Examine the implications of ethical, legal, and regulatory policy issues on health care information systems.

Case Study, Stage 3: Meeting Meaningful Use Requirements

Before you begin this assignment, be sure you have read the “UMUC Family Clinic Case Study”, the syllabus readings for Week 3, which discuss meaningful use and reporting requirements, and your graded work (with any feedback received) for the previous stages of this case study.

Purpose of this Assignment

This assignment gives you the opportunity to learn about the regulatory requirements governing meaningful use and the financial incentives that the government offers to providers and healthcare institutions that meet meaningful use in order to improve the quality of care in the United States.  It will require you to do more external research beyond the textbook. Since your textbook is older than the information on the Centers for Medicaid and Medicare Services (CMS) website, your source of information will primarily be the CMS website. This assignment addresses the following course outcomes to enable you to:

  • Evaluate the organizational environment in the health care industry to recognize how technology solutions enable strategic outcomes
  • Evaluate technology solutions in the health care industry to improve the quality of care, safety, and financial management decisions.
  • Examine the implications of ethical, legal, and regulatory policy issues on health care information systems.

Achieving Meaningful Use Stage 1

According to the statute, meaningful use (MU) will be defined in at least 3 stages. As of this date, MU Stage 1 and MU Stage 2 have been published.  For the purpose of the case study, we will only focus on achieving MU Stage 1.

For your Stage 2 Project, you proposed a certified EHR system to improve a business process at the UMUC Family Clinic. The implementation of a certified EHR system will help the Clinic achieve meaningful use in order to qualify for the financial incentives available.  In this assignment, you will provide the Clinic with a report that will recommend which incentive program to apply for and help them understand the reporting requirements of meaningful use.

As the EHR consultant, you realize that there is more than one EHR Incentive Program for meaningful use: at the federal level is the Medicare Incentive Program, and at the state-level are the Medicaid Incentive Programs.  States and Territories participate on a voluntary basis.

There is a restriction that a health care provider can apply for only one incentive program.  To achievemeaningful use you will need to decide on which incentive program to pursue: the Medicaid or the Medicare Incentive program.  You will need to do more external research on the CMS website at:

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html

The requirements to achieve meaningful use Stage 1 involve some attestation and some reporting requirements of core and menu objectives, which can be found at the URL above for “meaningful use”.

In addition, to the core and menu objectives, eligible professionals will also need to report on clinical quality measures (CQM). Beginning in 2014, the reporting of clinical quality measures (CQMs) have changed for all providers. More information can be found at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_MeasuresTable_Posting_CQMs.pdfFurthermore, per CMS, eligible professionals must report on 9 of the 64 approved Clinical Quality Measures (CQMs), with a requirement that the selected CQM cover at least 3 of the national quality strategy domains. CMS promotes a list of Recommended Core CQMS, which are optional.

Assignment

Using the Complete EHR technology system you proposed in Stage 2, you should briefly explain it and then copy the 4 tables below and complete the remaining columns.  For each area of the core objectives, menu objectives, and CQM, provide a brief explanation, a minimum of two sentences for each, to justify the selection.  Explanations must provide enough information to convey the reasoning behind the selection.  You may copy the objectives, measures, and other parts of the tables from the CMS source documents, but you must use your own words to demonstrate your understanding of the measure of the objective/CQM as you provide in your explanations.

 

 

You must include at least one external source, a source other than the textbook and other materials provided in class.  Remember to correctly cite and reference your sources with APA format.  Use the Grading Rubric to be sure you have covered everything.  Submit your paper with answers to parts 1 through 4 below via your Assignment Folder as a Microsoft Word document with your last name included in the filename (LASTNAME_Stage3).

 

Part 1: Briefly explain which incentive program you recommend that the medical practice pursue and provide a table similar to the below with the detailed expected incentives for the clinic for the duration of the program. Click on the upper left corner of the table to copy it into your paper.

 

Table 1:  Incentive Program and Amounts
Payment Amounts If the practice – as aMedicare eligible Professional – Qualifies to Receive First Payment in 2014
Payment Amount will be in 2014 $12,000
Payment Amount will be in 2015 $ 8,0000
Payment Amount will be in 2016 …..
Total Payment Amount will be $$$$$

 

Identify which incentive program you recommend for the practice, how much the practice is expected to receive – if it complies for the duration of the program – detailing individual year amounts, followed by the total. The table is an example if you were to recommend the MedicareIncentive program. Please adapt the table to the incentives program that you will recommend for the practice.

