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Meaningful Use


Meaningful Use
RamSoft PowerServer 6.0 was certified by an ONC-ATCB in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services as a 2014 Certified Complete Ambulatory EHR.* PowerServer 6.0 is available in RIS/PACS and TelePlus models. PowerServer RIS/PACS is a complete solution for outpatient imaging centers. PowerServer Tele Plus is a complete solution for radiology groups. RamSoft’s Meaningful Use Module includes support and connectivity to NewCrop, Microsoft HealthVault, and MedLinePlus Connect; all for a nominal monthly fee for each eligible radiologist.

Purpose of Meaningful Use
Meaningful Use is designed to:

  • Improve transparency, coordination and patient care between providers
  • Allow radiology providers to communicate electronically with patients and other providers
  • Maintain privacy and security of health information
  • Empower patients by providing them with electronic access to their medical records

Meaningful Use Improves Workflow by Connecting Providers and Patients

  1. Referring provider sends electronic radiology order with patient chart
  2. Radiology provider sends reports with image link to referring provider
  3. Patient is provided with electronic access to report and images

Meaningful Use Experts
RamSoft’s Meaningful Use experts provide outstanding guidance and training on how to achieve Meaningful Use. In 2013 alone, RamSoft helped radiologists receive over $1,000,000 in Meaningful Use incentive payments. *This certification does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments.


Meaningful Use – 2014 Stage I (active for 2015 and beyond)
CORE SET OBJECTIVES

  • Measure : More than 30 percent of all unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE.
  • Exclusion : Any EP who writes fewer than 100 prescriptions during the reporting period
  Excluded for most Radiologists, but available in our software.
  • Measure : The EP has enabled this functionality for the entire EHR reporting period.
  • PowerServer 6.0 : This feature is enabled.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 80 percent of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data.
  • PowerServer 6.0 : Problem list is automatically maintained.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 40 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.
  • Exclusion 1 : Any EP who writes fewer than 100 prescriptions during the EHR reporting period.
  • Exclusion 2 : Any EP who does not have a pharmacy within his/her organization and there are no pharmacies that accept electronic prescriptions within 10 miles of the EP’s practice location at the start of his/her EHR reporting period.
Excluded for most Radiologists, but available in our software.
  • Measure : More than 80 percent of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data.
  • PowerServer 6.0 : Medication list is automatically maintained.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 80 percent of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data.
  • PowerServer 6.0 : Medication allergy list is automatically maintained.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 50 percent of all unique patients seen by the EP have demographics recorded as structured data
  • PowerServer 6.0 : Only Date of Birth and Sex have no default entries but are usually populated in DICOM.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : For more than 50 percent of all unique patients seen by the EP have blood pressure (for patients age 3 and over only) and height and weight (for all ages) recorded as structured data.
  • Exclusion : An EP who believes that all three vital signs of height, weight, and blood pressure have no relevance to their scope of practice is excluded from recording them.
Excluded for most Radiologists, but available in our software.
  • Measure : More than 50 percent of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data.
  • PowerServer 6.0 : A default value is used to ensure smoking status is recorded.
  • Exclusion : Any EP who sees no patients 13 years or older.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : Implement one clinical decision support rule.
  • PowerServer 6.0 : Alerts are configurable based on diagnosis codes.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 50 percent of all unique patients seen by the EP are provided timely online access to their health information.
  • Exclusion : Any EP who neither orders nor creates any of the information listed for inclusion as part of the measure, except for “Patient name” and “Provider’s name and office contact information”.
Excluded for most Radiologists, but available in our software.
  • Measure : Clinical summaries provided to patients for more than 50 percent of all office visits within 3 business days
  • Exclusion : Any EP who has no office visits during the EHR reporting period.
Excluded for most Radiologists, but available in our software.
  • Measure : Conduct or review a security analysis each period.
  • PowerServer 6.0 : PowerServer 6.0 is secure. Client responsible for performing security risk analysis in accordance with HIPAA.
Satisfied by our software with no extra clicks for Radiologists.
MENU SET OBJECTIVES

