Seeing synergy: Aligning Meaningful Use measures with accreditation standards.
Subject: Medical records (Measurement)
Regulatory compliance (Measurement)
Author: Grantham, Dennis
Pub Date: 11/01/2012
Publication: Name: Behavioral Healthcare Publisher: Vendome Group LLC Audience: Academic; Trade Format: Magazine/Journal Subject: Health; Health care industry; Psychology and mental health Copyright: COPYRIGHT 2012 Vendome Group LLC ISSN: 1931-7093
Issue: Date: Nov-Dec, 2012 Source Volume: 32 Source Issue: 6
Topic: Event Code: 350 Product standards, safety, & recalls; 930 Government regulation
Accession Number: 313161182
Full Text: When compliance officers compared how the actions needed to comply with accreditation standards aligned with the measurement steps required to achieve Meaningful Use of EHRs, they discovered a surprising synergy.

For many providers who otherwise meet eligibility criteria for participation in electronic health record (EHR) incentive programs, there can be a nagging concern that halts steps toward system implementation. They worry that the efforts needed to qualify for EHR Meaningful Use incentive dollars will somehow "cost" more than they are worth in clinical time, effort, or service productivity, or that these measures could conflict with other critical operating standards, such as JCAHO or CARF behavioral health program accreditation requirements, resulting in more, rather than less efficiency.

In a recent webinar, two compliance professionals from provider organizations teamed with Mary Givens, Meaningful Use program manager for webinar sponsor Qualifacts to discuss whether and how the data gathering and patient service processes required to meet accreditation standards might serve to meet Meaningful Use measures as well.

Overall, the two compliance officers--Lance Niles of Sound Community Services (New London, Conn.) and Jennifer Woods of Albertina Kerr (Portland, Ore.) found broad alignment.

Niles, whose organization relies on CARF standards, found that the data required to detail eight of 15 "core" (required) Meaningful Use measures corresponded closely with that required to demonstrate compliance with nine current CARF standards. He also noted that data to meet three of the ten Meaningful Use "menu set" measures (five "menu set" measures must be selected) related closely to that required for three CARF standards (see MU/CARF chart).

To get eligible providers "on board" for EHR implementation, Niles says that "you have to sell them on two ideas: First, that an EHR will improve the care they are already providing and second, that Meaningful Use will not be extra work for them. Aligning the Meaningful Use measures with the accreditation standards gives the eligible professional a clear picture of the goals of each, and may even provide additional tools they were not currently using."

He maintains that by streamlining workflows to include rules, standards and contractual requirements and setting up service documentation to eliminate duplication and discrepancies--both of which can be done with an EHR system, providers can avoid creating "an extra burden of effort."

Woods found that a comparison of MU measures and JCAHO behavioral health care standards showed that eight of the 15 core MU measures aligned closely with 11 Joint Commission standards, while an additional three menu set measures aligned with four Joint Commission standards (see MU/JCAHO chart).

By comparing the Joint Commission standards with the Meaningful Use measures, it is easy to see the inherent alignment. The main goal for any accrediting body is to improve the quality, safety and engage individuals in their own treatment. Meaningful Use measures support and reinforce these same goals, Woods explained.
Meaningful Use Measure           CARF Standard

Core 2: Implement drug-drug     Medication Monitoring and
and drug-allergy interaction    Management (Section 5. E.) 1.
checks

Core 3: Maintain an up-to-date  Screening and Access to
problem list                    Services (Section 2. B.) 14.

Core 4: ePrescribing            Medication Use (Section 2. E.)
                                7.

Core 5: Maintain an Active      Medication Monitoring and
Medication list                 Management (Section 5. E.) 1.

Core 6: Maintain an Active      Medication Monitoring and
Medication Allergy List         Management (Section 5. E.) 1.

                                Strategic Planning (Section 1.
                                C.)

Core 7: Record Demographics     Performance Measurement and
                                Management (Section 1. M.)

                                Performance Improvement
                                (Section 1. N.)

Core 12: Electronic copy of
health information upon
request

Core 13: Clinical Summary       Screening and Access to
after each office visit         Services (Section 2. B.) 14.
                                0.

Menu 5: Access to health        Rights of Persons Served
information (portal)            (Section 1.K.) d.

Menu 7: Medication              Medication Use (Section 2. E.)
reconciliation                  10. a,b,c,d,e.

Menu 8: Summary of Care Record  Program/Service Structure
                                (Section 2.A.) 7.a,b.

Meaningful Use Measure           Joint Commission Standard

Core 2: Implement drug-drug     Medication Management .01.01.01
and drug-allergy interaction    Record of Care, Treatment, and
checks                          Services .02.01.01

Core 3: Maintain an up-to-date  Record of Care, Treatment, and
problem list                    Services .02.01.01--(2)

                                Medication Management
                                .04.01.01(14)

Core 4: ePrescribing            Not Applicable

Core 5: Maintain an Active      National Patient Safety Goal
Medication list                 .03.06.01(1)

Core 6: Maintain an Active      Medication Management
Medication Allergy List         01.01.01(1), .07.01.03

                                Record of Care, Treatment, and
                                Services .02.01.01(2)

Core 7: Record Demographics     Care, Treatment, and Services
                                .02.02.01 (1)

                                Record of Care, Treatment, and
                                Services .01.01.01, 02.01.01

Core 9: Smoking Status          Care, Treatment, and Services
                                .02.03.07--(1)

Core 12: Electronic copy of     Information Management .02.02.03
health information upon         --(2), (3)
request

Core 13: Clinical summary       Record of Care, Treatment, and
after each office visit         Services .01.01.01--(13)

Menu 5: Access to health
information (portal)

Menu 7: Medication              Medication Management .03.01.05--
reconciliation                  National Patient Safety Goal
                                .03.06.01--(1), (3)

Menu 8: Summary of Care Record  Care, Treatment, and Services
                                .06.02.05
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