 

Before you begin the following Part 2 and Part 3:

Please review ONLY the core and menu objectives in the document “MU_Stage1_ReqOverview” posted in Content>Course Resources and available at the following URL:https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/MU_Stage1_ReqOverview.pdf

Do not use the above PDF for Part 4 of this assignment as the CQM information in it is not valid for 2014. In Part 4, the instructions provide you with the link to the updated 2014 CQM Reporting Guidelines.

 

For the Clinic in this case study, you should use the sections of MU that apply to “eligible professionals” (EP) vs. hospitals.

 

Part 2:  Table detailing the Core Objectives that you recommend that the UMUC Family Clinic report.  In the document above, you will find the list of 15 Core Objectives.  These are followed by several pages showing the “Stage 1 Core Set Objectives.”  You should select 15 Stage 1 Objectives and corresponding Stage 1 Measures that will be collected by the EHR you have selected in your Stage 2 project.  Then, you should explain for each one how the objective will be met at the UMUC Family Clinic using the EHR you have proposed for them.  15 entries are required, and an example for one entry is provided below (it may or may not be included in your selected EHR system).  Click on the upper left corner of the table to copy it into your paper.

 

Table 2
Count Stage 1 CoreObjective Measure Explanation of how the objective will be met at the UMUC Family Clinic using the selected EHR(minimum of 2 sentences each)
1 Record and chart vital signs: height, weight, blood pressure, calculate and display BMI, plot and display growth charts for children 2-20 years, including BMI For more than 50% of all unique patients age 2 and overseen, height, weight, and blood pressure are recorded as

structured data

 

Since the clinic is a family medical practice, this is information that is already being captured in the workflow and will be entered in the EHR during the visit. At reporting, the EHR system will automatically extract the percentage satisfying this measure.
2
..
15

 

Part 3:  Table detailing the recommended Menu Objectives that you recommend that the UMUC Family Clinic report.  In the document referred to above, you will find the list of 10 Menu Objectives.  These are followed by several pages showing the “Stage 1 Menu Set Objectives.”  You should select 5 Stage 1 Objectives and corresponding Stage 1 Measures that will be collected by the EHR you have selected in your Stage 2 project.  5 entries are required, and an example for one entry is provided below (it may or may not apply to your selected EHR system).  Click on the upper left corner of the table to copy it into your paper.

 

Table 3
Count Stage 1 MenuObjective Measure Explanation of how the objective will be met at the UMUC Family Clinic using the selected EHR(minimum of 2 sentences each)
1 Implement drug formulary checks.  The Clinic has enabled thisfunctionality and has access to at least one internal or external drug formulary for the entire EHR reporting

period

 

All that needs to be done is to ask the EHR vendor to enable this functionality and to have access to at least one internal or external formulary for the entire EHR reporting period. Then at reporting attest to “Yes”
2
..
5

 

 

Before you begin the following Part 4:

Please review the list of the clinical quality measures (CQM) in the document “EP_MeasureTables Posting CQMs” posted in Content>Course Resources and available at the following URL:http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_MeasuresTable_Posting_CQMs.pdf

 

Part 4:  Table detailing the recommended Clinical Quality Measures (CQM) that you recommend that the UMUC Family Clinic report.  In the document referred to above, you will find a list of the CQMs, including their eMeasure ID, Title and Domain.  You should select 6 CQMs, one from each of the 6 domains listed on the first page of the document.  6 entries are required, and an example for one entry is provided below (it may or may not apply to the EHR system you selected). Click on the upper left corner of the table to copy it into your paper.

