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ACOs Hope for the Best, Expect the Unexpected

DELL-Rick R — Mon, 04 Jun 2012 16:33:55 GMT

By Ken Fody, Esq. and Richard Richel, MBA

Accountable Care Organizations (ACOs) are generating news and interest as a result of the 2010 Affordable Care Act. ACOs are quickly being put in place with 27 already in operation and another 150 organizations awaiting approval to begin July 1.

ACOs are intended to promote higher quality care and lower costs than the existing fee for services system. But before working with an ACO, it’s important to have a strategy and plan in case they do not provide the expected results, or if some fail.

The Centers for Medicare & Medicaid Services (CMS) and health plans offer ACOs a percentage of savings in exchange for the ACO’s effective management of patients within their provider networks. This type of arrangement commonly involves risk-sharing, including the risk of sharing of profits and as well as losses. It is prudent for ACOs that desire to succeed in this environment to have a business strategy in place that allows them to cover the cost of running the organization for at least 18 months without a steady revenue stream until (hopefully) a surplus is declared and distributed.

The primary question to ask prior to creating or working with an ACO is what happens if the ACO’s share of the savings incurred by the ACO does not cover its costs, or in a worst case scenario: no savings are generated? How will an ACO deal with losses? Secondarily, what happens if the profits of the ACO are not sufficient to reward the participating providers who will likely see a reduction in their revenues? What if the method of distributing any surplus fails to meet expectations? If ACOs do not deliver financial rewards to providers, the result could put doctors and hospitals in serious financial trouble.

History provides a possible scenario of not achieving intended savings with Health Maintenance Organizations (HMOs). During the 1990s, risk contracting arrangements between HMOs and provider organizations were common, but merely shifting responsibility to physicians and hospitals through contract arrangements was not always successful. Many Physician-Hospital Organizations (PHOs) and Independent Practice Association (IPA) groups that could not manage risk suffered financial difficulty. Instead, providers and state officials typically looked to health plans to spend more money to solve the problem.

Recommendations for Payers

Payers need to be prepared for the likely event that some ACOs will not succeed. Here are a few suggested strategies that payers should consider that may help improve the odds of long-term success:

1. Develop a budget for the ACO and closely monitor both operational and capital expenditures. Look into the possibility of purchasing ACO reinsurance, if available.

2. Monitor the financial performance of the ACO closely. Identify costly patients closer to real-time and alert the ACO so they can ensure better management of care. Also, put procedures in place to communicate with the ACO if savings are not being realized at the anticipated rate.

3. Have your own contingency plan for what to do when an ACO does not produce the intended results and complaints start coming in front of providers and members. Consider whether the ACO will provide a financial lifeline or some other support. Determine whether members will be allowed to opt-out of the ACO and providers to either dropout or change to another ACO.

The majority of articles written to date about ACOs have been very positive. However, by having a strategy for working with ACOs, health plans will be prepared for numerous possible outcomes.

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Bridging the Great Divide to Achieve Meaningful Use Stage 2 – Part 3 of 3

DELL-Paul Ro — Mon, 04 Jun 2012 16:29:00 GMT

By Angela Reed and Paul Rosenbluth

Perhaps the most significant changes to Meaningful Use in Stage 2 are related to health information exchange and access to information. The proposed regulations are putting more emphasis on making information available to the external stakeholder, including patients and other caregivers.

This controversial initiative is reflected in several core objectives, including:

· Ongoing transmission of health data (rather than the previous single test) to immunization registries and public health agencies. There are three separate objectives, one each for immunizations, reportable lab results and syndromic surveillance data. Syndromic surveillance is a menu for eligible professionals (EPs).

· Electronic transmission of a summary of care record to an entity not using the same certified technology

· Providing patients access to health records with the ability to view on-line, download and transmit to a third party

EPs have additional objectives related to the transmission of data, a core objective for secure electronic messaging and menu objectives for identifying and reporting cases to a cancer registry and a “specialized registry other than a cancer registry”.

The Centers for Medicare and Medicaid Service (CMS) clearly states that while the use of physical media, such as USB drives, satisfies the download requirements, it does not satisfy the transmission requirements. There is already much discussion as to how a provider could track or achieve the threshold related to a patient independently transmitting data.