Radiologists in Stage 1 must select 5 of 9 Menu Set Objectives to attest to. The remaining 4 objectives are disregarded.
* indicates that most radiologists will select this objective

  • Measure : Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submission if the test is successful.
  • Exclusion 1 : An EP who administers no immunizations during the EHR reporting period.
  • Exclusion 2 : If there is no immunization registry that has the capacity to receive the information electronically
Excluded for most Radiologists, but available in our software.
  • Measure : Performed at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful.
  • Exclusion 1 : The EP does not collect any reportable syndromic information on their patients during the EHR reporting period.
  • Exclusion 2 : There is no public health agency that has the capability to receive the information electronically.
  • PowerServer 6.0 : PowerServer 6.0 supports the transmission of syndromic surveillance data.
Excluded for most Radiologists, but available in our software.
  • Measure : The EP has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period.
  • Exclusion : Any EP who writes fewer than 100 prescriptions during the EHR reporting period.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 40 percent of all clinical lab test results ordered by the EP whose results are either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data.
  • Exclusion : The EP orders no lab tests where results are either in a positive/negative affirmation or numeric format during the EHR reporting period.
Excluded for most Radiologists, but available in our software.
  • Measure : Generate at least one report listing patients of the EP with a specific condition.
  • Exclusion : Patient List feature is available.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 20 percent of all patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period.
  • Exclusion : The EP has no patients 65 years old or older or 5 years old or younger with records maintained using certified EHR technology.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 10% of all unique patients seen by the EP are provided patient-specific education resources.
  • PowerServer 6.0 : Educational resources are available.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : The EP performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP.
  • Exclusion : Any EP who was not the recipient of any transitions of care during the EHR reporting period.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals.
  • Exclusion : An EP who does not transfer a patient to another setting or refer a patient to another provider during the EHR reporting period.
Excluded for most Radiologists, but available in our software.