 

Table 4
Count CMS eMeasure ID CQM Measure Title Domain Explanation of how the objective will be met at the UMUC Family Clinic using the selected EHR(minimum of 2 sentences each)
1 CMS117v1  Childhood Immunization Status  Population/Public Health Using the EHR system to record the vaccines will capture the needed information.  A report will be generated from the EHR at the end of the reporting period.
2
..
6

 

GRADING RUBRIC:

 

Attribute Full Points Partial Points No points Possible Points Points Earned
Part I Incentive Program Selection Explanation of incentive program selected reflects critical thinking and is convincing. Table of incentives is complete and accurate. Explanation of incentive program and/or the table presented is adequate or may be incomplete. No incentive program selected and Table 1 is not provided. 18
Core Objectives Selection of 15 core objectives is appropriate to the case study; explanations provided demonstrate understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking. Core objectives are adequately explained, or some selected core objectives are not linked to the case study, and/or may not demonstrate understanding of course concepts, meaningful use reporting requirements, analysis, and/or critical thinking. Table 2 not provided. 30 

(2 points each)

 

Menu Objectives with explanations 5 menu objectives are appropriate to the case study; explanations provided demonstrate understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking. Menu objectives adequately explained, or some menu objectives are not linked to the case study, and/or may not demonstrate understanding of course concepts, meaningful use reporting requirements, analysis, and/or critical thinking. Table 3 not provided. 10 

(2 points each)

 

Clinical Quality Measures 6 CQMs, one from each domain, are appropriate to the case study; with explanation provided and demonstrates understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking. CQMs adequately explained, or some CQMs are not linked to the case study; may be duplicate domain, and/or may not demonstrate understanding of course concepts, meaningful use reporting requirements, analysis, and/or critical thinking. Table 4 not provided 12 

(2 points each)

 

Table Format Information is professionally presented; uses correct sentence structure, grammar, and spelling. Information is adequately presented, or may not be professionally presented, and/or contains grammar and/or spelling errors. Information is extremely poorly written and does not convey the information. 15
External Research At least one source other than the textbook and the materials provided in class is incorporated and used effectively. Source(s) used are relevant and timely and contribute to the analysis and support conclusions. Correct APA format is used for citations and References. A source other than the textbook or class materials may be used, but is not properly incorporated or used to contribute to the analysis or support conclusions, and/or is not effective or appropriate and/or is not relevant or timely, and/or APA format for citations and references is not followed. No external research is incorpor
ated
15
TOTAL Points 100
100 points =15% of final course grade 

Points Recorded

(total points x .15)

 

Attachments:

Case Study, Stage 3: Meeting Meaningful Use Requirements

Before you begin this assignment, be sure you have read the “UMUC Family Clinic Case Study”, the syllabus readings for Week 3, which discuss meaningful use and reporting requirements, and your graded work (with any feedback received) for the previous stages of this case study.

Purpose of this Assignment

This assignment gives you the opportunity to learn about the regulatory requirements governing meaningful use and the financial incentives that the government offers to providers and healthcare institutions that meet meaningful use in order to improve the quality of care in the United States.  It will require you to do more external research beyond the textbook. Since your textbook is older than the information on the Centers for Medicaid and Medicare Services (CMS) website, your source of information will primarily be the CMS website. This assignment addresses the following course outcomes to enable you to:

  • Evaluate the organizational environment in the health care industry to recognize how technology solutions enable strategic outcomes
  • Evaluate technology solutions in the health care industry to improve the quality of care, safety, and financial management decisions.
  • Examine the implications of ethical, legal, and regulatory policy issues on health care information systems.

Achieving Meaningful Use Stage 1

According to the statute, meaningful use (MU) will be defined in at least 3 stages. As of this date, MU Stage 1 and MU Stage 2 have been published.  For the purpose of the case study, we will only focus on achieving MU Stage 1.

For your Stage 2 Project, you proposed a certified EHR system to improve a business process at the UMUC Family Clinic. The implementation of a certified EHR system will help the Clinic achieve meaningful use in order to qualify for the financial incentives available.  In this assignment, you will provide the Clinic with a report that will recommend which incentive program to apply for and help them understand the reporting requirements of meaningful use.

As the EHR consultant, you realize that there is more than one EHR Incentive Program for meaningful use: at the federal level is the Medicare Incentive Program, and at the state-level are the Medicaid Incentive Programs.  States and Territories participate on a voluntary basis.

There is a restriction that a health care provider can apply for only one incentive program.  To achieve meaningful use you will need to decide on which incentive program to pursue: the Medicaid or the Medicare Incentive program.  You will need to do more external research on the CMS website at:

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html

The requirements to achieve meaningful use Stage 1 involve some attestation and some reporting requirements of core and menu objectives, which can be found at the URL above for “meaningful use”.

