a hammer and hardwired everything...get fast printers and fast hard drives...

Roxanne,
What you are describing is similar to what I did. I started with AC in late 2010. The very first thing is to make a flow chart of everything you do now, each office procedure and workflow, and envision how you will do it with the EMR and other new processes. There are many decisions to be made from how you will do document management, how to handle old records, transferring data to the new system, how to document(templates, Dragaon dicatate,typing), on and on. I spent several months using the search function of this board to answer these questions. Many kind users have already posted their experience in adapting to AC. I suggest using the Advanced search function to pull up older posts about a topic about which you need information.

Once I got AC up and running, I had my staff enter demographics. You have to decide if you will use a data transfer or manual entry for this. Then, I began to construct templates and play with notes. Then, I began to use AC for one patient a day, the rest still paper. As my speed improved, I did more. I realized I needed to set up charts ahead of visits to manage it. I taught my staff to scan and manage documents, then eventually converted to electronic faxes. UpDox is great and many use it. I have chosen another method for now, but did trial UpDox.

I did our conversion in small steps so as to try not to overwhelm us, and at times, it was still hair-pulling. It took most of 2011 to get comfortable, then I was able to collect my 3 months data for MU and attest in late 2011. So, I think your method and time frame sounds realistic. There are others who may have gone cold turkey into everything AC with all patients, but I did better with a slow progression.

Read the threads under the MU forum for some important points. CMS has a lot of great educational materials on their website, and some of them have been referenced in prior threads. If you can find other users in your area, it is really helpful to collaborate to learn.

Post your questions. This is a wonderful community of very kind and helpful users.

Hi Donna

Thanks for the post...it was imeasurably helpful. In particular the affirmation of our strawmodel timeline. I noted your progression and volume limiters....this is key data I suspect we will use as we build our workplan. One thing still vexes me though....I recevied some help from others who posted to my original MU plea...but am still trying to get my hands wrapped around the following:

Unlike PCP or office (POS 11) practices I am largely a facility (65% POS 21/exempt from CMS MU/EHR demands) 37% POS 31 Hosptial SNF or External SNF specialist. All of the chart detail comes from outside my office, in various forms......so I am working to try and sort out workflow to support transition from paper/faxed supported medical charts to the EHR format. I bill in house using Meedisoft but ti appears linkage between Medisoft and AC is a bit expensive and challenging. Manual demo entry for the patients may be onerous as I see approx 350 new patients annually (very few reats year over)of which 70% are CMS lives.
Based on some extraordinary posting already it appears our MU focus will be on the POS 31 CMS lives for MU but I beleive I should use AC for emr regardless.

I really liked your stepped approach and plan to copy it as we move forward our workplan. I am hoping that out in the user community there are maybe even 1 or 2 specialists that fall into my somewhat unique category of: Hospital and SNF based specialist....whereby 98%+ of all clinical data is created external to the office.

Again my thanks for your comments.....

B/R

Roxanne

Roxanne,
Donna gives excellent and accurate advice, and I am sure you will benefit from it. I certainly agree with what she suggests.
I have answered some of your other questions in response to your PM.

I know, Donna. My question is: can you not to do meaningful use for the first few months of 2012 and still pass when you attest at the end of 2012?

Thanks,

Your FIRST attestation is only required to be 90 days of the 1st calendar year in which you are attesting. You can attest anytime after reaching 90 days of data (provided you have billed out the min approx $24,000 in Medicare allowables).

so you can collect data in 2012 for Jan/Feb/March then attest anytime from the end of March to the end of December or even as late as Feb of 2013!

Or you can collect data for Oct/Nov/Dec and attest at the end of Dec to as late as Feb 2013.

However, SUBSEQUENT years you will be attesting to the entire year.

to answer your question simply, "yes."

I have a question regarding the menu item - checking drug formulary. I went into the Rx write screen and then clicked on the "check drug formulary". A new box dropped down with the patient's drug lists but I did not really know what to do in that window. I closed it and then refilled (e-prescribed) the medication in question in the usual way. In checking the meaningful use report, it appears that there is now a green check mark on that menu item. Does that mean I did what I needed to do? It also says "click to not attest".
Donald Phillips MD Cedar Hill, Texas

Thanks Donna and Adam for helping with this.....I am hoping you may help us confirm the following:

If we deploy and implement this year 2012 with the idea of late year 2012 90 days of data...we can attest at/towards CY end, or even shortly after start of year 2013?. This will satify first year attestation.
However second year 2013 we are required to attest for the full year....this supports the premis your intial momentum towards MU can be sustained correct?

Attestation in 2013 then must meet only the $24k threshold or must we also meet a time threshold such as completing a full CY of MU prior to our attestation for 2013 data.

I am asking so we can help develop some key premises for our workplan. While trying not to get backwards the key criteria.

B/R

Roxanne

This gets a little confusing because "Year 1" is 2011 for some and 2012 for others.

To Cindy's original question: you attested year 1 in 2011, so 2012 is year 2. As Donna says, MU applies for the full 12 months. But I think Cindy knows she has to do this for all 12 months; she is saying that since many of the criteria do not require 100% adherence, maybe you can take a break from the extra clicking and questions for some portion of 2012. So, for example, you have to attest that you have drug interaction checking on for the entire year. 80% of your charts need to have a problem list, medication list, and allergies. But if you do those things routinely, many of the other criteria only have a 50% threshold, so you could "take a few months off" for all of those. I would look at this carefully though because it may vary based on your choices of menu and CQM items.