Meaningful Use – 2014 Stage II (active for 2015 and beyond)
CORE SET OBJECTIVES

  • Measure : More than 60 percent of medication, 30 percent of laboratory, and 30 percent of radiology orders created by the EP are recorded using CPOE.
  • Exclusion : Any EP who writes fewer than 100 medication, radiology, or laboratory orders during the EHR reporting period
Excluded for most Radiologists, but available in our software.
  • Measure : More than 50 percent of all permissible prescriptions, or all prescriptions, written by the EP are queried for a drug formulary and transmitted electronically using CEHRT.
  • Exclusion : Any EP who writes fewer than 100 permissible prescriptions during the EHR reporting period.
Excluded for most Radiologists, but available in our software.
  • Measure : More than 80 percent of all unique patients seen by the EP have demographics recorded as structured data.
  • PowerServer 6.0 : Only Date of Birth and Sex have no default entries but are usually populated in DICOM.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 80 percent of all unique patients seen by the EP have blood pressure (for patients age 3 and over only) and/or height and weight (for all ages) recorded as structured data.
  • Exclusion 1 : Any EP who sees no patients 3 years or older is excluded from recording blood pressure.
  • Exclusion 2 : Any EP who believes that all 3 vital signs of height/length, weight, and blood pressure have no relevance to their scope of practice is excluded from recording them.
  • Exclusion 3 : Any EP who believes that height/length and weight are relevant to their scope of practice, but blood pressure is not, is excluded from recording blood pressure.
  • Exclusion 4 : Any EP who believes that blood pressure is relevant to their scope of practice, but height/length and weight are not, is excluded from recording height/length and weight.
Excluded for most Radiologists, but available in our software.
  • Measure : More than 80 percent of all unique patients 13 years old or older seen by the EP have smoking status recorded as structured data.
  • PowerServer 6.0 : A default value is used to ensure smoking status is recorded.
  • Exclusion : Any EP that neither sees nor admits any patients 13 years old or older.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure 1 : Implement five clinical decision support interventions related to four or more clinical quality measures at a relevant point in patient care for the entire EHR reporting period.
  • Measure 2 : The EP has enabled and implemented the functionality for drug-drug and drug-allergy interaction checks for the entire EHR reporting period.
  • PowerServer 6.0 : Includes tools necessary to implement the required clinical decision support interventions.
  • Exclusion : For the second measure, any EP who writes fewer than 100 medication orders during the EHR reporting period.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure 1 : More than 50 percent of all unique patients seen by the EP are provided timely online access to their health information
  • Measure 2 : More than 5 percent of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download, or transmit to a third party their health information.
  • Exclusion : Any EP who: (1) Neither orders nor creates any of the information listed for inclusion as part of both measures, except for “Patient name” and “Provider’s name and office contact information, may exclude both measures. (2) Conducts 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 3Mbps broadband availability may exclude only the second measure.
Excluded for most Radiologists, but available in our software.
  • Measure : Clinical summaries provided to patients or patient-authorized representatives within one business day for more than 50 percent of office visits.
  • Exclusion : Any EP who has no office visits during the EHR reporting period.
Excluded for most Radiologists, but available in our software.
  • Measure : Conduct or review a security analysis each period.
  • PowerServer 6.0 : PowerServer 6.0 is secure. Client responsible for performing security risk analysis in accordance with HIPAA.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 55 percent of all clinical lab tests results ordered by the EP whose results are either in a positive/negative or numerical format are incorporated in Certified EHR Technology as structured data.
  • Exclusion : Any EP who orders no lab tests where results are either in a positive/negative affirmation or numeric format during the EHR reporting period.
Excluded for most Radiologists, but available in our software.
  • Measure : Generate at least one report listing patients with a specific condition.
  • PowerServer 6.0 : Patient List feature is available.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 10 percent of all unique patients who have had 2 or more office visits with the EP within the 24 months before the beginning of the EHR reporting period were sent a reminder, per patient preference when available
  • Exclusion : Any EP who has had no office visits in the 24 months before the EHR reporting period
Excluded for most Radiologists, but available in our software.
  • Measure : More than 10% of all unique patients are provided patient-specific education resources.
  • Exclusion : Any EP who has no office visits during the EHR reporting period.
Excluded for most Radiologists, but available in our software.
  • Measure : The EP who performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP.
  • Exclusion : Any EP who was not the recipient of any transitions of care during the EHR reporting period.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure 1 : The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals.
  • Measure 2 : The EP who transitions or refers their patient to another setting of care or provider of care provides a summary of care record for more than 10 percent of such transitions and referrals.
  • Measure 3 : An EP must satisfy one of the following criteria: (1) Conducts one or more successful electronic exchanges of a summary of care document. (2) Conducts one or more successful tests with the CMS designated test EHR during the EHR reporting period.
  • Exclusion : Any EP who transfers a patient to another setting or refers a patient to another provider less than 100 times during the EHR reporting period is excluded from all three measures.
Excluded for most Radiologists, but available in our software.
  • Measure : Successful ongoing submission of electronic immunization data from CEHRT to an immunization registry or immunization information system for the entire EHR reporting period.
  • Exclusion : An EP who administers no immunizations during the EHR reporting period, where no immunization registry has the capacity to receive the information electronically, or where it is prohibited.
Excluded for most Radiologists, but available in our software.
  • Measure : A secure message was sent using the electronic messaging function of CEHRT by more than 5 percent of unique patients (or their authorized representatives) seen by the EP.
  • Exclusion : Any EP who has no office visits during the EHR reporting period, or any EP who conducts 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 3Mbps broadband availability.
Excluded for most Radiologists, but available in our software.
MENU SET OBJECTIVES

Radiologists in Stage 2 must select 3 of 6 Menu Set Objectives to attest to. The remaining 3 objectives are disregarded.
* indicates that most radiologists will select this objective