While more information is to be published, it is important to note that CMS is acknowledging the fact that too many entities are currently relying on costly and complex interfaces to achieve transmission of data. At this point in time, hospitals can transmit via any transport standard such as HL7, which is the only acceptable way to transmit the public health measure data, or File Transfer Protocol (FTP) to meet the objectives. However, the intent is to implement a common transport standard and to that end, the Office of the National Coordinator for Health Information Technology (ONC) is proposing certain transmission protocols in the certification criteria for electronic health records.

For the objective related to patient access to health records, the means by which the hospital grants such access is left to the institution’s discretion, such as hosting a portal or contracting with a vendor to host a portal. Many Electronic Medical Record (EMR) vendors include portals as a component of the software.

As procedurally required, CMS has invited public commentary on the proposed rule. However, given the extensive rationales provided, it is not anticipated that there would be significant changes to the final rule.

The biggest issues around this part of the rule revolve around security (specifically encrypting data at rest, which can be very challenging to maintain the needed system performance) and enforcing the use of the data made electronically available for patients. Caregivers have little control over getting patients to use these new mechanisms to access their records.

Expanded and robust strategies for incorporating technology with processes are key to achieving success for these criteria.

The public comment period on the CMS proposed rule and the ONC proposed rule closed on May 7^th.

Click to view Part 1 and Part 2.

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Summary of Benefits Coverage: What do health plans do now?

DELL-Ken F — Mon, 04 Jun 2012 16:16:00 GMT

By Ken Fody, Esq. and Rick Richel, MBA

The Affordable Care Act includes a requirement that health plans and self-funded groups must provide a Summary of Benefits and Coverage document (SBC) to all enrolled members and anyone else who asks for it. The purpose of the SBC is to provide individuals with standard information so they can compare medical plans as they make decisions about which plan to choose.

The SBC mandate is effective for plan/policy years and open enrollment periods beginning September 23, 2012. Starting on that date, health insurers and self-insured group health plans will be required to provide a standard SBC to all individuals the first time they enroll in coverage and updated SBCs prior to each renewal. SBCs can be sent on paper or electronically. Health plans also need to be ready to send SBCs in languages other than English under certain circumstances.

Preparing a SBC can seem like a daunting task, especially since health plans must issue SBC using the specific template laid out in the federal regulations (a four-page, front and back, 12 point font, in color or gray scale with the text and layout explicitly prescribed).

A project to implement SBCs starts with making some key decisions about how a health plan can, and will, meet this requirement. The following is a general flow the activities in a project to implement SBCs:

It is wise to document everything done during this project and evaluate the lessons learned post-go live, because some or all of this process will need to be repeated later. Benefit plans will be modified, and the SBCs will have to be changed. The delivery mechanism may change, either from paper to electronic or new methods may be added later (e.g. creating an App for that), or vendors selected initially may be replaced. If the decisions and details of the first project are well documented then the future projects can be carried out more easily.

For more information on how Dell can provide support in developing and executing a SBC project, please visit us here or email Kenneth_Fody@Dell.com.

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Ask the Expert- April 2012

DELL-Kareem S — Mon, 09 Apr 2012 21:28:13 GMT

By Kareem Saad, Director, Healthcare & Life Sciences Solution Partners and Global Biopharmaceutical Business Group

Q: How will personalized medicine impact the delivery of care to patients?

A: Personalized medicine allows doctors to look beyond the anecdotal evidence of a patient’s history, current symptoms and lab results to look directly at his or her genetic makeup and see specific mutations in the genetic code that may cause a disease or a reaction to a particular medication. Information-driven healthcare is the foundation needed to realize personalized medicine, and together, with the continuous explosion of information and the proliferation of personal health devices that we see today, it opens the door for patients to take control of their health. This will ultimately lead to better care through the use of better information. In order for personalized medicine to reach that point, both patients and healthcare providers must understand what personalized medicine is and how close we are to making it a reality.

In 1990, the United States Department of Energy and National Institutes of Health began what would be a 13-year journey in sequencing the first human genome. Through that project, scientists realized that we could eventually acquire the ability to understand the DNA sequence of any patient at any given time at an affordable cost.

Ten years ago, “affordable” would not be a word many would use to describe the $2.7 billion (in FY 1991 dollars) that the original human genome sequencing project cost. During his fight against pancreatic cancer, Steve Jobs was one of 20 people in the world, at that time, to have all the genes in his cancerous tumor and in his regular DNA sequenced, which cost him $100,000. Thanks to competing companies that specialize in sequencing genetic codes, such as Illumina and Life Technologies, the price of genetic sequencing has dropped to as little as $3,000-5,000, and there are claims of a $1,000 genome in the near future. With genomic sequencing becoming more affordable, it will become accessible to more people which will make it more useful in everyday medical practice.

