Mental Health Software ONC 2 HIT Certified for Meaningful Use
Vericle, the platform that powers ClinicMind has received 2014 Meaningful Use certification from the Office of the National Coordinator for Health Information Technology (ONC HIT Stage 2). This certification means that Vericle meets the 2014 Edition EHR certification criteria, which support the proposed changes to the Medicare and Medicaid EHR Incentive Programs, including the new and revised objectives and measures for Meaningful Use.
Beginning in 2014, in order to demonstrate Meaningful Use, a medical practice must use software — such as Vericle — that meets the requirements set forth by the 2014 ONC certification guidelines.
Medicare-eligible professionals who do not meet meaningful use requirements by 2015 are subject to payment adjustments to their Medicare reimbursements, starting at 1% per year, increasing annually to 5%.
In addition to avoiding Medicare penalties, practices that leverage an ONC-certified software product like Vericle are better equipped to make well-informed, timely decisions that affect revenue, patient visits and, ultimately, the success of their practice.
Throughout the testing and certification process, users praised the Vericle system — a system they use in their practices every day. One participant described it as “quick, convenient, accurate,” while another characterized it as “intricate, [with] many choices and options than other EHR software.” Other users complimented the system’s extensive features, including “notice alerts, workbench info [and] practice help monitor,” and “menus [that] give indication of the actions that can be completed.”
In Vericle’s System Usability Questionnaire, users showed extreme trust in Vericle for their practices. Survey respondents unanimously agreed with the statements, “I think that I would like to use this system frequently,” “I thought the system was very easy to use” and “I found the various functions in this system were well integrated.” Further, users overwhelmingly agreed with the statements “I would imagine that most people would learn to use this system very quickly” and “I felt very confident using the system.”
Finally, even practices that don’t attest for Meaningful Use can still use all of the system’s tabs to record information as completely as they need to — and communicate with patients securely.
Stage 1 ONC Certification
Stage 1 certification included 24 measures — 14 core (required) measures and 10 menu measures. Out of those 10 menu measures, vendors needed to select 5 to report on, with 1 of those 5 being a health reporting measure. One of the core measures was to report CQMs (Clinical Quality Measures); there were an additional 9 measures (some with multiple parts) for the CQMs.
For each measure, the system needed to determine if the patient was part of the denominator for each measure, and then determine if the practice had met the measure for that patient. For the most part, to be a part of the measure, the system had to look at the age of the patient (both at the beginning of the reporting period and the end for the CQMs) and if the patient had an encounter (appointment with the doctor the report is for) recorded for a date within the reporting period. Some of the CQMs looked at weight, BMI, blood pressure and smoking status to determine if the patient needed to be in the denominator, and they all looked at the diagnoses and procedures recorded for the patient.
Once the patient was determined to be in the denominator, the system then looked at the requirements for meeting the measure, and looked to see if the patient is in the numerator as well. Each measure looked at different things — vitals being entered, smoking status, demographics, etc.
Vericle also integrated with New Crop in order to pull those medications and allergies entered in their system into our system and incorporate them into our reporting.
Stage 2 certification includes 23 measures — 17 core measures and 6 menu measures (vendors had to choose 3). Some of the Stage 1 measures were combined to be one measure in Stage 2, but all parts still need to be completed. There were also updates to the Stage 1 requirements that needed to be added (vitals could be completed by being excluded from all 3, being excluded from height & weight, being excluded from blood pressure, or completing all 3), and each variation needed to be tracked.
In order to qualify for Stage 2 certification, Vericle instituted 40 separate required features. Safety-enhanced design required building of these features, plus the recording of clients testing the features successfully.
Each feature had concrete requirements that had to be met, and test cases that needed to be followed exactly; the 2014 certification requires not only that the system have specific capabilities, but also the ability to upload data, parse it, and load it as editable data. Further, Vericle’s development team converted the former CCR (continuity of care record) to four different types of CCDA (Consolidated-Clinical Document Architecture); this CCDA had to be able to be uploaded, exported, and transmitted/received securely.
The sending of the patient summaries needed to be updated to not only be able to send to the patient, but also a patient representative. An entirely new reconciliation system had to be built in order to pull information from an uploaded file and convert it to data to be added into the system for allergies, medications, and problems (diagnoses). The system also needed to accept uploaded lab reports, pull information from them and create a report from that information.
The Encounters were entirely redone; the tab now displays the date, the status, and the creator of that encounter. All other columns from Stage 1, plus new fields (facility, secondary care teams, referrals, and medication administered during visit) are still required.
Three new tabs were added: Plan of Care, Family History, and Functional/Cognitive Status, with all the required fields and logic to back them up. The Results tab (the one that will accept file uploads) also interacts with the files tab on the patient account to tag image files uploaded to be part of the lab results. Each result can also have a narrative attached to it.
A secure messaging system was created so the doctor can communicate with the patient or the patient representative about questions the patient has or information that the patient needs from the doctor. In addition, Vericle created a new email architecture, to enable direct and secure email to a provider.
New codes needed to be accepted from the Problems and Procedures tabs (SNOMED) and the Lab Results (LOINC) and the descriptions for those needed to pull.
- Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines.
- Generate and transmit permissible prescriptions electronically (eRx).
- Record the following demographics: preferred language, sex, race, ethnicity, date of birth.
- Record and chart changes in the following vital signs: height/length and weight (no age limit); blood pressure (ages 3 and over); calculate and display body mass index (BMI); and plot and display growth charts for patients 0-20 years, including BMI.
- Record smoking status for patients 13 years old or older.
- Use clinical decision support to improve performance on high-priority health conditions.
- Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the eligible provider (EP).
- Provide clinical summaries for patients for each office visit.
- Protect electronic health information created or maintained by the Certified EHR Technology through the implementation of appropriate technical capabilities.
- Incorporate clinical lab-test results into Certified EHR Technology as structured data.
- Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.
- Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care and send these patients the reminders, per patient preference.
- Use clinically relevant information from Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient.
- The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.
- The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide a summary care record for each transition of care or referral.
- Capability to submit electronic data to immunization registries or immunization information systems except where prohibited, and in accordance with applicable law and practice.
- Use secure electronic messaging to communicate with patients on relevant health information.
- Capability to submit electronic syndromic surveillance data to public health agencies except where prohibited, and in accordance with applicable law and practice.
- Record electronic notes in patient records.
- Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through CEHRT.
- Record patient family health history as structured data.
- Capability to identify and report cancer cases to a public health central cancer registry, except where prohibited, and in accordance with applicable law and practice.
- Capability to identify and report specific cases to a specialized registry (other than a cancer registry), except where prohibited, and in accordance with applicable law and practice.