  • Measure : Successful ongoing submission of electronic syndromic surveillance data from CEHRT to a public health agency for the entire EHR reporting period.
  • Exclusion : Any EP that meets one or more of the following criteria may be excluded from this objective: (1) the EP is not in a category of providers that collect ambulatory syndromic surveillance information on their patients; (2) the EP operates in a jurisdiction for which no public health agency is capable of receiving electronic syndromic surveillance data in the specific standards required by CEHRT at the start of their EHR reporting period; (3) the EP operates in a jurisdiction where no public health agency provides information timely on capability to receive syndromic surveillance data; or (4) the EP operates in a jurisdiction for which no public health agency that is capable of accepting the specific standards required by CEHRT at the start of their EHR reporting period can enroll additional EPs.
  • PowerServer 6.0 : PowerServer 6.0 supports the transmission of syndromic surveillance data.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : Enter at least one electronic progress note created, edited and signed by an EP for more than 30 percent of unique patients with at least one office visit during the EHR reporting period.
  • Exclusion : Any EP who has no office visits.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 10 percent of all tests whose result is one or more images ordered by the EP are accessible through CEHRT.
  • Exclusion : Any EP who orders less than 100 tests whose result is an image during the EHR reporting period; or any EP who has no access to electronic imaging results at the start of the EHR reporting period.
  • PowerServer 6.0 : Images results of all ordered exams are accessible in system.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : More than 20 percent of all unique patients seen by the EP have a structured data entry for one or more first-degree relatives.
  • Exclusion : Any EP who has no office visits during the EHR reporting period.
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : Successful ongoing submission of cancer case information from CEHRT to a public health central cancer registry for the entire EHR reporting period.
  • Exclusion : Any EP that meets at least 1 of the following criteria may be excluded from this objective: (1) The EP does not diagnose or directly treat cancer; (2) The EP operates in a jurisdiction for which no public health agency is capable of receiving electronic cancer case information in the specific standards required for CEHRT at the beginning of their EHR reporting period; (3) The EP operates in a jurisdiction where no PHA provides information timely on capability to receive electronic cancer case information; or (4) The EP operates in a jurisdiction for which no public health agency that is capable of receiving electronic cancer case information in the specific standards required for CEHRT at the beginning of their EHR reporting period can enroll additional EPs.
  • PowerServer 6.0 : PowerServer 6.0 supports the transmission of cancer case information
Satisfied by our software with no extra clicks for Radiologists.
  • Measure : Successful ongoing submission of specific case information from CEHRT to a specialized registry for the entire EHR reporting period.
  • Exclusion : Any EP that meets at least 1 of the following criteria may be excluded from this objective: (1) The EP does not diagnose or directly treat any disease associated with a specialized registry sponsored by a national specialty society for which the EP is eligible, or the public health agencies in their jurisdiction; (2) The EP operates in a jurisdiction for which no specialized registry sponsored by a public health agency or by a national specialty society for which the EP is eligible is capable of receiving electronic specific case information in the specific standards required by CEHRT at the beginning of their EHR reporting period; (3) The EP operates in a jurisdiction where no public health agency or national specialty society for which the EP is eligible provides information timely on capability to receive information into their specialized registries; or (4) The EP operates in a jurisdiction for which no specialized registry sponsored by a public health agency or by a national specialty society for which the EP is eligible that is capable of receiving electronic specific case information in the specific standards required by CEHRT at the beginning of their EHR reporting period can enroll additional EPs.
  • PowerServer 6.0 : PowerServer 6.0 supports the transmission of specific case information
Satisfied by our software with no extra clicks for Radiologists.

Frequently Asked Questions

Which radiologists are eligible for Meaningful Use?

ELIGIBLE PROFESSIONALS (EPs):

  • Radiologists who read > 10% out-patient studies (not Emergency Room or in-patient)
  • Radiologists who work on-site as well as remotely (teleradiology)
  • Radiologists who read for Medicare and/or Medicaid patients
  • Radiologists who read hospital and non-hospital studies may exclude hospital studies
  • Radiologists must read 50% of their studies using certified EHR technology and only required to meet objectives for those studies

What are the incentive payments?

Medicare Program

2014 was the last year the CMS was offering incentive payments for radiologists starting the Medicare MU Program. Radiologists who started Meaningful Use participation in or before 2014 must continue to meet and attest to the Meaningful Use objectives each year to continue receiving incentive payments during their payment schedule.

