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Resource Overview
  • Promoting Interoperability
  • Requirements
  • Related Links
  • Measures

Promoting Interoperability (PI) is the Centers for Medicare and Medicaid Services (CMS)’s update of what were formerly the EHR Incentive and Meaningful Use programs. Specifically, what is now called the Medicare and Medicaid Promoting Interoperability Programs was formerly known as the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs for Eligible Hospitals, Critical Access Hospitals (CAHs), and Eligible Professionals (EPs). The Meaningful Use program was introduced as a method for encouraging the use of certified EHRs and standardized interface technologies. As uptake and utilization of EHRs and HIT has become widespread, the focus has expanded to promoting interoperability across EHRs to improve health outcomes and standardize the reporting of clinical data. Additionally, PI also focuses on health information exchange (HIE), information blocking, and patient access to healthcare information. The Medicaid PI requirements are updated annually. Below is an outline of the FY 2020 Medicaid PI requirements and a list of helpful resources.
 

FY 2020 Medicaid Promoting Interoperability Requirements

For FY 2020, there are three main program requirements:

  • EHR Reporting Period

    • The EHR reporting period for Medicaid EPs is a minimum of any continuous 90-day period within CY 2020. For state-specific information on attestation period and deadline, refer to your State Medicaid Agency.

  • eCQM Policies

    • All Medicaid EPs must report on a 90-day eCQM reporting period for any six available eCQMs related to their scope of practice. Additionally, they are required to report on at least one outcome measure. If there are no relevant outcomes measures to the EP, then they must report on at least one other high-priority measure. If no outcome or high priority measures are relevant to the EP, then they must report on any six relevant measures. 

  • 2015 Edition Certified Electronic Health Record Technology (CEHRT) 

    • All Medicaid PI participants must use 2015 Edition CEHRT. The 2015 Edition must be in place by the first day of the EHR reporting period, but did not have to be implemented by January 1, 2020. The EHR product must be certified to the 2015 Edition criteria by the last day of the EHR reporting period and the EP must be using the 2015 Edition functionality for the full EHR reporting period. 

Objectives and Measures for 2020

Objective

Description

Measure

Tips for Health Centers

Protect Patient Health Information

Protect electronic protected health information (ePHI) created or maintained by the certified electronic health record technology (CEHRT) through the implementation of appropriate technical, administrative, and physical safeguards. 

Measure 1: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR  64.308(a)(1),

including addressing the security (including encryption) of data

created or maintained by CEHRT in accordance with requirements

under 45 CFR 164.312(a)(2)(iv) and 45 CFR 164.306(d)(3),

implement security updates as necessary, and correct identified

security deficiencies as part of the provider’s risk management

process

 

Electronic Prescribing

Generate and transmit permissible prescriptions electronically. 

   

Clinical decision support

Implement clinical decision support (CDS) interventions focused on improving performance on high-priority health conditions. 

   

Computerized Provider Order Entry

Use computerized provider order entry (CPOE) for medication,

laboratory, and diagnostic imaging orders directly entered by any

licensed healthcare professional, credentialed medical assistant, or

a medical staff member credentialed to and performing the equivalent duties of a credentialed medical assistant, who can enter orders into the medical record per state, local, and professional guidelines. 

   

Patient electronic access to health information

The eligible professional (EP) provides patients (or patient authorized representative) with timely electronic access to their health information and patient-specific education. 

   

Coordination of Care through Patient Engagement

Use CEHRT to engage with patients or their authorized representatives about the patient’s care.

   

Health Information Exchange

The EP provides a summary of care record when transitioning or referring their patient to another setting of care, receives or

retrieves a summary of care record upon the receipt of a transition or referral or upon the first patient encounter with a new patient, and incorporates summary of care information from other providers into their EHR using the functions of CEHRT.

   

Public Health and Clinical Data Registry Reporting

The EP is in active engagement with a public health agency (PHA)

or clinical data registry (CDR) to submit electronic public health

data in a meaningful way using CEHRT, except where prohibited,

and in accordance with applicable law and practice. 

   

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To review the changes that have taken place from the old Meaningful Use to the 2015-2017 revision, take a look at the following materials.

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To ease the transition to a Modified Stage 2 Meaningful Use, CMS has created a series of Alternate Exclusions for the 2015 and 2016 reporting years to assist providers currently in Stage 1. 

You can also find a series of interactive worksheets and checklists to help guide you through the process of participating and attesting.

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CMS has also compiled a series of documents providing further information on measures or circumstances that eligible providers have expressed particular difficulty with. These include topics related to:

  • Public Health Reporting
  • Broadband Access Exclusions
  • Practicing in Multiple Locations
  • Patient Electronic Access
  • Health Information Exchange

 

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Acknowledgements

This resource collection was compiled by the HITEQ staff with input provided by the HITEQ Advisory Committee and partners who have shared their experiences.

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