One of the reasons why personalized medicine is becoming affordable is that scientists have discovered that a small fraction of the total human genetic code (by some accounts approximately two percent of the total 3 billion base pairs —or the equivalent of 60,000 base pairs) needs to be sequenced in order to target the genes that will unveil a wealth of information about an individual’s susceptibility to certain diseases or that will give clues to an individual’s likely reaction to specific drugs or treatment strategies.

Today, personalized medicine is primarily being applied to cancer patients who face complex, heritable forms of cancer that have limited treatment options. Therapeutic treatments, such as chemotherapy and radiation, are used to control tumors and are not equally effective on every patient. In the case of two lung cancer patients who appear to be identical at the clinical level undergoing the same therapeutic treatment, there is a chance that one will respond favorably and one will not survive because they are different on the molecular level with different genetic mutations. By sequencing a patient’s normal and tumor DNA, doctors can match the patient with specific treatments that have been proven to work on tumors and patients with similar genetic markers. Personalized medicine removes much of the guessing factor and can help save money by targeting diseases with specific treatments, as well as improve the quality of life of patients by reducing unnecessary and debilitating side effects of ineffective drugs.

Personalized medicine, however, is not limited just to cancer patients, and understanding genetic sequencing is not just for geneticists or oncologists. Tools are being developed to turn genetic data into easily digestible information that is not only easy to understand for a physician (who may not have had much exposure to genetics since medical school), but also to patients and their families, ultimately enabling them to make more informed decisions for their health and well-being.

We are seeing personalized medicine become more of a reality through the collision of multiple factors:

1. Patients worldwide are leveraging personal health devices, and pairing them with their smartphones and tablets to track and manage their own health information.

2. Some newer peripheral diagnostic devices, such as arm cuffs that can measure blood pressure around the clock and send that data to a secure cloud, are leading to real-time clinical information.

3. Scientists can study a patient’s unique and personal genetic sequence more affordably and faster than ever before.

4. Real-time clinical information, paired with genetic data over a larger population, is being used by the healthcare and life science industry to discover patterns and markers for disease, which will result in powerful information-driven and cost-effective strategies for the way care is delivered to patients.

Patients can receive better care when healthcare providers have access to better information. A patient can monitor and track their blood pressure, pulse, cholesterol and glucose levels, and many other health factors, and store it in a secure cloud. Whether a patient is in for a routine doctor’s visit or in the emergency room following a heart attack, healthcare providers can access their longitudinal health information to make a more precise decision on care. The right information about the patient at the right time is the foundation for better care.

Learn more about how Dell is playing a role in using Personalized Medicine to fight pediatric cancer.

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Healthcare in Abu Dhabi: A Beacon for the Middle East

John Nicholls — Mon, 09 Apr 2012 21:25:25 GMT

By John Nicholls, Director Healthcare Business Development, Middle East

Abu Dhabi has one of the fastest changing healthcare markets in the world today. In just two and half years, the city has initiated the privatization of healthcare, achieved universal health insurance for citizens, streamlined communication between health authorities and providers, and implemented a universal ID system. These are just the initial changes made as the government transitions from healthcare provider to healthcare regulator.

While healthcare in the United Arab Emirates (UAE) compares favorably to the rest of the Middle East, its capital, Abu Dhabi, definitely leads the way. With a life expectancy of 76.5 years, Abu Dhabi fares better than most Gulf Cooperation Council (GCC) countries. It also closely matches health indicators in other developed countries like the U.K., which has a life expectancy of 78. Abu Dhabi has even been named the third most popular medical tourism destination in the region by the World Bank.

A public-private partnership

Abu Dhabi’s impressive performance has been helped by the government’s decision to revamp the healthcare system. Until 2007, all government healthcare facilities had been run by the General Authority for Health Services (GAHS). After moving to a more regulatory role, the Abu Dhabi Health Services Company, SEHA, now manages government healthcare facilities, while the Health Authority – Abu Dhabi (HAAD) regulates health policy.

With the government acting as ombudsman, the healthcare industry has also opened up to the private sector. SEHA chairman Saif Al Qabasi recently told global consultancy company Oxford Business Group (OBG) that healthcare-related government agencies were doing their best to encourage participation from the private sector for construction of new hospitals and clinics.