For Roxanne, year 2 will be 2013. Once again, you must meet the requirements for all 12 months, and attest at the end of that time. Unlike year 1, where people can attest and receive incentive money all year long (as they meet their 90 days), in year 2, I think every one will have to wait until January of the following year to attest.

Exactly, JBS. Thanks for explaining for me. In 2011, I did 3 month (ending Sept.)and got $18000 = $6000/month doing extra (meaningless)clickings. If I continue, Oct. Nov. Dec +12 months in 2012, then I need to do extra clicking for 15 month for $12000; = $800/month. Since most of the bars are not too high and I do some of the cores anyway, can I start extra clicking say, Sept. of 2012 and still passing? trying to outsmart them? The game is based on my judgement: same or maybe better patient care will be achieved by less clicking.

Of course, this is just a joke. I am not actually doing this. But as a way of voice us soloist to the ruler of meaningful use.

JBS provides a great explanation.

My approach is just to periodically run the MU wizard report to be sure that I am on track as I go through the year.

The criteria do not require perfection of clicking every item for every patient.

Roxanne in answer of your questions:


Yes you can attest 2012 CY anytime after the 90 day period is met, and yes you can attest for 2012 in 2013 probably again as late as Feb 2013.

Yes you attest to the full year for each subsequent year of MU participation.
Yes you will certainly be able to maintain momentum toward MU once you have the systems in place to achieve success.

You must meet the $24K threshold (if not you will be paid a fraction of the allowed payment) AND you must meet the time threshold.

Here is a little heads up and the reason why you should jump on this asap: we are currently in stage 1 MU. Stages 2 and 3 get more complicated and thus presumably more difficult to simply jump into at a later stage. You are wise to investigate this immediately, unless you have made a business decision not to participate at all. Again, if you are contemplating getting on the MU Incentive program there is no time like the present.

Donna you raise an excellent point about utilizing the MU wizard.
I placed a recurring appointment into MicroSoft Outlook, so that every Friday at noon I am reminded to run the MU Wizard. I print the report, review the areas of weakness (if any) and can address the matter before I reach a failing status. In this way I feel that I am in control and can forecast a successful year of attestation or a failed year.

Donna & Adam my thanks for your comments. It affirms my Pratice Adminsitrators (PAD) current opinion that in spite of the many hurdles we suspect we will face (as a laregly Facility and not office based practice) we need to set our workplan into gear for stage 1 this year...

Question regarding Stage II and III, if one participates in stage I but finds over time the following stage requirments are either so onerous or time consuming that the practice cannot support it, are there punitive measures or clawbacks of stage I monies......? I ask based on our challenge even with stage I MU CQM that we effectivly will be recontructing our chart based on external data derived from outside facility systems, charts etc....we may be faced with obstacles that make stage II and III prohibitive.

B/R

Roxanne

Adam.BTW...I do like your signature saying. Having gone to RCSI I can appreciate the importance of a pint.

I will not speak on this matter as an absolute authority, but I understand the program is voluntary. Therefore there are no penalties for failing to attest. You simply don't get the money for that year. We in fact have some AC users here who failed attestation and they were not made to pay any penalties.

however, in 2015 when the program is no longer voluntary there will be penalties assessed for failure to attest. No rewards for attestation unless you enrolled within the incentive program-years, simply penalties for failure to meet the goals.

Roxanne (and Leslie),
First keep in mind that this issue is not about stages 1,2, and 3 of MU... it is a matter of which year of the program you are in. You can do as many or as few years of MU as you want. In fact, the money is "front loaded", so that after the first two years, you will have earned $30k of the $44k total, and that might be a reasonable time to stop (the next three years only get you $14k total). You won't have to give that incentive money back, BUT in 2015 the penalties begin for those who do not use an EMR. The penalties are 1%, 2%, and 3% reduction in Medicare collections, respectively for 2015,6, and 7.
No need to be sold like a slave; just take your money and run if you don't think the program's benefits are worth the cost to you.

Interesting that the Amazing Charts Users Conference this year is going to be in NOV 2012, rather than in summer. I guess that is because the level 2 for meaningful use (MU) hasn't been nailed down. I did MU medicare in 2011 for $18K and expect 2012 to get $12K. but 2013 with MU Level 2 may be a lot more difficult for $8K. Will have to see what final rules are but I suspect many doctors will not attest for 2013 level 2. As I mentioned before, one of my primary pharmacies is a military base that has no electronic prescribing. currently the bar is set at 40% and I am at 50% but in 2013 would be like 65% and I can't do that due to the military (government) PHARMACY. Maybe I shouldn't even try?

Isn't it just like the Government to on one hand require you do A, but then on the other hand make it impossible for you to do! I remember under HIPPA initially, all insurance companies had to quit using SS numbers as IDs, this forced a lot of changes and cost on the companies as well as the Physicians office, hospital etc, who had to recollect all pt. data. Many software programs also had to be upgraded to accomodate...yet who still uses SS#, Medicare of course.