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Deadline Looms for ENTs to Put Electronic Health Records to Meaningful Use

by Richard Quinn •

Dr. Koriwchak’s practice was an early adopter, but he understands why there are practices that have taken their time. There are three stages of meaningful use, and only Stage 1 is currently active. EPs, hospitals and critical-access hospitals don’t have to qualify for Stage 2 until next year, and Stage 3 is set to begin in 2016. (See “The ABCs of EHRs,” p. 12). CMS penalties for noncompliance climb to 2 percent of PFS payments in 2016 (based on 2014 reporting data) and max out at 3 percent in 2017 (based on 2015 reporting).

“Now is a good time to look at systems, but don’t panic,” added Dr. Koriwchak. “EMR brings huge cultural and operational changes to your practice. You can’t rush the cultural change, you can’t rush the decision making and you can’t rush the acquisition of necessary skills for the docs and the staff. If you move too fast, you’re going to have an expensive disaster on your hands.”

David Nielsen, MD, executive vice president and chief executive officer of AAO-HNS, said practices must look at meaningful use requirements in the context of the broader, generational health care reform initiatives the federal government is pushing.

Meaningful use “is not being implemented in a vacuum, or even in an otherwise stable system,” he said. “One of the great challenges facing otolaryngologists in complying with [the] requirements is the needed harmonization between multiple ongoing reward/penalty programs through CMS in which they are required to participate. These include electronic prescribing, reporting on quality measures for PQRS and the value-based purchasing modifier being developed, which will require physicians to report on quality and cost in the near future.”

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The ABCs of EHRs

Stage 1 requirements: Eligible professionals (EPs) must report on 20 to 25 meaningful use objectives to qualify for an incentive payment. Fifteen core objectives are required, with an additional five or more chosen from a list of 10 set objectives. EPs must also report six clinical quality measures (CQM) from a list of 44 choices. EPs must report three measures from the Core and Alternate Core choices, along with three additional measures, chosen from 38 other CQMs.

Stage 2 requirements: EPs must report 17 core objectives and three of six menu objectives—or qualify for an exclusion—to successfully attest to meaningful use. EPs must also report on nine CQMs out of a list of 64, in addition to the core and menu objectives. EPs have the choice of reporting via the Physician Quality Reporting System (PQRS).