This public-private partnership has had some early success with SEHA collaborating with major U.S. healthcare providers like Cleveland Clinic and Johns Hopkins. The Susan G. Komen *** Cancer Foundation is also working with the government to spread awareness about *** cancer within the UAE.

In 2011 alone, HAAD issued new licenses to 70 new healthcare facilities and 32 pharmaceutical institutions. The aggressive expansion of the private sector is expected to continue, with 125 other healthcare institutions and 33 pharmaceutical companies awaiting approval for their licenses.

The health insurance industry has also received a boost from the July 2006 legislation that mandates health insurance for all expatriate workers. This segment makes up about 80 percent of Abu Dhabi residents, with their numbers expected to increase in the future.

But while the government encourages the privatization of the health sector, it also continues its investment in health infrastructure through SEHA. Today, SEHA owns 12 hospitals of a total of 33 hospitals and operates 2,644 beds or about 66 percent of total beds in the capital. It has 62 medical centers and employs about 17,500 doctors, nurses, ancillary care and administrative personnel across Abu Dhabi. SEHA has also outlined an impressive growth strategy. Carl Stanifer, the CEO of SEHA told OBG:

Construction has begun on the Mafraq Hospital, which will eventually contain 739 beds and provide 139 outpatient clinics, as well as providing thoracic and orthopedic surgery and burn treatment. SEHA also has a land bank and it is currently our mission to increase the amount of private beds in Abu Dhabi, so there are yet other projects that we will be working on in the future.

As the government continues building Abu Dhabi’s health infrastructure, they are also shifting their focus to policy issues, such as standardizing provider-payer contracts, as well as campaigns aimed at disease prevention and improved safety. For example, with a high incidence of chronic lifestyle-related ailments, such as diabetes and obesity, the Abu Dhabi government has initiated awareness campaigns and screening drives. In 2010, HAAD ran a successful campaign that resulted in a 17.4 percent decrease in road traffic fatalities.

Working through HAAD, the government also monitors their progress in achieving the long-range goals outlined in their report, "Plan Abu Dhabi 2030.” Through this initiative, the government plans to make “significant improvements to the Emirate’s healthcare system, expanding capacity and raising standards across the sector. This includes a number of new healthcare institutions and the development of existing facilities.”

In addition, HAAD’s commitment to providing easy access to health services has resulted in a 100 percent e-claims system and more than 83 percent automation of HAAD processes.

Unfortunately, like the rest of the world, Abu Dhabi faces the dual challenge of budget cuts and rising healthcare costs. While private investments will ease some of the burden, the government is also encouraging healthcare institutions to achieve financial self-sufficiency.

Another challenge is making sure their health infrastructure keeps pace with international standards. Despite recent gains, Abu Dhabi has just 2.6 beds per 1,000 people compared to 3.9 in the U.K. and 8.3 in Germany. Abu Dhabi also faces a shortage of healthcare professionals. Most of the doctors and nurses are non-nationals and can stay for a limited period of time. Stanifer explains that one of the biggest challenges is ensuring a steady pipeline of healthcare professionals.

It’s also ironic that Abu Dhabi, despite being an attractive medical tourist destination sends its citizens abroad for treatment especially in oncology, neurology, orthopedics and cardiology. In 2009, more than 2,000 patients were sent abroad for treatment to various countries including Britain, Germany, India and Thailand. Thailand receives 130,000 patients from the GCC annually. This trend has to be reversed if Abu Dhabi is to remain the leading healthcare provider in the region.

The unique public-private partnership forged by the Abu Dhabi government could be just the tool it needs to sustain the pace of healthcare reform. Besides transforming healthcare in Abu Dhabi, it also has the potential to transform healthcare policy in the Middle East today.

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Bridging the Great Divide to Achieve Meaningful Use Stage 2 – Part 2 of 3

DELL-Paul Ro — Mon, 09 Apr 2012 21:19:47 GMT

By Angela Reed and Paul Rosenbluth

Silos – that is the best term for the way many healthcare organizations currently operate. To tackle the newest Meaningful Use Stage 2 requirements, it could get even worse as providers struggle to achieve the clinical quality measures (CQMs) that are tied to these six domains:

· Patient and Family Engagement

· Care Coordination

· Patient Safety

· Clinical Process/Effectiveness

· Efficient Use of Healthcare Resources

· Population/Public Health

Fortunately, most, if not all, of the CQMs are already in place due to other regulatory reporting requirements promulgated by other organizations, such as The Joint Commission. These CQMs are tied to well-known performance improvement clinical indicators, such as Emergency Department (ED) throughput, stroke, venous thromboembolism, acute myocardial infarction and the surgical care improvement project.

