VersaForm and MU
In order to receive the $44,000 (Medicare) or $64,000 (Medicaid) incentive payments, “meaningful use” must be made of your Certified EHR software. The initial parameters included 15 required and 10 elective Meaningful Use Objectives, each with its Measure. Below we describe how VersaForm EHR Certified helps you to achieve these objectives and to prove it.
Meaningful Use Required (“Core”) Measures
- Use CPOE for medication orders. You must use CPOE (Computerized Provider Order Entry) to enter at least one medication in a patient's medication list. This must be done for more than 30% of all your patients who have at least one medication order.
Method: When you enter medications in VersaForm EHR Certified, the information appears automatically on the patient’s medication list. This is true for all prescriptions, whether electronic or printed.
- Implement drug-drug and drug-allergy interaction checks.
Method: VersaForm EHR Certified performs the checks when you enter prescriptions. When applying for the incentive payments, you just certify that this feature was turned on. In VersaForm, it’s always on.
- Record at least one problem, or indicate “no known problems”, for more than 80% of your patients.
Method: Simply document patients’ problems (i.e., diagnoses) in VersaForm EHR Certified; the program does the counting automatically.
- Transmit electronically more than 40% of permissible prescriptions.
Method: VersaForm eRx transmits permissible prescriptions electronically and keeps track automatically.
- Record at least one medication (or indicate that there are none) for more than 80% of all patients seen.
Method: This is an automatic byproduct of VersaForm eRx. but you must note discontinuances and “no meds” as well.
- Record at least one medication allergy (or indicate that there are none) for more than 80% of patients seen.
Method: You or your staff must ask your patients if they have a history of adverse drug reactions or if they are allergic to any medications, and record the result.
- Record the demographics of more than 50% of all your patients.
Method: There are a few new demographics fields. As each patient is seen, have his or her record updated to include Preferred Language, Gender, Race, Ethnicity, and Date of Birth.
- Record vital signs for more than 50% of all your patients age 2 and over. Height, weight, and blood pressure are recorded as structured data.
Method: VersaForm EHR Certified makes it easy to record the data. There are exclusions for providers who see no patients 2 years or older or who believe that all three vital signs have no relevance to their scope of practice.
- Record the smoking status of more than 50% of patients 13 years old or older.
Method: This information is entered into the Demographics screen.
- Report ambulatory clinical quality measures to CMS.
Method: VersaForm EHR Certified computes these for you based on your recorded patient data; there is no extra effort needed to collect or compute the data. At present, this data is reported by attestation, but when the government is ready to receive the data electronically, VersaForm will send it.
Note: As of 2013, this is no longer included as an objective, although it is still required.
- Implement one clinical decision support rule.
Method: This is an automatic VersaForm EHR Certified function. You specify what you want to be reminded of, and VersaForm EHR Certified will pop up a reminder when it is appropriate. VersaForm EHR Certified comes with several pre-set decision supports (for instance, a reminder to check certain items for patients with diabetes) that you can use as is or modify.
- Provide an electronic copy of a patient's health information record within 3 business days of a request for more than 50% of those patients who request one.
Method: VersaForm EHR Certified has a new function that can produce a standard electronic document, called a Continuity of Care Document (CCD). The CCD contains a list of the patient’s problems, medications, allergies, and lab results. Diagnostic results that have not been reviewed are excluded, as are any results that you have marked as not to be released. The document is designed so it can be read by a computer or by a person. When a patient requests an electronic copy of their health information, click the button on the chart and a CCD will be produced. It can be written to a flash drive, to a CD, or sent by secure email to the patient. You can do it on the spot. VersaForm EHR Certified will track the request and its fulfillment.
- Provide clinical summaries within 3 business days for more than 50% of all office visits.
Method: Print a CCD, using the same button as above.
- Perform at least one test of the EHR technology’s capacity to electronically exchange key clinical information.
Method: Produce a CCD and have VersaForm EHR Certified email it securely to any provider or institution listed in your Referring Providers table. You must try this at least once. The test does not have to be successful.
Note: As of 2013, this is no longer included as an objective.
- Protect electronic health information created or maintained by the EHR technology through the implementation of appropriate technical capabilities.
