MU3 Deadline Extension Doesn’t Mean You Can Wait to Implement Workflow Changes

Why do today what you can put off until tomorrow?

Except when it comes to Meaningful Use stage 3 (MU3) requirements. Despite a Centers for Medicare & Medicaid Services (CMS) extension, healthcare facilities should make plans now to iron out changes to their workflows and promote the interoperability goals prompted by this rule change, says Brian Laskaris, Director of Interoperability and Product Strategy for MEDHOST.

Many facilities have slowed down their efforts to comply with MU3 in 2018, after the Centers for Medicare and Medicaid Services (CMS) released the rule (FY2018 Medicare Hospital Inpatient Prospective Patient System [IPSS] and Long Term Acute Care Hospital [LTCH] Prospective Payment System Final Rule [CMS-1677-F]) last August that hospitals can attest to Stage 3 or Modified Stage 2 in 2018, and pushed the requirement for attesting to MU3 to January 1, 2019.

MU3 Upgrades Means New Workflows and Functionality

After working on MU3 compliance with several hospitals, MEDHOST has first-hand experience in what many facilities will face as they prepare for the rule change, and has several hospital customers ready to attest to Meaningful Use Stage 3 immediately.

“Even though the CMS extension technically allows a facility six to eight months to put off its MU3 project, we’ve continued to urge our customers to proceed right away, get the software in place, and train their staff,” Laskaris says.

“Any stage brings a lot of new workflows and a lot of new functionality—and stage 3 is no exception. You will not only have to rebuild a lot of processes, but also create processes that didn’t exist before within your facility. Based on a hospital’s size, that could take a significant amount of time.”

About Meaningful Use Stage 3

In addition to moving the start of required Meaningful Use Stage 3 to 2019, CMS changed the attestation period for 2018. The Meaningful Use attestation period is now any continuous 90 days, as opposed to a full year of data. Facilities may attest to either MU3 or Modified MU2 this year. Laskaris says that CMS continues to indicate they prefer a full-year reporting period. So we should not count on a 90-day period in 2019.

Meaningful Use Stage 3 has four new measures and modifications to existing measures. Each of the new measures will require a strategy to change workflows involving:

  • Patient Portal Enrollment
  • Patient Registration
  • Capturing Patient Consent
  • Coordination of Care
  • Transitions of Care
  • Secure Messaging of Patients
  • Clinical Reconciliations

While some hospitals have calculated the cost of Meaningful Use compliance as higher than non-compliance penalties to reimbursement, they are missing an opportunity. The main point of compliance is to achieve the underlying aims of improving patient care and facilitating provider communication. MU3 compliance is critical for hospitals to evolve toward delivering high-quality care most efficiently, Laskaris says.

“Stage 3 objectives are designed to promote interoperability,” Laskaris says. “These measures focus on the advanced use of EHR technology and electronic standards, as well as the interoperable exchange of health information between systems. MEDHOST believes implementing MU3 is essential in achieving those goals.”

Putting Patients First

Meaningful Use Stage 3 compliance means some tricky workflows to implement, Laskaris says. Secure messaging of patients is one of those requirements that represents a culture change.

“Many hospitals don’t feel like patient messaging falls into their role in the healthcare delivery process,” he says. “Primary care physicians had to deal with that in stage 2, but the hospitals didn’t. It makes sense that a primary care physician would be reaching out to patients regularly. Especially, sending messages about their clinical progress. But some hospital leaders wonder, ‘Why would a patient want to continue talking to someone from the hospital?’ Finding a valid use case within the hospital for messaging patients is a challenge for many facilities.”

Interoperability, along with issues involving care transitions and care coordination, are other areas of change triggered by MU3 that will take time to address.

“Although Meaningful Use Stage 2 has pushed hospitals to work on their care transitions—electronically sending a patient’s summary of care document to the primary care physician or the receiving facility—most facilities still aren’t that great at it,” Laskaris says.

Care coordination, which now requires attempts to obtain a summary of care document for inbound patients, is another challenge, Laskaris explains. “It’s something the industry is not prepared for—and it may be the most challenging issue we’ve addressed so far with our customers.”

The clock is ticking, Laskaris says.

“We recommend starting an initial attempt at a 90-day reporting period for MU3 by July 1, 2018,” he says. “We can help clients be successful if they take action now. Moreover, We have had numerous customers already meet the requirements to attest for Stage 3, and the secret to their success was giving themselves enough time to prepare, implement, monitor, and improve on the workflows tied to the Stage 3 measures.”

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