For the purposes of Meaningful Use CQM reporting, the proposed rule suggests that eligible hospitals and critical access hospitals will select 24 of 49 measures and eligible professionals will select 12 of 125 measures, with at least one from each domain. To manage this kind of data on a daily basis, providers are going to need to put more emphasis on clinical decision support and computerized physician order entry (CPOE) systems to support these initiatives. Making them a seamless operating model is going to be crucial to long-term success for providers.

CMS (Centers for Medicare and Medicaid Services) has invited commentary on the proposed CQMs, both in terms of content for all of the measures, as well as reporting options for EPs, and expects to publish only a subset of CQMs that are aligned with other regulatory programs. For all providers, CMS ties the CQMs into successful performance of other objectives. For the objective of using clinical decision support to improve performance on high-priority health conditions, providers must implement five clinical decision support interventions related to five or more CQMs at a relevant point in patient care. Furthermore, with regard to the objective of generating lists of patients by specific conditions, CMS establishes the expectation that providers will use this list in conjunction with the interventions to improve performance on a high-priority issue.

In addition to clinical decision support, an underlying concept of Stage 2 is the meaningful use of technology to support clinical decision making, and as outlined in the CMS health outcome priorities previously listed, to improve safety, efficiency, public health and reduce health disparities. To achieve this global objective, many reporting and structured data requirements not only have elevated thresholds, but also have been moved from the menu to the core set. By way of example, the relevant objectives include, but are not limited to, vital signs, smoking status and demographics. These indicators provide critical insight into clinical decisions and risk factors for individual patients and populations at large.

A related and more complex objective is the requirement to provide patient-specific education resources. The most noticeable change in Stage 2 is the requirement that these resources must be identified by the certified technology, meaning that the technology itself should suggest the education resources. The resources do not have to be stored or generated by the technology. While CMS indicates that the certified technology should use problem list, medication list and lab results for this functionality, it also acknowledges that hospitals may base such education on other information housed within the system.

The public comment period to let your voice be heard on the CMS proposed rule and the ONC proposed rule closes on May 7^th.

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HealthWatch- April 2012

Dr. Jamie Coffin — Mon, 09 Apr 2012 21:14:48 GMT

A monthly digest of the latest news in the healthcare industry

Facilitating Care during Natural Disasters - Happy Spring, and welcome to tornado season! With hurricane season just around the corner, it is comforting to know that public health officials can use electronic interventions to care for large groups of people during natural disasters. A recent report by the Institute of Medicine recommends and offers a framework for using a systems-based approach to distribute resources and deliver care quickly to the most people possible during the aftermath of tornadoes, hurricanes, earthquakes or disease outbreak. Electronic interventions were successfully used in many regions to provide early treatment during the H1N1 outbreak.

Remote Patient Monitoring to Grow Globally - A recent report by GBI Research, reports that the global market for remote patient monitoring devices can be expected to grow from $6.1 billion in 2010 to $8 billion in 2017. Growth is expected due to advancements in wireless and censor technology, increasing global life expectancy and the driving need for remote monitoring devices. The report provides analysis on the competitive landscape and market trends relating to devices, such as remote patient monitoring devices and accessories, micro-electro mechanical systems, non-invasive blood pressure monitors, multi-parameter patient monitoring devices and neonatal and fetal monitors. These devices are expected to help reduce the length of hospital stays, provide continuous monitoring from a patient’s home, improve quality of life and reduce healthcare costs.

Healthcare Professionals Meaningful Use Eligibility Deadline Extended - The Centers for Medicare and Medicaid Services (CMS) has extended the deadline for healthcare professionals to file appeals for Meaningful Use to April 30^th. Providers may submit an appeal to show that they met all the requirements for Meaningful Use and should have received incentive payments for 2011, but did not due to uncontrollable circumstances. More information on the appeals process can be found here.

Roadmap for HIEs - The National eHealth Collaborative released the “Health Information Exchange Roadmap: The Landscape and a Path Forward,” which is intended to help stakeholders build and operate Health Information Exchanges (HIEs). The roadmap offers an in-depth look into the ONC’s efforts to develop standards for local health data initiatives, current initiatives that use national standards to provide health data exchange functionality and services and steps to deploy interoperable electronic health records (EHRs), health IT tools and real-time data sharing through HIEs.