Method: The practice must conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308(a)(1). This is the HIPAA Security Risk Analysis, which requires the practice to assess the security risks to data it holds. For more information on the HIPAA Security Rule, see: http://www.hhs.gov/ocr/privacy/hipaa/understanding/srsummary.html. The review must be performed by or on behalf of the practice; it is not done by software. Government guidelines are available at the following website: http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__privacy___security_framework/1173. See Security Information for useful documents we have compiled. When you apply for the incentive payments, the review must be attested to. However, it is just an annual or one-time event, not a regular workload.
Meaningful Use Elective (“Menu”) Measures
NOTE: Choose 1 of the first 2 and 4 of the last 8.
- Perform at least one test of the EHR's capacity to submit electronic data to immunization registries, with follow-up submission if the test is successful.
Method: When you request it, VersaForm EHR Certified creates an electronic file with the required information. Only a test is required at this time, as there is no standard way to submit immunization data yet. It has always been state-by-state, and we can hope that the various governments get their acts together. In the meantime, the most that can be asked of the provider is a test. There is an exclusion if none of the immunization registries to which the provider submits such information can receive the information electronically, and another exclusion if the provider doesn’t perform immunizations.
- Perform at least one test of the EHR’s capacity to provide electronic syndromic surveillance data to public health agencies, with follow-up submission if the test is successful.
Method: When you request it, VersaForm EHR Certified creates an electronic file with the required information. Only a test is required at this time, as there is no standard way to submit syndromic data to public health agencies; thus the most that can be asked of the provider is a test.
There is an exclusion if a provider does not collect any reportable syndromic information on their patients during the reporting period, or if no public health agency to which the provider submits such information can receive the information electronically.
- Enable drug formulary checks and show that you have access to at least one formulary for the entire EHR reporting period.
Method: Once insurance plans are set up with their respective formularies, VersaForm Electronic Prescribing automatically performs formulary checks. Staff must add the formulary choice when setting up an insurance plan. There is no impact on day-to-day workflow.
- Record more than 40% of all clinical lab test results ordered by the provider during the EHR reporting period that are either in a positive/negative or numerical format.
Method: The best way to satisfy this objective is to have lab results sent to your system electronically. VersaForm EHR Certified can read the report that the lab sends and put the data in the chart automatically. You get results faster, with abnormals flagged, and nothing has to be entered by hand. The lab data in the system can then be used for recalls or clinical decision support rules, and automatically goes into the CCDs used for communication with other providers.
A provider who orders no lab tests with results in these formats is excluded from this requirement.
- Generate at least one report listing patients who have a specific condition.
Method: This is a reporting facility that is built in to VersaForm EHR Certified. You can generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach. VersaForm EHR Certified can test not only patient problems, but also allergies, lab results below or above a certain value, medications taken, immunizations, age and sex.
- Send an appropriate reminder to more than 20% of all patients 65 years or older, or 5 years old or younger, during the EHR reporting period.
Method: VersaForm EHR Certified can not only print a list of patients to be contacted, it can print or email the letters.
Providers who have no patients 65 years old or older, or 5 years old or younger, are excluded from this requirement.
- Provide timely (within 4 business days) electronic access to patients' health information to at least 10% of patients seen by the provider, subject to the provider’s discretion to withhold certain information.
Method: VersaForm EHR Certified sends a secure message (containing the CCD, see #12 above) to the patient, who can then read it online. All you need to make this work is the patient's email address.
- Provide patient-specific education resources to more than 10 % of all unique patients seen by the provider.
Method: VersaForm EHR Certified has two types of education resources: 1) Medication education is available in English and numerous other languages when prescribing; and 2) Problem- and diagnostic-oriented information can be displayed and printed from the patient chart at any time.
There is no time limit, and the patient does not have to ask for the information.
- Perform medication reconciliation for more than 50% of transitions of care in which the patient is transitioned into the care of the provider.
Method: When a CCD is received from another provider, VersaForm EHR Certified can extract the medication information from the CCD and present a side-by-side comparison with the medications recorded in the EHR. From this, it is easy to select which medications should remain in the patient’s chart and which should be corrected or added.
- Provide a summary of care record for more than 50% of transitions of care and referrals.
Method: VersaForm EHR Certified sends a secure message or a file (containing the CCD, see #12 above) to the other provider, who can then read it online. All you need to make this work is the other provider's email address.