Medicare EHR Incentive Payment Schedule
First Year of Participation
2012 2013 2014 2015 and later
2012 $18,000
2013 $12,000 $15,000
2014 $8,000 $12,000 $12,000 $0
2015 $4,000 $8,000 $8,000 $0
2016 $2,000 $4,000 $4,000 $0
Total $44,000 $39,000 $24,000 $0

Medicaid Program

Radiologists must have a minimum Medicaid patient volume of 30% (20% for pediatric radiologists) to participate in the Medicaid MU Program. The incentive payments for the Medicaid program are based on the cost attributed to payment for Certified EHR Technology or support services. A cost of least $25,000 for the first year and $10,000 the following 5 years is required for the maximum incentive payment in the Medicaid MU Program. 2016 is the last year the CMS will be offering incentive payments for radiologists starting the Medicaid MU Program.

The following table outlines the potential incentive payments for radiologists starting the Meaningful Use Program in 2014:

Medicaid EHR Incentive Payment Schedule
First Year of Participation
2012 2013 2014 2015 2016
2012 $21,250
2013 $8,500 $21,250
2014 $8,500 $8,500 $12,000
2015 $8,500 $8,500 $8,500 $12,000
2016 $8,500 $8,500 $8,500 $8,500 $12,000
2017 $8,500 $8,500 $8,500 $8,500 $8,500
2018 $8,500 $8,500 $8,500 $8,500
2019 $8,500 $8,500 $8,500
2020 $8,500 $8,500
2021 $8,500
Total $63,750 $63,750 $63,750 $63,750 $63,750

 

When do radiologists begin Stage 2?

Radiologists utilizing PowerServer 6.0 will enter into Stage 2 at different times, depending on when they started participation in the Meaningful Use program. The table below explains when radiologists utilizing PowerServer 6.0 can expect to move to the various stages in the Meaningful Use program.

1stYear Stage of Meaningful Use
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
2012 1 1 1 2 2 3 3 TBD TBD TBD
2013 1 1 2 2 3 3 TBD TBD TBD
2014 1 1 2 2 3 3 TBD TBD
2015 1 1 2 2 3 3 TBD
2016 1 1 2 2 3 3
2017 1 1 2 2 3

 

What will radiologists’ reporting period be each year?

In 2014, radiologists must select a single, calendar-based quarter. Starting in 2015, radiologists beyond their first year of participation must select the full calendar year for their reporting period for each year of participation.

Are radiologists required to utilize an electronic patient portal?

Not necessarily. CMS has defined Stage 1 and 2 objectives which requires providing patients with the ability to view, download, and transmit certain health information to at least 50% of patients. In addition, CMS requires that in Stage 2 at least 5 percent of patients actually view, download, or transmit their health information. However, many radiologists will attest under the exclusion for this objective since they neither order nor create the health information that must be available for the patients to view/download/transmit. Read imagingBiz’s Q&A with an ACR representative for more information on this topic: Click here!

What are office visits and how do they relate to radiologists?

An office visit is defined by the CMS as follows: Office Visit – Office visits include separate, billable encounters that result from evaluation and management services provided to the patient and include: (1) Concurrent care or transfer of care visits, (2) Consultant visits, or (3) Prolonged Physician Service without Direct (Face-To-Face) Patient Contact (tele-health). A consultant visit occurs when a provider is asked to render an expert opinion/service for a specific condition or problem by a referring provider.
Click here!
Typically, CPT codes within the 99201 – 99397 range are recognized as office visits. The procedure codes that an organization considers office visits is configurable in PowerServer 6.0. Most radiologists do not perform office visits and are therefore excluded from the following objectives:

Stage 1 – Core Objective 12: Clinical Summaries

Stage 2 – Core Objective 8: Clinical Summaries

Core Objective 12: Preventative Care

Core Objective 13: Patient-Specific Education Resources

Core Objective 17: Use Secure Electronic Messaging

What is Direct Messaging?

The “Direct Project” specifies a set of standards, policies and services that enable simple, secure transport of health information between authorized care providers. Since PowerServer 6.0 conforms to these strict requirements, it is able to facilitate the communication of referrals, radiology reports, lab results and other clinical information among providers, eliminating the need to send the information via courier, fax, or HL7 interface.

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