ifsm305 Case Study Stage 3 latest 2015

Question # 00130606 Posted By: spqr Updated on: 11/08/2015 06:59 AM Due on: 12/12/2015
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Case Study, Stage 3: Meeting Meaningful Use Requirements

Before you begin this assignment, be sure you have read the “ 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 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 ofclinical quality measures (CQMs) have changed for all providers. More information can be found athttp://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_MeasuresTable_Posting_CQMs.pdf Furthermore, 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 ofRecommended 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 explain the possiblepayment adjustments the Family Clinic will incur in 2015 if meaningful use is not achieved. 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 aMedicareeligible 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 and include a short summary of the possiblepayment adjustments the Family Clinic will incur in 2015 if meaningful use is not achieved.

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 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 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 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 over

seen, 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 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 Family Clinic using the selected EHR

(minimum of 2 sentences each)

1

Implement drug formulary checks.

The Clinic has enabled this

functionality 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 enablethis 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 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 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:

Criteria

90-100%

Far Above Standards

80-89%

Above Standards

70-79%

Meets Standards

60-69%

Below Standards

< 60%

Well Below Standards

Possible Points

Part I Incentive Program Selection

16-18 Points

Explanation of incentive program selected reflects critical thinking and is convincing. Table of incentives is complete and accurate.

14-15 Points

Explanation of incentive program selected is clear and complete. Table of incentives is complete and accurate.

12-13 Points

Explanation of incentive program selected is provided. Table of incentives is complete.

10-11 Points

Explanation of incentive program and/or the table presented is adequate or may be incomplete.

0-9 Points

No incentive program selected, and Table 1 is not provided or is incomplete.

18

Core Objectives

27-30 Points

Selection of 15 core objectives and measures is appropriate to the case study; explanations provided are convincing and demonstrate understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking.

24-26 Points

Selection of 15 core objectives and measures is appropriate to the case study; explanations provided are clear and demonstrate understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking.

21-23 Points

Selection of 15 core objectives and measures is appropriate to the case study; explanations are provided for each.

18-20 Points

Fewer than 15 core objectives/

measures are presented, or are inadequately explained, or some selected core objectives/ measures are not linked to the case study, and/or may not demonstrate understanding of meaningful use reporting requirements.

0-17 Points

Table 2 not provided or many of the core objectives/

measures are inappropriate or incomplete.

30

Menu Objectives with explanations

9-10 Points

5 menu objectives/ measures are appropriate to the case study; explanations provided are convincing and demonstrate understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking.

8 Points

5 menu objectives/ measures are appropriate to the case study; explanations provided are clear and demonstrate understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking.

7 Points

5 menu objectives/ measures are appropriate to the case study; explanations are provided for each.

6 Points

Fewer than 5 menu objectives/ measures are presented, or are inadequately explained, or some are not linked to the case study, and/or may not demonstrate understanding of meaningful use reporting requirements.

0-5 Points

Table 3 not provided or many of the menu objectives/ measures are inappropriate or incomplete.

10

Clinical Quality Measures

11-12 Points

6 CQMs, one from each domain, are appropriate to the case study; explanations provided are convincing and demonstrate understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking.

9-10 Points

6 CQMs, one from each domain, are appropriate to the case study; explanations provided are clear and demonstrate understanding of course concepts, meaningful use reporting requirements, analysis and critical thinking.

8 Points

6 CQMs, one from each domain, are appropriate to the case study; explanations are provided for each.

7 Points

Fewer than 6 CQMs are presented, or are inadequately explained, or some CQMs are not linked to the case study; and/or may duplicate domains.

0-6 Points

Table 4 not provided or many of the CQMs are inappropriate or incomplete.

12

Table Format

13-15 Points

Information is professionally presented; uses sophisticated writing and correct sentence structure, grammar, and spelling.

11-12 Points

Information is presented well; uses correct sentence structure, and has few grammar, and spelling errors.

10 Points

Information is presented with some grammar and/or spelling errors.

9 Points

Information is not profession-ally presented, and/or contains several grammar and/or spelling errors.

0-8 Points

Information is extremely poorly written; has many grammar and/or spelling errors; and/or does not convey the information adequately.

15

External Research

13-15 Points

Two or more sources, other than the course material, are incorporated and used effectively. Sources used are relevant and timely. References are appropriately incorporated and cited using APA style.

11-12 Points

At least one source other than the course material is incorporated and used effectively. Source(s) used are relevant and timely. References are appropriately incorporated and cited using APA style.

10 Points

At least one source other than the course material is incorporated correctly. Reference is cited using APA style.

9 Points

A source other than the course material may be used, but is not properly incorporated or used; and/or is not effective or appropriate; and/or is not relevant or timely; and/or does not follow APA style for references and citations.

0-8 Points

No external research is incorporated or reference(s) listed is (are) not cited within text.

15

TOTAL Points

100

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