A Guide To Achieving CMS ‘Meaningful Use’ Standards

Start Page: 74
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Author(s): 
Jonathan J. Key, DPM, FACFAS

   I became familiar with meeting the measure of an objective and calculating a percentage based on numerators and denominators for each objective. The numerator is the number of patients for whom the practice met the objective. The denominator is the total number of patients for whom the practice could have met the objective. Ultimately, these numbers give a percentage by which one can meet Meaningful Use. Certain percentages for the first year have been preset for each core set and menu set objective. I learned about qualifying for exclusions to objectives and finally a new word (“attestation“) came into play.

Overcoming Implementation Hassles

I began scratching my head and asking why I had to meet certain objectives like taking vital signs and recording height, weight and blood pressures. I quickly realized I had embarked on a very arduous, time-consuming task. What happened to simple? Wasn’t an EHR supposed to make my life easier, more efficient, paperless, get me out of the office earlier, allow me to see more patients and cut down on staffing?

   I found it even more entertaining to ask my colleagues, especially from other specialties, what they were doing to meet Meaningful Use and what their game plan was with reference to implementing a certified EHR. Most looked at me like I was from the planet Mars and asked what I was talking about.

   Now let me clarify. Utilizing an EHR solely as a functional piece of software for charting is much different than utilizing an EHR and successfully achieving Meaningful Use. This became more and more clear as I began utilizing the EHR in an effort to achieve Meaningful Use. Luckily, the program I chose, CareTracker, has a Meaningful Use “dashboard.” This allowed me to monitor my core set and menu set objectives daily to see if I was meeting the minimum requirements in order to attest and qualify successfully for the year one financial incentive.

   Shortly after signing up with Ingenix, I was assigned an implementation team that included separate specialists/trainers for the practice management portion of the program and a specialist for the EHR. I did not realize it at the time but my implementation specialist, Deidre Robinson, would later play a particularly vital role in making this transition as well as attempting to meet Meaningful Use successfully.

   Our training initially entailed watching videos online and subsequently participating in webinar training sessions with our implementation specialist. When I say “our,” I am referring to my entire staff from my medical assistant to my practice manager. Prior to this venture, little did I know that not only would I be trained on how to use the program but my staff would become just as important with the utilization of the program, especially with meeting Meaningful Use. I quickly learned that meeting Meaningful Use was a team effort rather than an individual achievement.

   So I was off and running and started using CareTracker in February 2011. The first available attestation date was April 2011, so one would have to have been meeting Meaningful Use for the previous 90 days starting in January 2011. I spoke with and at the very minimum e-mailed Deidre daily. She was constantly available and monitored my progress remotely paying close attention to every detail of my utilization of CareTracker. I realized if there is not constant monitoring and you are not meeting a core set objective or menu set objective, it may not be recognized in a timely manner. Several hundred patient visits could go by prior to this being flagged. Certainly, this could negatively impact the numerator and denominator numbers. These numbers are ultimately what are reported during the attestation process to CMS.

In Conclusion

I quickly realized meeting the criteria for Meaningful Use was going to be extremely difficult for physicians as a whole. By mid-May, approximately 150 physicians had successfully attested out of roughly 660,000 physicians and surgeons in the U.S.

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