In addition, to the core and menu objectives, eligible professionals will also need to report on clinical quality measures (CQM). Beginning in 2014, the reporting of clinical quality measures (CQMs) have changed for all providers. More information can be found at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_MeasuresTable_Posting_CQMs.pdfFurthermore, per CMS, eligible professionals must report on 9 of the 64 approved Clinical Quality Measures (CQMs), with a requirement that the selected CQM cover at least 3 of the national quality strategy domains. CMS promotes a list of Recommended Core CQMS, which are optional.

Assignment

Using the Complete EHR technology system you proposed in Stage 2, you should briefly explain it and then copy the 4 tables below and complete the remaining columns.  For each area of the core objectives, menu objectives, and CQM, provide a brief explanation, a minimum of two sentences for each, to justify the selection.  Explanations must provide enough information to convey the reasoning behind the selection.  You may copy the objectives, measures, and other parts of the tables from the CMS source documents, but you must use your own words to demonstrate your understanding of the measure of the objective/CQM as you provide in your explanations.

 

 

You must include at least one external source, a source other than the textbook and other materials provided in class.  Remember to correctly cite and reference your sources with APA format.  Use the Grading Rubric to be sure you have covered everything.  Submit your paper with answers to parts 1 through 4 below via your Assignment Folder as a Microsoft Word document with your last name included in the filename (LASTNAME_Stage3).

 

Part 1: Briefly explain which incentive program you recommend that the medical practice pursue and provide a table similar to the below with the detailed expected incentives for the clinic for the duration of the program. Click on the upper left corner of the table to copy it into your paper.

 

Table 1:  Incentive Program and Amounts
Payment Amounts If the practice – as aMedicare eligible Professional – Qualifies to Receive First Payment in 2014
Payment Amount will be in 2014 $12,000
Payment Amount will be in 2015 $ 8,0000
Payment Amount will be in 2016 …..
Total Payment Amount will be $$$$$

 

Identify which incentive program you recommend for the practice, how much the practice is expected to receive – if it complies for the duration of the program – detailing individual year amounts, followed by the total. The table is an example if you were to recommend the Medicare Incentive program. Please adapt the table to the incentives program that you will recommend for the practice.

 

Before you begin the following Part 2 and Part 3:

Please review ONLY the core and menu objectives in the document “MU_Stage1_ReqOverview” posted in Content>Course Resources and available at the following URL: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/MU_Stage1_ReqOverview.pdf

Do not use the above PDF for Part 4 of this assignment as the CQM information in it is not valid for 2014. In Part 4, the instructions provide you with the link to the updated 2014 CQM Reporting Guidelines.

 

For the Clinic in this case study, you should use the sections of MU that apply to “eligible professionals” (EP) vs. hospitals.

 

Part 2:  Table detailing the Core Objectives that you recommend that the UMUC Family Clinic report.  In the document above, you will find the list of 15 Core Objectives.  These are followed by several pages showing the “Stage 1 Core Set Objectives.”  You should select 15 Stage 1 Objectives and corresponding Stage 1 Measures that will be collected by the EHR you have selected in your Stage 2 project.  Then, you should explain for each one how the objective will be met at the UMUC Family Clinic using the EHR you have proposed for them.  15 entries are required, and an example for one entry is provided below (it may or may not be included in your selected EHR system).  Click on the upper left corner of the table to copy it into your paper.

 

Table 2
Count Stage 1 Core Objective Measure Explanation of how the objective will be met at the UMUC Family Clinic using the selected EHR(minimum of 2 sentences each)
1 Record and chart vital signs: height, weight, blood pressure, calculate and display BMI, plot and display growth charts for children 2-20 years, including BMI For more than 50% of all unique patients age 2 and overseen, height, weight, and blood pressure are recorded as

structured data

 

Since the clinic is a family medical practice, this is information that is already being captured in the workflow and will be entered in the EHR during the visit. At reporting, the EHR system will automatically extract the percentage satisfying this measure.
2
..
15

 

Part 3:  Table detailing the recommended Menu Objectives that you recommend that the UMUC Family Clinic report.  In the document referred to above, you will find the list of 10 Menu Objectives.  These are followed by several pages showing the “Stage 1 Menu Set Objectives.”  You should select 5 Stage 1 Objectives and corresponding Stage 1 Measures that will be collected by the EHR you have selected in your Stage 2 project.  5 entries are required, and an example for one entry is provided below (it may or may not apply to your selected EHR system).  Click on the upper left corner of the table to copy it into your paper.