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Ask the Expert

Steven Rich — Mon, 19 Mar 2012 21:21:25 GMT

By Steve Rich, Director, Advanced Solutions Group, Dell Healthcare & Life Sciences

Question: How can the latest data center technologies enable innovation across the healthcare delivery model?

Though virtualization may not be recognized as “the latest” data center technology, I see it as the foundation for enabling innovation in the healthcare arena. We are seeing more and more hospitals and hospital systems around the world taking advantage of the many benefits virtualization offers, including cost savings that allow them to drive innovation in other areas, eliminate the need for downtime during system upgrades and maintenance and improve access to data during disaster recovery.

Virtualization essentially comes down to consolidating data centers. Moving servers to a virtual environment allows multiple operating systems to run on one server, which can help cut down on real estate, power and cooling costs. For example, a hospital may have one data center that hosts 400 servers, each running only one operating system, and thus only use a small fraction of their computing power. If the hospital moves their data to a virtualized environment, so that each machine runs at 100 percent of its computing power, it can now run the 400 operating systems on as few as 60 or 70 servers. That hospital can now invest the money they save by running 330 fewer servers on innovative technology that will improve patient care.

Clinicians and application managers rarely experience downtime in system upgrades when data is hosted in a virtualized environment. “Mission critical” data, or data that hospitals cannot afford to have down for routine maintenance and upgrades, is virtually hosted across multiple servers, allowing more efficient data management and ensuring the data is backed up 24/7. Virtualization helps reduce downtime for scheduled maintenance by enabling flexibility and mobility. In a virtual world, a system that requires maintenance, whether it is hardware or software, can be moved to another physical box to complete the maintenance, while the mission critical data is still available to be used by the hospital.

Hospitals must always be prepared for the unexpected disaster, when mission critical data becomes even more critical. During a disaster, multiple machines work together as a “cluster” to ensure that mission critical data is available for use. Mission critical data that needs to be hosted in a physical environment for maximum efficiency transfers automatically to a virtual environment, and though it may not run at its peak performance in the virtual environment, the data is accessible when it is needed the most.

Moving data to a virtualized environment improves business continuity and data management, reduces costs and provides unlimited access to mission critical data. Virtualization is a key to unlocking innovation in the healthcare delivery model.

Send your “Ask the Expert” question to Ask_Dell@Dell.com.

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Bridging the Great Divide to Achieve Meaningful Use Stage 2 – Part 1 of 3

DELL-Paul Ro — Mon, 19 Mar 2012 21:19:32 GMT

By Angela Reed and Paul Rosenbluth

Meaningful Use has become the regulatory catalyst in healthcare to bridge the strategic gap between information technology (IT) tools and clinical quality outcome improvement efforts. Closing this gap is even more relevant now in order for caregivers to attain the proposed Meaningful Use stage 2 requirements.

Long gone are the days of separating the IT functions from the clinical and quality realms of business. Stage 2 of Meaningful Use not only raises thresholds for specific Stage 1 objectives, but also introduces new objectives which clearly demonstrate the intent of meaningful use. That is why it is more important than ever for clinical, quality and technology initiatives to be seamless, coming together to create a holistic approach to putting the systems and processes in place to address the requirements for expanded interoperability, access to health information by both patients and providers, and health information exchanges through true data transport via a standardized transmission protocol.

There is and will continue to be a significant and increased focus on leveraging technology to promote clinical decision support functionality and reporting on clinical quality measures, both of which contribute to an escalation in the requirement for structured data.

The Centers for Medicare and Medicaid Services (CMS) propose that to successfully demonstrate meaningful use of certified Electronic Health Record (EHR) technology for Stage 2, providers, which includes eligible professionals (EPs), eligible hospitals (EHs) and critical access hospitals (CAHs), must attest, through a secure mechanism in a specified manner, to the following during the EHR reporting period:

· the provider used certified EHR technology and specified the technology was used

· the provider satisfied each of the applicable objectives and associated measures

· the provider successfully reported the clinical quality measures selected by CMS

The CMS-defined outcome priorities to which the specific performance objectives are each individually attached, including the following:

· Improving quality, safety, efficiency, and reducing health disparities

· Engage patients and families in their healthcare

· Ensure adequate privacy and security protections for personal health information

· Improve care coordination

· Improve population and public health

Is your organization prepared to align IT and quality needs? Are your organization’s quality measures to meet these new Meaningful Use requirements integrated into your EHR and CPOE systems? A strategic centralized plan with strong governance is going to be essential in navigating the newest course to Meaningful Use compliance.