 

Table 3
Count Stage 1 Menu Objective Measure Explanation of how the objective will be met at the UMUC Family Clinic using the selected EHR(minimum of 2 sentences each)
1 Implement drug formulary checks.  The Clinic has enabled thisfunctionality and has access to at least one internal or external drug formulary for the entire EHR reporting

period

 

All that needs to be done is to ask the EHR vendor to enable this functionality and to have access to at least one internal or external formulary for the entire EHR reporting period. Then at reporting attest to “Yes”
2
..
5

 

Before you begin the following Part 4:

Please review the list of the clinical quality measures (CQM) in the document “EP_MeasureTables Posting CQMs” posted in Content>Course Resources and available at the following URL: http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_MeasuresTable_Posting_CQMs.pdf

 

Part 4:  Table detailing the recommended Clinical Quality Measures (CQM) that you recommend that the UMUC Family Clinic report.  In the document referred to above, you will find a list of the CQMs, including their eMeasure ID, Title and Domain.  You should select 6 CQMs, one from each of the 6 domains listed on the first page of the document.  6 entries are required, and an example for one entry is provided below (it may or may not apply to the EHR system you selected). Click on the upper left corner of the table to copy it into your paper.

 

Table 4
Count CMS eMeasure ID CQM Measure Title Domain Explanation of how the objective will be met at the UMUC Family Clinic using the selected EHR(minimum of 2 sentences each)
1 CMS117v1  Childhood Immunization Status  Population/Public Health Using the EHR system to record the vaccines will capture the needed information.  A report will be generated from the EHR at the end of the reporting period.
2
..
6

 

GRADING RUBRIC:

 

Attribute Full Points Partial Points No points Possible Points Points Earned
Part I Incentive Program Selection Explanation of incentive program selected reflects critical thinking and is convincing.  Table of incentives is complete and accurate. Explanation of incentive program and/or the table presented is adequate or may be incomplete. No incentive program selected and Table 1 is not provided. 18
Core Objectives Selection of 15 core objectives is appropriate to the case study; explanations provided demonstrate understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking. Core objectives are adequately explained, or some selected core objectives are not linked to the case study, and/or may not demonstrate understanding of course concepts, meaningful use reporting requirements, analysis, and/or critical thinking. Table 2 not provided. 30 

(2 points each)

 

Menu Objectives with explanations 5 menu objectives are appropriate to the case study; explanations provided demonstrate understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking. Menu objectives adequately explained, or some menu objectives are not linked to the case study, and/or may not demonstrate understanding of course concepts, meaningful use reporting requirements, analysis, and/or critical thinking. Table 3 not provided. 10 

(2 points each)

 

Clinical Quality Measures 6 CQMs, one from each domain, are appropriate to the case study; with explanation provided and demonstrates understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking. CQMs adequately explained, or some CQMs are not linked to the case study; may be duplicate domain, and/or may not demonstrate understanding of course concepts, meaningful use reporting requirements, analysis, and/or critical thinking. Table 4 not provided 12 

(2 points each)

 

Table Format Information is professionally presented; uses correct sentence structure, grammar, and spelling. Information is adequately presented, or may not be professionally presented, and/or contains grammar and/or spelling errors. Information is extremely poorly written and does not convey the information. 15
External Research At least one source other than the textbook and the materials provided in class is incorporated and used effectively.  Source(s) used are relevant and timely and contribute to the analysis and support conclusions.  Correct APA format is used for citations and References. A source other than the textbook or class materials may be used, but is not properly incorporated or used to contribute to the analysis or support conclusions, and/or is not effective or appropriate and/or is not relevant or timely, and/or APA format for citations and references is not followed. No external research is incorporated 15
TOTAL Points 100
100 points =15% of final course grade 

Points Recorded

(total points x .15)

 

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